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Q: I have been checking MDS item P1e, monitoring acute medical condition, only for my Medicare Part A residents. Should I be checking this item for any resident with an acute condition?

Julia's PPS Chat, April 13, 2004

Welcome back to our PPS chat!

How often do you think about your residents' conditions and wonder whether they are acute or chronic? And how do you show this on the MDS?

This question and answer may help you with any indecision you have about this assessment area.

Q: I have been checking MDS item P1e, monitoring acute medical condition, only for my Medicare Part A residents.

Should I be checking this item for any resident with an acute condition?

A: Yes, any resident may need monitoring for an acute condition, not just a Medicare Part A resident.

The definition of this item on p. 3-183 of the revised Resident Assessment Instrument User's Manual states that this monitoring "includes observation by a licensed nurse for ANY acute physical or psychiatric illness."

The manual specifically states that the payer source should not be a factor when checking this item.

Therefore, this item is based solely on the resident's clinical status and not on a payer source. If the resident exhibits any type of acute illness, either physical or psychiatric, and monitoring is required, you should check item P1e.

Hopefully now you'll understand more clearly when to check this item on the MDS.

Our next PPS Chat will talk about more coding dilemmas-specifically coding medications on the MDS.

Until then-