1.Which of the following situations is most likely a significant change in status as defined by the OBRA regulations? Mrs. M. is having an adverse reaction to the over-the-counter cold medication sh

1.Which of the following situations is most likely a significant change in status as defined by

the OBRA regulations?

Mrs. M. is having an adverse reaction to the over-the-counter cold medication she started taking

yesterday. The resulting delirium has caused incontinence of urine, mental confusion, and she is not

able to feed herself independently as she was yesterday.

Mrs. P. has had the flu for the past week. She is feeling weak and requires much more assistance with

toileting and personal hygiene than she did before she became ill.

Mr. S. has been exhibiting increasing signs of sadness in the weeks since his wife died, despite taking

antidepressant medication. It is now noted that he has had a significant weight loss.

Mrs. Q has been on hospice for six months for terminal cancer and now has stopped transferring

altogether and is being spoon fed by staff and family all the time.

2. After completing the Quarterly MDS, when must it be transmitted to the national QIES

ASAP system?

Within 7 days

Within 14 days

Within 21 days

Within 31 days

3. While reviewing a resident’s medical record, it is discovered that the resident’s race was

incorrectly coded at A1000 on the most recent comprehensive assessment. What is the

correct course of action?

Complete an SCPA within 14 days of identifying the error

Complete a modification utilizing the section X Correction Request

Complete an SCSA within 14 days of identifying the error

Complete an inactivation utilizing the section X Correction Request.

4. When a significant, uncorrected error has been identified, what qualifies the error as

significant requiring a significant correction of a prior comprehensive or quarterly

assessment?

The resident had two uncorrected errors identified

The resident’s birthdate was coded as January 1, 1936, but the correct birthdate is January 19, 1936

The clinical status was misrepresented and a subsequent assessment with the correct information was

not submitted

The resident was admitted to Hospice after the assessment’s ARD, but before the assessment was

completed

5. The interdisciplinary team is in the process of completing a Quarterly assessment for a

resident.  The ARD was yesterday.  The dietitian reports to the MDS coordinator that she just

realized the resident’s weight on the quarterly three months ago was incorrect. The weight

that was coded and care planned was 102 lbs. and the actual weight was 120 lbs.  What is the

correct course of action now?

Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled

Quarterly that is already in progress when the error was found

Modify the previous Quarterly to correct the weight

Modify the previous Quarterly to correct the weight and follow up with a significant correction to prior

Quarterly within 14 days

Modify the previous Quarterly to correct the weight.  Change the reason for assessment on the current

Quarterly to a significant correction of prior Quarterly

6. A long term resident fell, fractured her femur, had a three-day stay in the hospital, and

returned on a Medicare A stay.  In the initial evaluation of the resident after hospitalization,

the interdisciplinary team noted that the fall with major injury was not coded on the OBRA

Discharge assessment.  What is the correct course of action now?

Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments.  Code

the first one as a combination Significant Correction of Prior Discharge/PPS 5-Day assessment

Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments, and

continue the OBRA schedule where it left off, considering significant change in status, if appropriate

Inactivate the OBRA Discharge assessment and perform a Significant Change in Status Assessment to

capture the fall prior to admission.  Begin the PPS schedule of assessments

Begin the PPS schedule of assessments.  Code the fall that happened prior to hospitalization in J1800

and J1900c on the current assessment

7. When the RNAC was reviewing an Annual assessment prior to attesting to completion in

Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment.  What

is the correct action now?

No action is required.  The RNAC’s signature verifies completion only.  The RNAC has no role in whether

an accurate assessment is transmitted to the national repository.  The RNAC should sign and lock the

assessment

The RNAC must ensure the error is corrected in the seven-day editing period prior to transmitting the

assessment and follow up with a Significant Correction to prior annual within 14 days

The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting.  If this is

done, no Significant Correction to prior comprehensive is required

The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days

with a Significant Change in status assessment

8. Which of the following usually describes when an OBRA Discharge assessment-return

anticipated form is used?

Is admitted to the hospital.

Goes with family home on a leave of absence.

Is discharged to Assisted Living.

Is discharged home.

9. Which of the following describes when an OBRA Discharge assessment is required for a

resident?

The resident leaves the facility for a temporary home visit.

The resident goes out for a temporary therapeutic leave.

The resident goes to the hospital for an observational stay of less than 24 hours when the hospital does

not admit the resident to an inpatient bed.

The resident goes to the hospital for an observational stay of more than 24 hours when the hospital

does not admit the resident to an inpatient bed.

10. For which situation is an OBRA Discharge assessment not required?

Transfer to acute hospital for admission.

Discharge to the assisted living facility on the same campus as the nursing home.

Discharge to another long-term care facility.

Leave of absence to emergency room less than 24 hours.

11. When should a Death in Facility tracking record be completed for a resident in a skilled

nursing facility?

When the resident dies within two hours of being admitted to the hospital

When the resident dies while in the ambulance on the way to the ER from the SNF

When the resident dies 26 hours after being sent to the hospital for observation

When the resident dies one hour after discharge from facility

12. Which of the following does not require a Death in Facility tracking record to be

completed for a resident in a skilled nursing facility?

When the resident discharges to home and dies the next day

When the resident dies 23 hours after being sent to the hospital for observation

When the resident dies after three hours in the emergency room

13. When the resident dies while on a Leave of Absence to home for a holiday visit

Which of the following is true regarding the Entry Tracking Record?

The transmission date must no later than the entry date plus seven days

The completion date must be no later than the entry date plus 14 calendar days

The transmission date must be no later than the completion date plus 14 days

14. The completion date must be no later than the entry date plus seven calendar days

When must an OBRA Discharge assessment be completed?

When the resident left the facility by ambulance and is admitted to acute care

When the resident dies in the ER less than 24 hours from leaving the facility

When the resident leaves the facility for an overnight temporary home visit

When the resident dies during a leave of absence from the facility