This regulation requires nursing facilities to conduct a quarterly review assessment of each resident using the CMS-approved Minimum Data Set (MDS) instrument at least once every 92 days between comprehensive assessments. The assessment reference date must fall within 92 days of the prior OBRA assessment, and the MDS must be completed within 14 days of that reference date. While Care Area Assessments are not required with the quarterly MDS, the interdisciplinary team must review and revise the resident's care plan following each assessment. Facilities must also document evidence of resident or representative participation in the assessment process.
View official sourceF638 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.20(c) Quarterly Review Assessment A facility must assess a resident using the quarterly review instrument specified by the State and approved by CMS not less frequently than once every 3 months. INTENT §483.20(c) To assure each resident is assessed using the standardized Quarterly Review assessment tool no less than once every 3 months between comprehensive assessments. DEFINITIONS §483.20(c) “Quarterly Review Assessment” is an OBRA ‘87-required, non-comprehensive assessment that must be completed at least every 92 days following the previous OBRA assessment of any type. It is used to track a resident’s status between comprehensive assessments to ensure critical indicators of gradual change in a resident’s status are monitored. As such, not all Minimum Data Set (MDS) items appear on the Quarterly assessment. GUIDANCE §483.20(c) At least every 92 days, the facility shall review each resident with respect to those MDS items specified in the CMS quarterly assessment (MDS). A Quarterly assessment is considered timely if: • The Assessment Reference Date (ARD) of the Quarterly MDS is within 92 days (ARD of most recent OBRA assessment +92 days) after the ARD of the previous OBRA assessment (Quarterly, Admission, Annual, Significant Change in Status, Significant Correction to Prior Comprehensive or Quarterly assessment) AND • The MDS completion date (Item Z0500B) must be no later than 14 days after the ARD (ARD + 14 calendar days). If the resident has experienced a significant change in status, the next quarterly review is due no later than 3 months after the ARD of the Significant Change in Status Assessment. For information on assessment scheduling for the MDS, see Chapter 2 of the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual. Link to the LTCF RAI User’s Manual: https://www.cms.gov/Medicare/Quality-Initiatives- Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html. NOTE: The Quarterly MDS does not require the completion of Care Area Assessments (CAAs). However, the resident’s care plan must be reviewed and revised by the interdisciplinary team after each assessment as required at §483.21(b)(2)(iii). PROBES §483.20(c) • Does the facility assess residents, using the CMS-specified quarterly review assessment, no less than once every 3 months, between comprehensive assessments? • Is there evidence of resident and/or resident representative participation in the assessment process? Examples include participating in the resident interviews and providing information about preferences or discharge goals.