Crosswalk - Discharge

Revision Crosswalk: IRF-PAI 2012 to Proposed IRF-PAI 2014 - Discharge

April 11, 2013

Issue #	Page #	Section	Action to be Performed	Changes to the Application (Proposed IRF-PAI 2014 Item- Discharge)	Reason for the Change
1	2012 Page 3	Discharge Information	Add 44C. Was the patient discharged alive? (0- No; 1- Yes)	44C. Was the patient discharged alive? (0- No; 1- Yes)	Provides clinicians with a skip pattern to promote efficient data collection.
2	2012 Page 3	Discharge Information	Change 44A. to 44D.; add skip pattern; updated response codes.	Patient’s discharge destination/living setting, using codes below: (answer only if 44C = 1; if 44C = 0, skip to item 46)(01 – Home (private home/apt., board/care, assisted living, group home; 02 Short-term General Hospital; 03 Skilled Nursing Facility (SNF); 50 Hospice; 62 Another Inpatient Rehabilitation Facility; 63 Long-Term Care Hospital (LTCH); 64 Medicaid Nursing Facility; 65 Inpatient Psychiatric Facility; 66 Critical Access Hospital; 99 Not Listed)	Provides clinicians with a skip pattern to promote efficient data collection. Response codes updated to reflect current care settings.
3	2012 Page 3	Discharge Information	Change 44 B. to 44E; add skip pattern.	Was patient discharged with Home Health Services? (Code only if item 44C =1 and 44D is 01 – Home)(0 - No; 1 - Yes)	Provides clinicians with a skip pattern to promote efficient data collection.
4	2012 Page 3	Discharge Information	Change the skip pattern on item 45.	45. Discharge to Living With (Code only if item 44C is 1-Yes and 44D is 01 - Home; Code using 1 - Alone; 2 - Family / Relatives; 3 - Friends; 4 - Attendant; 5 - Other)	Provides clinicians with a skip pattern to promote efficient data collection.
5	2012 Page 3	Quality Indicators	Quality Indicator Section: Separated Admission and Discharge into two columns	Quality Indicator Section: Separated Admission and Discharge into two columns	Admission and discharge assessment data are reported separately.
6	2012 Page 3	Quality Indicators	Added item and skip pattern	M0210. Does this patient have one or more unhealed pressure ulcer(s) at Stage 1 or higher on Discharge?	Provides clinicians with a skip pattern to promote efficient data collection.
7	2012 Page 3	Quality Indicators	Added items about Stage 1 pressure ulcers; changed numbering	M0300A1. Enter total number of pressure ulcers currently at Stage 1.	Clinical experts recommended adding Stage 1 pressure ulcer items to allow for more detailed data collection. New numbering is consistent with numbering in other item sets.
8	2012 Page 3	Quality Indicators	Added items about Stage 1 pressure ulcers; changed numbering	M0300A2. Of these Stage 1 pressure ulcers present at discharge, enter number that were: (a) present on admission as a Stage 1 and (b) remained at Stage 1 at discharge.	Clinical experts recommended adding Stage 1 pressure ulcer items to allow for more detailed data collection
9	2012 Page 3	Quality Indicators	Added items about Stage 1 pressure ulcers; changed numbering	M0300A3. Of these Stage 1 pressure ulcers, enter the number that were not present on admission. (i.e. – New stage 1 pressure ulcers that have developed during the IRF stay)	Clinical experts recommended adding Stage 1 pressure ulcer items to allow for more detailed data collection
10	2012 Page 3	Quality Indicators	Changed wording and numbering of item 48A.	M0300B1. Enter Total number of pressure ulcers currently at Stage 2.	Added instructions
11	2012 Page 3	Quality Indicators	Added sub-questions to Stage 2 pressure ulcer items.	M0300B2. Of these Stage 2 pressure ulcers present at discharge, enter the number that were: (a) present on admission, and (b) remained at Stage 2 at discharge.	Updated wording allows for more detailed data collection items
12	2012 Page 3	Quality Indicators	Added sub-questions to Stage 2 pressure ulcer items.	M0300B3. Of these Stage 2 pressure ulcers present at discharge, enter the number that were: (a) present on admission as an unstageable pressure ulcer due to the presence of a non-removable device and (b) when it became stageable, the pressure ulcer was staged as a Stage 2, and (c) it remained at Stage 2 at the time of discharge.	Updated wording allows for more detailed data collection items
13	2012 Page 3	Quality Indicators	Deleted item 49A. Added sub-questions to Stage 2 pressure ulcer items.	M0300B4. Of these Stage 2 pressure ulcers present at discharge, enter the number that were: (a) not present on admission; or (b) were at a lesser stage at admission and worsened to a Stage 2 during the IRF stay	Updated wording allows for more detailed data collection items
14	2012 Page 3	Quality Indicators	Changed wording and numbering of item 48B.	M0300C1. Enter total number of pressure ulcers currently at Stage 3.	Added instructions
15	2012 Page 3	Quality Indicators	Added sub-questions to Stage 3 pressure ulcer items.	M0300C2. Of these Stage 3 pressure ulcers present at discharge, enter the number that were: (a) present on admission, and (b) remained at Stage 3 at discharge.	Updated wording allows for more detailed data collection items
16	2012 Page 3	Quality Indicators	Added sub-questions to Stage 3 pressure ulcer items.	M0300C3. Of these Stage 3 pressure ulcers present at discharge, enter the number that were: (a) present on admission as an unstageable pressure ulcer, and (b) when it became stageable, it was staged as a Stage 3; and (c) it remained at Stage 3 at the time of discharge.	Updated wording allows for more detailed data collection items
17	2012 Page 3	Quality Indicators	Deleted Item 49B. Added sub-questions to Stage 3 pressure ulcer items.	M0300C4. Of these Stage 3 pressure ulcers present at discharge, enter the number that were: (a) not present on admission; or (b) were at a lesser stage at admission and worsened to a Stage 3 during the IRF stay; or (c) were unstageable at admission, initially became stageable at a lesser stage, but then progressed to a Stage 3 by the time of discharge.	Updated wording allows for more detailed data collection items
18	2012 Page 3	Quality Indicators	Changed wording and numbering of item 48C.	M0300D1. Enter total number of pressure ulcers currently at Stage 4.	Added instructions
19	2012 Page 3	Quality Indicators	Added sub-questions to Stage 4 pressure ulcer items.	M0300D2. Of these Stage 4 pressure ulcers present at discharge, enter number that were: (a) present on admission at Stage 4, and (b) remained at Stage 4 at discharge.	Updated wording allows for more detailed data collection items
20	2012 Page 3	Quality Indicators	Added sub-questions to Stage 4 pressure ulcer items.	M0300D3. Of these Stage 4 pressure ulcers present at discharge, enter the number that were: (a) present on admission as an unstageable pressure ulcer, and (b) when it became stageable, it was staged as a Stage 4, and (c) it remained at Stage 4 at the time of discharge.	Updated wording allows for more detailed data collection items
21	2012 Page 3	Quality Indicators	Deleted Item 49C. Added sub-questions to Stage 4 pressure ulcer items.	M0300D4. Of these Stage 4 pressure ulcers present at discharge, enter the number that were: (a) not present on admission; or (b) were at a lesser stage at admission and worsened to a Stage 4 by discharge; or (c) were unstageable on admission, initially became stageable at a lesser stage, and then progressed to a Stage 4 by the time of discharge.	Updated wording allows for more detailed data collection items
22	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300E1. Enter total number of pressure ulcers currently Unstageable due to a Non-removable dressing or device.	Updated wording allows for more detailed data collection items
23	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300E2. Of these Unstageable pressure ulcers due to a non-removable dressing or device present at discharge, enter number that were:(a) present on admission as an unstageable pressure ulcer due to non-removable dressing or device; and (b) remained unstageable due to non-removable dressing or device until discharge.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
24	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300E3. Of these Unstageable pressure ulcers due to non-removable dressing or device present at discharge, enter number that were (a) present on admission as a stageable pressure ulcer; and (b) became unstageable due to non-removable dressing or device during the IRF stay; (c) remained unstageable due to a non-removable dressing or device until discharge.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
25	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300F1. Enter total number of pressure ulcers currently Unstageable due to a Slough and/or Eschar	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
26	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300F2. Of these Unstageable pressure ulcers due to slough and/or eschar present at discharge, enter number that were: (a) present on admission as an unstageable pressure ulcer due to slough and/or eschar; and (b) remained unstageable due to slough and/or eschar until discharge.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
27	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300F3. Of these Unstageable pressure ulcers due to slough or eschar present at discharge, enter number that were: (a) present on admission as a stageable pressure ulcer and became unstageable due to slough and/or eschar during the IRF stay; and (b) remained unstageable due to slough and/or eschar until discharge.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
28	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300G1. Enter total number of unstageable pressure ulcers with Suspected Deep Tissue Injury.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
29	2012 Page 3	Quality Indicators	Added items about unstageable pressure ulcers.	M0300G2. Of these unstageable pressure ulcers with suspected DTI present at discharge, enter number that were:(a) present on admission as an unstageable pressure ulcer due to a suspected deep tissue injury; and (b) remained unstageable due to a suspected DTI until discharge.	Clinical experts recommended adding unstageable pressure ulcer items to allow for more detailed data collection
30	2012 Page 3	Quality Indicators	Changed numbering and format of 50.	M0900A. Healed Pressure Ulcers Indicate the number of pressure ulcers that were: (a) present on Admission; and (b) have completely closed (resurfaced with epithelium) upon Discharge- Stage 1	Renumbered to harmonize with 3.0; reformatted item allows for more streamlined items and more efficient data collection
31	2012 Page 3	Quality Indicators	Changed numbering and format of 50.	M0900B. Healed Pressure Ulcers Indicate the number of pressure ulcers that were: (a) present on Admission; and (b) have completely closed (resurfaced with epithelium) upon Discharge- Stage 2	New numbering is consistent with numbering in other item sets; reformatted item allows for more streamlined items
32	2012 Page 3	Quality Indicators	Deleted 50A.	Deleted 50A.	Reformatted item allows for more streamlined items
33	2012 Page 3	Quality Indicators	Changed numbering and format of 50.	M0900C. Healed Pressure Ulcers Indicate the number of pressure ulcers that were: (a) present on Admission; and (b) have completely closed (resurfaced with epithelium) upon Discharge- Stage 3	New numbering is consistent with numbering in other item sets; reformatted item allows for more streamlined items
34	N/A	Quality Indicators	Changed numbering and format of 50.	M0900D. Healed Pressure Ulcers Indicate the number of pressure ulcers that were: (a) present on Admission; and (b) have completely closed (resurfaced with epithelium) upon Discharge- Stage 4	New numbering is consistent with numbering in other item sets; reformatted item allows for more streamlined items
35	N/A	Quality Indicators	Add influenza vaccination collection items	O0250A. Did the patient receive the influenza vaccine in this facility for this year’s influenza vaccination season?	Influenza Vaccination items added for new quality measure: patient influenza vaccination
36	N/A	Quality Indicators	Add influenza vaccination collection items	O0250B. Date influenza vaccine received	Influenza Vaccination items added for new quality measure: patient influenza vaccination
37	N/A	Quality Indicators	Add influenza vaccination collection items	O0250C. If influenza vaccine not received, state reason:	Influenza Vaccination items added for new quality measure: patient influenza vaccination
38	N/A	Signature of Persons Completing the Assessment	Add signature page	Item Z0400A. Signature of Persons Completing the Assessment	Provides official record of signature of persons completing the assessment; harmonized other item sets.