Q: I work as a swing bed coordinator and I’m still learning the MDS. I have a patient that will be discharged on the 14th day. I set the 5-day PPS ARD for the 8th day (grace) and the next ARD for the 13th day. Do I need to submit a 14-day PPS since they are going to be discharged on the 14th day?
Also, since I set the ARD for the 8th day my observation period are days 2-8. The initial weight and skin assessments were done on Day 1. Can I still use these for the 5-day PPS?
A: If the patient is being discharged on Day 14, there is no need to complete or transmit the 14-day Medicare assessments, since it would not be effective for payment until Day 15 of the stay. Choosing Day 8 for the ARD date of the 5-day assessment restricts your ability to use the skin assessment completed on Day 1 since the observation period is Day 2-8 and the skin assessment must be completed within that 7 day look-back period.
The weight can be used as the instruction asks for weight within the last 30 days. In the future, you might consider using Day 6 or Day 7 if that allows you to capture enough therapy minutes to eliminate the need to repeat any assessments and also to be able to capture ADLs which may be worse on Day 1.