Laying the Foundation – Care Area Assessments to Care Plans

by | Feb 1, 2025 | CAA & Care Plans

Explore More Posts from MDS Consultants

Because Care Area Assessments (CAAs) are not submitted to CMS, and the Resident Assessment Instrument (RAI) manual offers little guidance on how to complete a CAA when compared to the Minimum Data Set (MDS) instructions, CAAs are a segment of the RAI that is easy to overlook and underutilize. With many other duties and concerns to manage on a daily basis, the Interdisciplinary Team (IDT) may view the CAA process as an inconvenience and tend to skimp on reviewing the components of the triggered CAA. However, when triggered CAAs are worked through, developed, and utilized as a basis for developing a comprehensive care plan, each triggered CAA can be an invaluable component of the RAI. When the IDT utilizes the CAA to support development of a comprehensive care plan, the resident is the beneficiary of a cohesive and effective plan to provide care that supports the resident’s safety, participation in cares, and engagement in activities they find meaningful – and supports staff in monitoring for changes in the resident’s needs.

 

What are CAAs?

Developing a person-centered, holistic, and effective care plan is based on a thorough investigation of the resident’s strengths and needs, as well as the resident’s personal preferences and goals for their care. This process starts with resident interviews and observations recorded in the health record, then coded into the MDS. Once the comprehensive MDS is coded, Care Area Assessments are “triggered” based on individual responses or combinations of responses to items on the MDS. These triggered care areas identify potential or actual problems the resident may experience that may need further investigation by the IDT.

A triggered CAA serves as a flag for the IDT to stop and examine the resident’s particular situation and how their medical conditions, cognitive abilities, functional abilities, and psychosocial needs impact that resident’s care needs. The CAA also prompts the IDT to consider how the resident might benefit from referrals to support health and psychosocial needs and possible rehabilitative interventions. Additionally, the CAA presents the opportunity to incorporate the resident and/or representative’s perception of each triggered area’s impact on the resident.   

The Centers for Medicare and Medicaid (CMS) has developed 20 CAAs to address problems that are common to nursing home residents; these are integrated into the RAI as part of the comprehensive MDS. Every CAA is a rigorous tool that supports the IDT to examine these areas of concern, and is grounded in current clinical standards of practice such as evidence-based or expert-endorsed research and clinical practice guidelines. Each CAA is intended to help the IDT review potential causes, risk factors, and complications that triggered the care area condition, and supports the IDT members to exercise critical thinking skills in developing an effective care plan for that area. 

 

CAA Components

Each CAA consists of three components:

  • Triggering conditions are pieces of information drawn from the MDS, the health record, and resident/representative interviews. The CAA is utilized as a tracking record to identify where specific triggering information is located in the health record as well as resident input.
  • Analysis of findings is a synthesis of the triggers and how they impact or could potentially impact the resident.
  • Care plan considerations are an evaluation of whether the triggered area is a problem or potential problem for the resident, which leads to a determination of whether a care plan should be developed to support the resident. The IDT creates a care plan that incorporates the CAA triggers into the care plan problems. Development of resident-centered care plan goals should be based on the resident’s goals related to the triggers/problems – to improve, maintain/prevent decline, avoid complications and/or support palliative measures. Approaches or Interventions are created to support the care plan goals, based on how the resident prefers care be delivered.

 

Build a Solid Foundation

CAAs provide a MDS-prompted framework to develop a thorough examination of each resident’s unique strengths and needs, as well as what constitutes each resident’s best quality of life based on their own goals and preferences. While CAAs focus on MDS-prompted investigations, there is the possibility that a resident has needs that may not be part of the initial CAA development process. The problems or concerns may not have been addressed on the MDS, or the needs may be unique to the resident; they could also be related to facility policy. In such cases, the same investigative procedure, goal development, and interventions or approaches would need to be implemented based on the resident’s needs, goals, and preferences to create a care plan that fits the resident’s situation.

Through CAA development and careful consideration of any resident needs not addressed on the MDS, the IDT can synthesize findings related to the resident’s medical conditions, cognitive abilities, functional abilities, psychosocial needs, and preferences into a workable, holistic care plan that supports the resident’s safety, participation in care, and engagement in activities they find meaningful. This process also helps the IDT monitor for changes in the resident’s needs and adjust the care and support provided on an individual basis. A great care plan is a solid foundation for guiding staff to support each resident’s highest quality of life.

 

 

More Resources

Explore More Posts from MDS Consultants

Reimbursement Concerns

Maximizing Case Mix with Special Programs: Respiratory Therapy and Restorative Nursing

Case mix is essential in skilled nursing facilities as it impacts both reimbursement and the care provided. Two key programs that significantly impact case mix scores when properly implemented and documented are Respiratory Therapy and Restorative Nursing. Both...

Strategic Admissions: The Path to Optimized Medicaid Reimbursement

Medicaid reimbursement plays a significant role in the financial health of long-term care facilities, particularly those serving a high percentage of Medicaid residents. While it may not be the sole source of revenue, it is an important component that supports the...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

Social Determinants of Health (SDOH) – A Global Initiative Important to Skilled Nursing Providers

The Centers for Medicare & Medicaid Services’ (CMS) Office of Mental Health report CMS Framework for Health Equity 2022 and 2032 states that health equity is defined by the attainment of the highest level of health for all people, where everyone has a fair and...

Read more on Toolbox Essentials

SNF Physician Certifications for Medical Review

One of the requirements of payment is a valid Physicians Certification for Medicare part A services. If SNF certifications and re-certifications are not completed and signed following CMS regulations, then the facility is at risk of losing payment for an entire claim...

Focused Infection Control Surveys and Directed Plan of Correction

It's a dreary Monday morning, and the state surveyors walk into your facility to conduct a Focused Infection Control survey. You and your team have been trying your hardest to comply with infection control procedures throughout the pandemic. At the end of the survey,...

New Advanced Beneficiary Notice

Is your facility using the proper ABN form? The Centers for Medicare & Medicaid Services (CMS) recently updated the Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The new ABN will be mandatory for use on 1/1/2021, but the new form can be...

Covid-19 and Skilled Status

In late June, CMS addressed two issues and posted MDS 3.0 Final Item Sets (V1.17.2).  The two edits were changes to facilitate the calculation of Patient-Driven Payment Model payment codes on OBRA assessments for states that wish to have this calculation performed. ...

Mind Your PHQs

Some skilled nursing facilities (SNFs) are concerned about accurate payment when a resident unexpectedly discharges and the Brief Interview for Mental Status (BIMS) has not yet been completed.However, they should be just as concerned about the PHQ-9. The PHQ-9...

MORE from MDS Experts

Maximizing Case Mix with Special Programs: Respiratory Therapy and Restorative Nursing

Case mix is essential in skilled nursing facilities as it impacts both reimbursement and the care provided. Two key programs that significantly impact case mix scores when properly implemented and documented are Respiratory Therapy and Restorative Nursing. Both...

Strategic Admissions: The Path to Optimized Medicaid Reimbursement

Medicaid reimbursement plays a significant role in the financial health of long-term care facilities, particularly those serving a high percentage of Medicaid residents. While it may not be the sole source of revenue, it is an important component that supports the...

Internet Quality Improvement and Evaluation System (iQIES): A New Age

Just when we thought we had a handle on QIES (Quality Improvement and Evaluation System), the Centers for Medicare & Medicaid Services (CMS) transitioned to the Internet Quality Improvement and Evaluation System (iQIES) in 2023.   Reports and Roles Reports...

A Significant Change in Status Assessment – There are Options

The Resident Assessment Instrument (RAI) system includes a significant change in status assessment (SCSA). What might be forgotten is the State Operation Manual (SOM), Appendix PP, includes information that mirrors the RAI manual at 42 CFR §483.20(b)(2)(ii), F637 -...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...