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Assessment Reference Date

  
  
  

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.

PEPPER Analysis

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Comments

Can you tell me about the signatures on the MDS? It is my understanding that no one should sign the MDS on the ARD, but it should be signed after the ARD but on or before the end date. Is that correct?
Posted @ Thursday, December 20, 2012 7:26 AM by Terry DeCola
Is there an F-Tag or Medicare requirement that residents have their photo taken upon admission to use as an identifier?
Posted @ Tuesday, January 22, 2013 8:26 AM by Rose Brungardt
I selected day 33 as my day ARD, because on the previously set date rehab category RMB was missed. Patient refused to participate. I maintained the same category throughout from the beginning except the above mentioned day. By selecting day 33 I was able to regain the category. Did I make a mistake? My computer program seems to suggest some mistake.
Posted @ Thursday, May 30, 2013 3:58 PM by Patrice
I would love to help you with your question, but I need a little information from you first. 
 
Your question leaves me with a few questions of my own that I will need answers to in order to best advise you. First, did the patient miss three consecutive days of therapy? Second, what were the number of days and number of minutes that you coded in section O? Finally, what is the warning message that you are receiving from your software, and what software are you using? 
 
You could scan and email me a copy of your PPS tracker if that is easier for you. Please be sure to completely block out any and all patient identifying information (name, SSN, etc) before you send it to me. 
 
I’d also be available to live chat with you if you prefer.  
Hope to hear from you soon!
Posted @ Tuesday, June 11, 2013 8:23 AM by Beckie Dow
When someone comes into a facility can you set there whole 100 days of ARD on admit. I understand the RAI states it must be set within the window. does that mean the date for the ARD must be picked in the window or Set in the window?
Posted @ Wednesday, October 23, 2013 11:47 AM by Anon
Great question! 
 
By "setting the ARD within the window" the RAI manual means that the date selected must be one that is valid for that assessment type. Many corporations have a plan to open the 5, 14, and 30 day assessments upon admission to ensure that none of these assessments are missed. 
 
So, you are allowed to open an assessment earlier than the ARD window, but you have to choose an ARD that falls within the prescribed window. 
 
Hope this helps! Please feel free to contact me directly if you have any further questions.
Posted @ Wednesday, October 23, 2013 1:42 PM by Beckie Dow
Hi, resident went out to ER and stayed there overnight for observation. Do i have to do DRA or just continue the last assessment?
Posted @ Tuesday, May 27, 2014 1:11 PM by Robi
Robi, Great question that many are unclear about. If the patient is not admitted to the hospital and is out less than 24 hours then you do not need to do a discharge assessment. You must confirm that the patient was not out more than 24 hours. The PPS skip day rules will apply. Reminder if a patient is out more than 24 hours, the PPS assessment cycle will restart. Also note that the ARD of a scheduled assessment cannot be on a PPS skip day. Once a patient is out over midnight, more than 24 hours and/or admitted to the hospital the PPS assessment cycle will restart. Please let us know if we can assist further. Thank you for blogging with Harmony! -Elisa Bovee 
ebovee@harmony-healthcare.com
Posted @ Tuesday, May 27, 2014 2:18 PM by Elisa Bovee
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