1.Which of the following situations is most likely a significant change in status as defined by
the OBRA regulations?
Mrs. M. is having an adverse reaction to the over-the-counter cold medication she started taking
yesterday. The resulting delirium has caused incontinence of urine, mental confusion, and she is not
able to feed herself independently as she was yesterday.
Mrs. P. has had the flu for the past week. She is feeling weak and requires much more assistance with
toileting and personal hygiene than she did before she became ill.
Mr. S. has been exhibiting increasing signs of sadness in the weeks since his wife died, despite taking
antidepressant medication. It is now noted that he has had a significant weight loss.
Mrs. Q has been on hospice for six months for terminal cancer and now has stopped transferring
altogether and is being spoon fed by staff and family all the time.
2. After completing the Quarterly MDS, when must it be transmitted to the national QIES
Within 7 days
Within 14 days
Within 21 days
Within 31 days
3. While reviewing a resident’s medical record, it is discovered that the resident’s race was
incorrectly coded at A1000 on the most recent comprehensive assessment. What is the
correct course of action?
Complete an SCPA within 14 days of identifying the error
Complete a modification utilizing the section X Correction Request
Complete an SCSA within 14 days of identifying the error
Complete an inactivation utilizing the section X Correction Request.
4. When a significant, uncorrected error has been identified, what qualifies the error as
significant requiring a significant correction of a prior comprehensive or quarterly
The resident had two uncorrected errors identified
The resident’s birthdate was coded as January 1, 1936, but the correct birthdate is January 19, 1936
The clinical status was misrepresented and a subsequent assessment with the correct information was
The resident was admitted to Hospice after the assessment’s ARD, but before the assessment was
5. The interdisciplinary team is in the process of completing a Quarterly assessment for a
resident. The ARD was yesterday. The dietitian reports to the MDS coordinator that she just
realized the resident’s weight on the quarterly three months ago was incorrect. The weight
that was coded and care planned was 102 lbs. and the actual weight was 120 lbs. What is the
correct course of action now?
Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled
Quarterly that is already in progress when the error was found
Modify the previous Quarterly to correct the weight
Modify the previous Quarterly to correct the weight and follow up with a significant correction to prior
Quarterly within 14 days
Modify the previous Quarterly to correct the weight. Change the reason for assessment on the current
Quarterly to a significant correction of prior Quarterly
6. A long term resident fell, fractured her femur, had a three-day stay in the hospital, and
returned on a Medicare A stay. In the initial evaluation of the resident after hospitalization,
the interdisciplinary team noted that the fall with major injury was not coded on the OBRA
Discharge assessment. What is the correct course of action now?
Modify the OBRA Discharge assessment to add the fall. Follow the PPS schedule of assessments. Code
the first one as a combination Significant Correction of Prior Discharge/PPS 5-Day assessment
Modify the OBRA Discharge assessment to add the fall. Follow the PPS schedule of assessments, and
continue the OBRA schedule where it left off, considering significant change in status, if appropriate
Inactivate the OBRA Discharge assessment and perform a Significant Change in Status Assessment to
capture the fall prior to admission. Begin the PPS schedule of assessments
Begin the PPS schedule of assessments. Code the fall that happened prior to hospitalization in J1800
and J1900c on the current assessment
7. When the RNAC was reviewing an Annual assessment prior to attesting to completion in
Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment. What
is the correct action now?
No action is required. The RNAC’s signature verifies completion only. The RNAC has no role in whether
an accurate assessment is transmitted to the national repository. The RNAC should sign and lock the
The RNAC must ensure the error is corrected in the seven-day editing period prior to transmitting the
assessment and follow up with a Significant Correction to prior annual within 14 days
The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting. If this is
done, no Significant Correction to prior comprehensive is required
The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days
with a Significant Change in status assessment
8. Which of the following usually describes when an OBRA Discharge assessment-return
anticipated form is used?
Is admitted to the hospital.
Goes with family home on a leave of absence.
Is discharged to Assisted Living.
Is discharged home.
9. Which of the following describes when an OBRA Discharge assessment is required for a
The resident leaves the facility for a temporary home visit.
The resident goes out for a temporary therapeutic leave.
The resident goes to the hospital for an observational stay of less than 24 hours when the hospital does
not admit the resident to an inpatient bed.
The resident goes to the hospital for an observational stay of more than 24 hours when the hospital
does not admit the resident to an inpatient bed.
10. For which situation is an OBRA Discharge assessment not required?
Transfer to acute hospital for admission.
Discharge to the assisted living facility on the same campus as the nursing home.
Discharge to another long-term care facility.
Leave of absence to emergency room less than 24 hours.
11. When should a Death in Facility tracking record be completed for a resident in a skilled
When the resident dies within two hours of being admitted to the hospital
When the resident dies while in the ambulance on the way to the ER from the SNF
When the resident dies 26 hours after being sent to the hospital for observation
When the resident dies one hour after discharge from facility
12. Which of the following does not require a Death in Facility tracking record to be
completed for a resident in a skilled nursing facility?
When the resident discharges to home and dies the next day
When the resident dies 23 hours after being sent to the hospital for observation
When the resident dies after three hours in the emergency room
13. When the resident dies while on a Leave of Absence to home for a holiday visit
Which of the following is true regarding the Entry Tracking Record?
The transmission date must no later than the entry date plus seven days
The completion date must be no later than the entry date plus 14 calendar days
The transmission date must be no later than the completion date plus 14 days
14. The completion date must be no later than the entry date plus seven calendar days
When must an OBRA Discharge assessment be completed?
When the resident left the facility by ambulance and is admitted to acute care
When the resident dies in the ER less than 24 hours from leaving the facility
When the resident leaves the facility for an overnight temporary home visit
When the resident dies during a leave of absence from the facility