07/17/2025

You Asked... We Answered...

You Asked: Why did the ADL Decline Quality Measure trigger when the resident was coded as dependent in all four late-loss ADLs on the prior MDS? 

We Answered: At first glance, it may seem that a resident coded as dependent in all four late-loss ADLs on the prior MDS should not trigger the ADL decline quality measure. While this level of dependence does meet one of the exclusion criteria, the timing of the prior assessment is also critical. 

For a prior assessment to be used in the ADL decline calculation, there must be a gap of at least 46 days between the prior MDS and the target MDS. If the gap is 45 days or less, that assessment is excluded, and the system searches for an earlier assessment that meets the timing requirement. If that earlier MDS shows the resident was functioning at a higher level, the measure may trigger, even though the most recent prior assessment showed total dependence.