06/12/2025

MDS Questions of the Month from the Ohio Department of Health

Each month, the Ohio Department of Health releases timely answers to common questions related to Minimum Data Set (MDS) coding. Below are June’s Questions of the Month from the RAI Coordinator.

A0310G1, Interrupted Stay
Question: When the assessment coordinator adjusts the assessment reference date on the 5-day assessment to a day after an interrupted stay, is the look-back period limited to the day the resident returns? Do interviews completed prior to the interrupted stay have to be repeated?
Answer: According to page 3-3 of the RAI 3.0 User’s Manual, the look-back period does not extend into the preadmission period unless stated otherwise in the item instructions. When a resident returns during the interruption window, CMS considers the stay continuous. Therefore, interviews and assessments completed prior to the interrupted stay—if they fall within the look-back period—can be used in the MDS and do not need to be repeated.

A0310H, Medicare Part A PPS Discharge Assessment
Question: If a facility fails to open a 5-day assessment before the end of a Medicare Part A stay, is the PPS Discharge Assessment still required? Will this impact Quality Reporting Program (QRP) thresholds?
Answer: Yes. Even if the 5-day assessment is missed, the PPS Discharge Assessment must still be completed. However, without the 5-day assessment, this constitutes missing data for the Skilled Nursing Facility QRP and may affect completeness thresholds.

A0310A-02, OBRA Quarterly Review Assessment
Question: Can a facility retroactively complete a Quarterly assessment for reimbursement purposes? For example, opening a Quarterly on June 30 with an ARD of May 5, between two existing assessments.
Answer: No. Per page 2-9 of the RAI 3.0 User’s Manual, the ARD must be set within the required timeframe for the type of assessment being completed. A facility cannot “go back in time” to insert an extra Quarterly assessment outside the prescribed window. This would not be a valid or compliant assessment.

If you have an MDS-related question to submit, email Cheryl.Moya@odh.ohio.gov with “Question of the Month” in the subject line.