The ARD is defined as the specific end point of look-back periods in the MDS assessment process.  It allows for those who complete the MDS to refer to the same period of time when reporting the condition of the resident.  For SNF PPS assessments, this date also determines payment.  Chapter 6, Section 6.8, of the RAI manual speaks specifically to early, late, and missed assessments.  It states that the ARD must be “established” or “set” within well-defined windows of time.  Backdating the ARD because you forgot to set it in the defined window is not allowed.  In order to prove that you are not backdating assessments, CMS has commented that the MDS is the only acceptable documentation form for establishing or setting the ARD.  Please read the Establishment of ARD from the Federal Register.  This means that your facility needs to set the ARD by opening the assessment in the computer and entering the ARD date in A2300 during the defined window of time.  The facility still has 14 days from the ARD to then complete the assessment and have all signatures in place.  If you have any questions, please contact Joan Brundick, State RAI Coordinator, at joan.brundick@health.mo.gov.