Table 1 The CHESS Scale

The CHESS scale: The RAI MDS 2.0 is completed by trained assessors. These make use of all possible sources of information to assess a LTCH resident. CHESS scale scores range from 0 (no health instability) to 5 (very high health instability) based on the following: 

• 1 point each for recent (within 2 weeks) decline in Activities of Daily Living and Cognitive Performance;

• Up to 2 points for the presence of any of the following: insufficient fluid intake, peripheral edema, shortness of breath, vomiting, weight loss, decrease in food eaten;

• 1 point based on the clinical judgement of a physician that a resident has at most 6 months to live.