No matter what I do to the MDS it does not score as Ultra. What did I do wrong?

Q: We had a rehab patient 5-day/OBRA MDS. By my accounts, he should have scored Ultra RUG RUA. I need advice. Our software is giving me a RVA RUG score when by all other accounts it should be RU (Ultra):

  • ST = 75 minutes and two days
  • OT = 360 minutes and six days
  • PT = 294 minutes and four days
  • Total = 729 minutes or Ultra

This difference was found in accounting of course. I missed this difference when closing the MDS. The error was discovered Nov. 14, 2011. I know how to do a correction; how can I achieve that Ultra? The resident is basically limited assistance in ADLs and his BIMS score was 4 at the time. No extensive nursing, very straight forward. No matter what I do to the MDS it does not score as Ultra. What did I do wrong?

A: This is a situation where you need to consider that you did not do anything wrong, but rather let’s focus on determining the origin of the coding and compliance problem you uncovered. The first step is to review your validation report to see if it agrees with your software or the logic of the situation. If the validation report indicates RUA, then you know you have a software problem. If the validation report also indicates RVA, than you need to look more closely at your assessment window. You did not provide enough details for us to give you a definitive answer. (Would need: Admission date, ARD, therapy days within the window, etc.).

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