Failure to Timely Complete and Transmit MDS Assessments
Penalty
Summary
The facility failed to ensure the timely completion and electronic transmission of Minimum Data Set (MDS) Assessments for four residents, as required by federal regulations. Specifically, the facility did not transmit a comprehensive MDS assessment for one resident until 141 days after completion, and an entry tracking MDS assessment for another resident was transmitted 140 days after completion. Additionally, a discharge tracking MDS assessment for a third resident was completed 19 days after the Assessment Reference Date (ARD), and an entry MDS assessment for a fourth resident was completed 27 days after the ARD. These delays were identified through record review and confirmed during an interview with the MDS Nurse, who acknowledged that the assessments were not completed or transmitted within the required 14-day timeframe. The review of the clinical records and interviews revealed that the facility was aware of the regulatory requirements outlined in the Resident Assessment Instrument (RAI) Manual, which mandates that comprehensive assessments be transmitted within 14 days of the care plan completion date and that entry and discharge tracking records be transmitted within 14 days of the event date. Despite this, the facility did not adhere to these timelines for the affected residents, resulting in significant delays in both the completion and transmission of required MDS assessments.