Q: I have a resident who had a quarterly assessment reference date (ARD) of February 8, 2013. She was admitted to the hospital on February 6 and returned on February 8. What would be her ARD for the quarterly assessment?
A: There are choices that the facility can make when these situations occur. The very first question is did the resident return within 30 days, and the second question is whether or not there is a significant change in the resident’s condition. If there is no significant change then you can either proceed with the first assessment if it was almost complete or restart after admission. I’ve enclosed the following information from Chapter 2, page 2-29 of the MDS Manual that supports this situation.
If a resident goes to the hospital (Discharge return anticipated and returns within 30 days) and returns during the assessment period and most of the assessment was completed prior to the hospitalization, then the nursing home may wish to continue with the original assessment, provided the resident does not meet the criteria for a significant change in status assessment.
Examples from the MDS 3.0 User’s Manual:
Resident A has a quarterly assessment with an ARD of March 20. The facility staff finished most of the assessment. The resident is discharged (return anticipated) to the hospital on March 23 and returns on March 25. Review of the information from the discharging hospital reveals that there is not any significant change in status for the resident. Therefore, the facility staff continues with the assessment that was not fully completed before discharge and completes the assessment by April 3 (which is day 14 after the ARD.)
Resident B also has a quarterly assessment with an ARD of March 20.She goes to the hospital on March 20 and returns March 30. While there is no significant change, the facility decides to start a new assessment and sets the ARD for April 2 and completes the assessment.