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Harmony Healthcare Blog

Assessment Reference Date

Posted by Kris Mastrangelo on Fri, Jun 18, 2010

Assessment Reference Date:  The Assessment Reference Date (ARD) is the date that signifies the end of the look back period.  This date is used to base responses to all MDS coding items.   

Ø Intent: To establish a common temporal reference point for all staff participating in the resident's assessment. Although staff members may work on competing a resident's MDS on different days, establishment of the assessment reference date ensures the commonality of the assessment period (i.e., "starting the clock" so that all assessment items refer to the resident's objective performance and health status during the same period of time).

Ø Definition: This date is the last day of MDS observation period. This date refers to a specific endpoint in the MDS assessment process. Almost all MDS items refer to the resident's status over a designated time period, most frequently the seven day period ending on this date. The date sets the designated endpoint of the common observation period, and all MDS items refer back in time from this point. Some cover the 14 days ending on this day, some 30 days ending on this date, and so forth.

Assessment

ARD's

Grace Days

Payment Period

5 day

1-5

6-8

1-14

14 day

11-14

15-19

15-30

30 day

21-29

30-34

31-60

60 day

50-59

60-64

61-90

90 day

80-89

90-94

91-100

 

The 5-Day Assessment:  Harmony clarified setting the Assessment Reference Date for the 5-day assessment.  There was a misconception in calculating therapy minutes for this assessment.  Therapy minutes are coded "for the past 7 days" based upon the ARD.  Therapy treatment minutes do not need to be consecutive in order to be captured in Section P.  For example:

An Assessment Reference Date of day 8 will include all therapy treatment minutes that the patient received on days 2-8, regardless if there was a break in daily treatment.

1

2

3

4

5

6

7

8

 

14-day Assessment:  Day 11 is the earliest ARD that may be selected.  Selecting day 11, includes minutes rendered on days 5-11.  The totals are coded on the MDS

 

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

30 day assessment:

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

60 day Assessment:

1

2

3

4

5

6

7

8

 

 

 

 

 

 

 

 

 

 

 

 

 

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

 

 

 

 

 

 

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

 

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

91

92

93

94

This spreadsheet calculates the 100 days for each beneficiary and highlights the dates available for each assessment along with payment periods.  Harmony recommends printing a calculator for each Medicare beneficiary to assist in planning ARD's and to reduce the risk of setting an Assessment Reference Date that is early or late.  Early or late Assesment Reference Date's result in default payment for the number of days that the stay is not covered with an assessment that has a valid Assessment Reference Date.

 

Early Assessment:  An assessment should be completed according to the designated Medicare assessment schedule.  If an assessment is performed earlier than the schedule indicates (the ARD is not in the defined window), the provider will be paid at the default rate for the number of days the assessment was out of compliance.  For example, a Medicare-required 14 day assessment with an ARD of day 8 (4 days early) would be paid at the default rate for the first 4 days of the payment period that begins on day 15.

Tags: ARD

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