SET EOT BEFORE your COT checkpoint!

I have searched the RAI manual for evidence to the contrary and found none, so PLEASE KEEP THIS IN MIND AS YOU SCHEDULE YOUR EOT’S AND COT’S.  Please set your EOT date on or before your COT checkpoint.

From page 6 in the attached webinar presentation

COT Side Note: Not a change in the RAI Manual

The discontinuation of therapy is not enough to end COT

assessments, some event must happen on or before the

COT date:

1.  An EOT is completed;  or

2.  The resident is discharged;  or

3.  The resident’s Medicare Part A stay ends.

Start of COT observation period after EOT-R

• In cases where the last PPS Assessment was an EOT-R, the end of the first COT observation period is Day 7 after the Resumption of Therapy date (O0450B) on the EOT- R, rather than the ARD. The resumption of therapy date is counted as day 1 when determining Day 7 of the COT observation period. For example:

— If the ARD for an EOT-R is set for day 35 and the resumption date is the equivalent of day 37, then the COT observation period ends on day 43

SNF Presumption- Conditions and care that result in required RUGs

SNF Presumption- Conditions and care that result in required RUGs

Special Care High

Comatose and completely ADL dependent or ADL did not occur

Septicemia

DM and insulin shots all 7 days and insulin order changes on 2 or more days during the look back

Quadriplegia with ADL score >=5 (Bed Mobility, Transfers, Toileting and Eating)

COPD and SOB when lying flat

Fever and pneumonia or vomiting or weight loss or feeding tube

Parenteral/IV feedings

Respiratory Therapy for all 7 days (we do not have this)

Special Care Low

Cerebral palsy, or Multiple sclerosis, or Parkinson’s with ADL score >=5

Respiratory failure and oxygen while a resident

Feeding tube

Two or more stage 2 pressure ulcers with two or more selected skin treatments

One stage 2 pressure ulcer and one venous/arterial ulcer with two or more selected skin treatments

Foot infection, DM foot ulcer or other open lesion of foot with application of dressings to feet

Radiation treatment while a resident (at cancer center)

Dialysis treatment while a resident (at hemodialysis unit)

Clinically Complex

Pneumonia (active diagnosis, still taking antibiotics)

Hemiplegia/hemiparesis with ADL score >=5

Surgical wounds or open lesions with any selected skin treatment (only one needed)

Burns

Chemo, or oxygen or IV medications or transfusion while a resident