Significant Change in Status Reassessment

The Significant Change in Status Reassessment (SCSA) is a critical component within the framework of the Minimum Data Set (MDS) 3.0 assessments, mandated by the Omnibus Budget Reconciliation Act (OBRA) for use in nursing facilities. This type of reassessment is initiated when a resident experiences a major change in physical, mental, or psychosocial status that is not self-limiting, is likely to be long-lasting, and impacts the resident’s care plan. Understanding the timing, scheduling, and implications of an SCSA is essential for ensuring that the care provided to residents remains person-centered and responsive to their changing needs.

Definition and Purpose:

• Significant Change in Status Reassessment: This is a comprehensive assessment that is performed when a nursing home resident undergoes a significant change in status – either improvement or decline – in one or more areas of health that affects their overall well-being and requires an update to their care plan.

Timing:

• The need for an SCSA is determined by the interdisciplinary team (IDT), including the attending physician, nursing staff, and other relevant healthcare professionals, based on a significant change in the resident's condition.
• There is no fixed schedule for conducting an SCSA; instead, it is conducted as needed, following the identification of a significant change in a resident’s health status that is not anticipated to resolve itself without intervention or that requires a substantial modification to the resident’s care plan.

Scheduling:

• Assessment Reference Date (ARD): Once a significant change has been identified, the facility must set an ARD for the SCSA. The ARD must be within 14 days of the IDT’s determination that a significant change has occurred. This date marks the end of the observation period for the assessment.
• Completion: The SCSA must be completed, and the MDS submitted within 14 days following the ARD. This ensures timely adjustments to the resident’s care plan in response to their changed status.

Key Points:

• Identification of Significant Change: A significant change is identified based on criteria that include major improvements or declines in physical, mental, or psychosocial status. Examples include a significant change in mobility status, a profound alteration in cognitive function, the onset of a new medical condition, or a significant adjustment in psychological or emotional status.
• Impact on Care Planning: The primary purpose of the SCSA is to ensure that the resident’s care plan is promptly updated to reflect their current needs and goals. This may involve introducing new interventions, discontinuing unnecessary treatments, or adjusting goals to align with the resident’s changed status.
• Interdisciplinary Team Involvement: The process of identifying a significant change, conducting the SCSA, and updating the care plan is a collaborative effort that involves input from an interdisciplinary team. This team-based approach ensures a comprehensive evaluation of the resident’s needs and the development of a coordinated plan of care.
• Regulatory Compliance and Quality of Care: Timely and accurate completion of the SCSA is not only a regulatory requirement but also a critical component of quality care delivery in nursing facilities. It ensures that residents receive care that is tailored to their current condition and promotes their well-being.

In summary, the Significant Change in Status Reassessment is a crucial mechanism for adapting the care provided in nursing facilities to the evolving needs of residents. By closely monitoring residents and promptly responding to significant changes in their condition, facilities can ensure that care plans remain relevant, person-centered, and effective in promoting residents’ health and quality of life.