Q0620: Reason Referral to Local Contact Agency (LCA) Not Made

Complete only if Q0610 = 0.

Item Rationale

Health-related Quality of Life

• Understanding the reason that referrals to the LCA were not made can help the care team support the resident to receive care that supports them to achieve their highest practicable level of functioning in the least restrictive setting.

Planning for Care

• Understanding the reason that referrals to the LCA were not made allows for comprehensive care planning by the facility team in conjunction with the resident and their family.

Steps for Assessment

1. If Q0610: Referral = 0, No, indicate the primary reason that the referral has not been made to the LCA.

Coding Instructions for Q0620, Reason Referral to Local Contact Agency (LCA) Not Made

• Code 1, LCA unknown

• Code 2, Referral previously made: if a referral has previously been made to the LCA, which is currently working with the resident and facility staff on an active discharge plan to return to the community.

• Code 3, Referral not wanted: if the resident (or family, significant other, legal guardian, or other legally authorized representative only if resident doesn’t understand or is unable to respond) responded they do not want a referral (Q0500B = 0).

• Code 4, Discharge date 3 or fewer months away: if the resident has an expected discharge date of three (3) months or fewer, has an active discharge plan in progress, and the discharge plan could not be improved upon with a referral to the LCA.

• Code 5, Discharge date more than 3 months away: if the resident has an expected discharge date of more than three (3) months and discharge plan is actively in progress.

Examples

1. Resident S has been in the nursing home for several months following an automobile accident. They plan to return home after their therapy regime ends, which is expected in three to four weeks. In conjunction with Resident S’s Admission assessment, the facility team made a referral to the LCA but the agency is not currently working with the resident. The interdisciplinary team and the resident have developed a safe discharge plan for Resident S that could not be improved upon with a referral to the LCA.

Coding: Q0620 would be coded 4, Discharge date 3 or fewer months away.

Rationale: Resident S’s discharge is expected within three to four weeks, and their discharge plan could not be improved upon with a referral to the LCA.

2. Resident J is unable to communicate verbally due to severe dementia. Their spouse met with the care team, and the spouse and care team agree that long-term nursing home placement on the secure dementia unit is appropriate for Resident J. The spouse declined a referral to the LCA.

Coding: Q0620 would be coded 3, Referral not wanted.

Rationale: Resident J is unable to communicate verbally due to severe dementia. Their spouse declined a referral to the LCA as they and the care team agree that long-term placement on the secure dementia unit is appropriate for Resident J.