CSA CSA Care Planning & Resident Assessment 2 — Questions and Answers
Question 1: What is the primary purpose of a Resident Assessment Protocol (RAP) triggered during the MDS process?
- To bill Medicare for services
- To identify risk areas and guide individualized care planning (Correct answer)
- To document physician orders
- To report quality measures to CMS
Correct answer: To identify risk areas and guide individualized care planning
RAPs (now called Care Area Assessments) flag potential clinical problems and guide the interdisciplinary team in developing targeted, individualized care plans.
Question 2: A 'significant change in status assessment' (SCSA) must be completed when a resident experiences which of the following?
- A minor cold lasting two days
- A major decline or improvement that is not expected to resolve (Correct answer)
- A routine medication change ordered by the physician
- A scheduled quarterly review date
Correct answer: A major decline or improvement that is not expected to resolve
An SCSA is required when a resident shows a major, non-temporary decline or improvement in status that affects multiple areas of functioning.
Question 3: Which document serves as the legal record of a resident's care planning decisions and must be kept current in the clinical record?
- Incident report
- Comprehensive care plan (Correct answer)
- Staffing schedule
- Dietary preference form
Correct answer: Comprehensive care plan
The comprehensive care plan is both the clinical roadmap and a legal document that must be regularly reviewed and updated to reflect the resident's current needs.
Question 4: Which of the following best describes a 'person-centered' approach to care planning in a long-term care facility?
- The administrator approves all care goals before implementation
- Goals and interventions reflect the resident's own preferences, values, and choices (Correct answer)
- Care plans are written by nurses without resident input to save time
- Physicians set all care goals based solely on medical diagnoses
Correct answer: Goals and interventions reflect the resident's own preferences, values, and choices
Person-centered care planning ensures that the resident's own preferences, values, and choices drive the goals and interventions documented in the care plan.
Question 5: Under CMS requirements, who is ultimately responsible for ensuring the MDS is completed accurately and on time in a nursing facility?
- The attending physician
- The state long-term care ombudsman
- The facility administrator (Correct answer)
- The Medicare fiscal intermediary
Correct answer: The facility administrator
The facility administrator bears ultimate accountability for ensuring that MDS assessments are completed accurately, on schedule, and transmitted to CMS.
Question 6: A resident who is cognitively capable must be offered the opportunity to participate in their own care plan conference. Under OBRA 87, what happens if the resident declines participation?
- The conference is cancelled until the resident agrees
- The facility may proceed without the resident and document the declination (Correct answer)
- The ombudsman must attend in the resident's place
- The physician must make all care decisions unilaterally
Correct answer: The facility may proceed without the resident and document the declination
If a capable resident declines to attend their care conference, the facility proceeds with the meeting and documents that the resident was offered the opportunity but chose not to participate.
CSA CSA Care Planning & Resident Assessment 2
What is the primary purpose of a Resident Assessment Protocol (RAP) triggered during the MDS process?