Q: Do all residents discharged from Medicare A have a Significant Change in Status Assessment (SCSA) done at that time? If so, where is it in the RAI manual?
A: The RAI User’s Manual defines a Significant Change in Status Assessment as: “A comprehensive assessment required when there is a decline or improvement in a resident’s status that (1) will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions, (2) impacts more than one area of the patient’s health status, and (3) requires interdisciplinary review and/or revisions of the care plan.” If these conditions exist with residents, regardless of payer, a significant change MDS is required. The RAI User’s Manual does not instruct the facility to conduct a SCSA for a change in payment status. OBRA assessments combined with PPS assessments should reflect the medical status of the resident as well as the payer type.