Understanding and Coding MDS 3.0 Item A1700: "Type of Entry"

Understanding and Coding MDS 3.0 Item A1700: "Type of Entry"

Introduction

Purpose:

MDS 3.0 Item A1700, "Type of Entry," is crucial for classifying the nature of a resident's entry into a long-term care facility. Accurate documentation of the type of entry ensures that the resident's admission or reentry is correctly categorized, which is essential for compliance with regulatory standards and for coordinating appropriate care. This item helps differentiate between various types of admissions, each of which may trigger different assessment and care planning requirements.

What is MDS Item A1700?

Explanation:

MDS Item A1700 captures the specific type of entry when a resident is admitted or reenters a long-term care facility. This item distinguishes between a new admission, a reentry after discharge, and other types of entries, ensuring that the resident's situation is correctly understood and documented. The classification helps guide the timing and type of assessments required and supports the facility in meeting regulatory obligations.

The different types of entry include:

1. Admission (Code 1): The resident is entering the facility for the first time.
2. Reentry (Code 2): The resident is returning to the facility after a temporary discharge to a hospital, another facility, or home.
3. Other (Code 3): Used for entries that do not fit into the categories of "Admission" or "Reentry," such as short-term stays for respite care or hospice.

Guidelines for Coding A1700

Coding Instructions:

1. Determine the Type of Entry:

   • Admission (Code 1): Select this code if the resident is being admitted to the facility for the first time.
   • Reentry (Code 2): Select this code if the resident is returning to the facility after a discharge.
   • Other (Code 3): Select this code for any other type of entry that doesn’t fit the first two categories.

2. Response Coding:

   • Enter 1 for Admission.
   • Enter 2 for Reentry.
   • Enter 3 for Other.

3. Documentation: Ensure that the type of entry is documented clearly in the resident's record, with supporting information that justifies the selected code. For example, if the entry is a reentry, documentation should include details about the previous discharge and the reason for the return.

Example Scenario:

Mr. Smith, who was discharged from the facility to the hospital after a fall, is now returning to the same facility after his hospital stay. For MDS Item A1700, this would be coded as 2 (Reentry).

Best Practices for Accurate Coding

Documentation:

• Maintain clear and consistent documentation that supports the type of entry selected. Include details such as the reason for reentry or the circumstances surrounding an initial admission.

Communication:

• Ensure that there is effective communication between the admissions team, nursing staff, and MDS coordinators to accurately classify the type of entry. This helps align assessments and care planning with the resident's specific circumstances.

Training:

• Train staff on the importance of accurately categorizing and documenting the type of entry. Emphasize how different entry types impact the timing and nature of assessments and care planning requirements.

Conclusion

Summary:

Accurately coding MDS Item A1700 is essential for correctly categorizing the type of resident entry, whether it is an admission, reentry, or other. Proper documentation and communication ensure that the resident’s entry type is accurately recorded, supporting effective care planning and compliance with regulatory requirements.

Click here to see a detailed Step-by-Step on how to complete this item set.

Reference

This information is based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Page 2-9.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item A1700: "Type of Entry" was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0. The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding. Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.