CMS Manual System - Louisiana Department of Health and Hospitals

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F273
§483.20(b)(2)
§483.20(b)(2) When required, a facility must conduct a comprehensive assessment of
a resident as follows:
(i) Within 14 calendar days after admission, excluding readmissions in which
there is no significant change in the resident’s physical or mental condition. (For
purposes of this section, ―readmission‖ means a return to the facility following a
temporary absence for hospitalization for therapeutic leave.)
Intent §483.20(b)(2)
To assess residents in a timely manner.
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F274
(Rev. 66, Issued: 10-01-10, Effective: 10-01-10 Implementation: 10-01-10)
§483.20(b)(2)(ii)
(ii) Within 14 days after the facility determines, or should have determined, that
there has been a significant change in the resident’s physical or mental
condition. (For purpose of this section, a ―significant change‖ means a major
decline or improvement in the resident’s status that will not normally resolve
itself without further intervention by staff or by implementing standard diseaserelated
clinical interventions, that has an impact on more than one area of the
resident’s health status, and requires interdisciplinary review or revision of the
care plan, or both.)
§483.20(b)(2)(ii) Guidelines
The following are the criteria for significant changes:
A significant change reassessment is generally indicated when a resident elects, and
revokes, the hospice benefit, and if decline or improvement is consistently noted in 2 or
more areas of decline or 2 or more areas of improvement:
Decline:
Any decline in activities of daily living (ADL) assistance where a resident is
newly coded as 3, 4 or 8 Extensive Assistance, Total Dependence, activity did
not occur (note that even if coding in both columns 1 and 2 of an ADL
category changes, this is considered 1 ADL change);