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Answered by: Jennifer Gross, Senior Healthcare Specialist, PointRight Inc.
Posted: November 11, 2016

Q. I thought the PPS End of Stay assessment was only required for planned discharges. Why does my EHR made me code A0310H for an unplanned discharge to the hospital?

A. The original training materials from CMS did state that the PPS End of Stay assessment was only for planned discharges. However, there has been a clarification that this assessment is required any time a Part A stay ends, including discharges to the hospital. You would complete the discharge MDS, code A0310H=1, but in this situation there is a skip pattern so that you would not complete Section GG.

Q: I’m concerned about the SNF QRP measure for the admission and discharge functional assessment. What if the resident doesn’t meet the discharge goal I set on the 5 day? Will that hurt my QM rating?

A: The SNF QRP measure, “Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan that Addresses Function,” is only measuring the percent of the time your facility is completing the Section GG admission assessment, discharge goals, and discharge assessment. CMS is not currently rating facilities on whether or not the goals are met. The best way to ensure that you have a good QM rating is to make sure that Section GG is complete, with no dashes in the admission and discharge functional assessments, and at least one discharge goal set.

Q: How can my facility complete the Section GG admission functional assessment within the first three days of the Part A stay? Our therapy department isn’t always available to evaluate the resident right away on admission.

A: Remember that Section GG is looking at the resident’s “usual performance” during the three-day assessment period. This means that all disciplines should be contributing to this assessment since that will give the full picture of the resident’s baseline performance before therapeutic intervention. This means that only the therapists’ evaluation is not sufficient, and your nursing and CNA staff should be familiar with the new functional assessment so that they can also have input.

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