Recognize, communicate, and act on the change with a closed loop:
Baseline vs current across the relevant systems, and the specific finding that constitutes the change.
The SBAR content and the data provided; who was notified (physician and representative) and when; and the orders received.
The interventions, the monitoring plan, any transfer, and whether the change meets Significant Change criteria (a non-self-limiting change in two or more areas).
MDS-supportive data
A significant, non-self-limiting change triggers a Significant Change in Status Assessment (SCSA) within 14 days (F637); a transfer/return is reflected in MDS Section A entry/discharge items. The record must support the trigger and the dates (F641).
