Assessment Reference Date:
Detailed Discussion of Impact on Rehabilitation Plus Categories: Harmony identified instances when use of an Assessment Reference Date of day 7 or 8 (to capture Rehab) impacted the ADL score and subsequently the RUG category. Specific strategies to improve selection of the appropriate Assessment Reference date as close to time of admit were discussed at exit. The MDS Coordinator should review pre-admission IV data and ADL flow sheet shortly after admission to determine the best date to capture ADL's. These efforts need to be coordinated with Rehabilitation and documented on the ADL flow sheet. We recommend Rehab using a computer generated tracker for easy tracking of extensive services. The Business Office can print a tracking sheet on admission for both the MDS Coordinator and Rehabilitation services. Another recommendation is Communicating the last Assessment Reference Date to rehab as soon as identified by the MDS Coordinator verses waiting until the weekly Medicare meeting. Harmony will continue to focus audits in this area as both the MDS Coordinator and Rehabilitation learn this new skill.