Step-by-Step Coding Guide for Item Set A0310G1: Interrupted Stay

This guide is designed to assist in accurately coding and documenting the Interrupted Stay in the MDS 3.0, specifically within item A0310G1.

1. Review of Medical Records

• Objective: Determine if the resident had an interrupted stay.
• Key Points:
  • Review the resident's admission, discharge, and re-entry dates to identify any short-term leaves from the facility that qualify as an interrupted stay.
  • Examine hospital transfer documentation, temporary leave records, and readmission paperwork.

2. Understanding Definitions

• Objective: Clarify what constitutes an "Interrupted Stay."
• Key Points:
  • Interrupted Stay: A situation where a resident is discharged from the facility for a hospital stay or other reason and then readmitted within a short, predefined period, typically within 3 days. This concept is relevant for certain CMS payment policies and MDS scheduling.

3. Coding Instructions

• Objective: Guide on how to accurately code for an interrupted stay.
• Key Points:
  • Code "1" if the resident had an interrupted stay, meaning they returned to the facility within the allowed timeframe after discharge.
  • Code "0" if the stay was not interrupted, meaning the resident either did not return within the allowed timeframe or did not leave the facility.

4. Coding Tips

• Verify the exact number of days the resident was out of the facility to ensure it meets the criteria for an interrupted stay.
• Consult the latest CMS guidelines for any updates on the definition or timeframe of an interrupted stay, as policies may change.

5. Documentation

• Objective: Maintain thorough documentation regarding the interrupted stay.
• Key Points:
  • Document the dates and reasons for the resident's departure and return to the facility in the resident's medical record.
  • Keep copies of any transfer or discharge documentation that supports the interrupted stay, including hospital admission and discharge summaries if applicable.

6. Common Errors to Avoid

• Incorrectly coding a stay as interrupted without verifying the timeframe between discharge and readmission.
• Failing to document the return date accurately, leading to incorrect coding of the interrupted stay.

7. Practical Application

• Scenario: Mr. John Doe, a resident of Green Valley Nursing Facility, was transferred to a hospital due to acute respiratory issues on April 1st. He was discharged from the hospital and readmitted to the facility on April 3rd. The MDS Coordinator reviews the hospital discharge summary and facility readmission documentation, verifying that Mr. Doe's absence and return fall within the 3-day window for an interrupted stay. Accordingly, the coordinator codes "1" for A0310G1, indicating an interrupted stay, and documents all relevant dates and details in Mr. Doe's medical record.

The Step-by-Step Coding Guide for item A0310G1 in MDS 3.0 Section A is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Healthcare guidelines, policies, and regulations can undergo frequent updates. Therefore, healthcare professionals must ensure they are referencing the most current version of the MDS 3.0 manual. This guide aims to assist with understanding and applying the coding procedures as outlined in the referenced manual version. However, in cases where there are updates or changes to the manual after the mentioned date, users should refer to the latest version of the manual for the most accurate and up-to-date information. The guide should not substitute for professional judgment and the consultation of the latest regulatory guidelines in the healthcare field.