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I'm still confused about when I need to complete the Resident Assessment Protocols (RAPs).

Julia's PPS Chat, February 4, 2004

Welcome back to our PPS chat!

How often have you thought you knew a concept so well, and then all of a sudden, someone asks you a question and you can't even remember your name? Well, it happens to us all. Maybe this question and answer will help you with any confusion you have about completing Resident Assessment Protocols.

Q: I'm still confused about when I need to complete the Resident Assessment Protocols (RAPs). My consultant is telling me that I only need to do RAPs with non-PPS assessments, but shouldn't they be completed with either the five-day or 14-day assessment even though these are both PPS assessments?

A: Apparently others share in your confusion because CMS clarified this in the revised Resident Assessment Instrument User's Manual.

Page 4-1 of the manual states that "RAPs are not required for Medicare assessments. RAPs are ONLY required for comprehensive clinical assessments. However, when a Medicare assessment is combined with a comprehensive clinical assessment, the RAPs must be completed in order to meet the requirements of the comprehensive clinical assessment."

So you are correct in that, depending on which assessment you designate as your admission assessment-the five-day or the 14-day-you do need to complete RAPs with that assessment.

If neither the five-day nor the 14-day is the admission assessment, you don't need to complete RAPs. This situation could occur if a resident was in your facility prior to a Medicare Part A stay and you had already completed the admission assessment with RAPs.

However, if the resident experienced a significant change upon readmission, you would have to complete this assessment by the 14th day and you could combine it with either the five-day or 14-day assessment. Remember that a significant change assessment also has the RAP requirement.

To review, the assessments that require completion of RAPs are the admission, annual, significant change in status assessment, and the significant correction of prior full assessment. If you combine any of your PPS-required assessments with one of these comprehensive assessments, you should complete the RAPs.

PPS assessments that are not combined with comprehensive assessments do not have the RAP requirement.

Hopefully, now when someone asks you when RAPs need to be completed, you'll know either the answer or where to find it.

Our next PPS chat will talk about preadmission screenings for Medicare residents.

Until then-