Nancy, There are different quidelines for coding Self-performance for bathing. Look on pages 3-101 and 3-102 of the manual. CMS understands that most residents will only receive a full body bath/shower once or twice a week. The instructions are to code the maximum amount of assistance that the resident received during the observation window even if it occurred only once. If you look at the last example on page 102 it shows a resident who required light quidance one day and total assistance another. You code the total for that resident. Rationale The coding directions for bathing state, "code for the most dependent inself performance and support."
-----Original Message----- From: Nancy Deonarine <[EMAIL PROTECTED]> Sent: Oct 29, 2003 9:06 AM To: [EMAIL PROTECTED] Subject: RE: section G issue For a skilled therapy this may help, but my major issue would be in bathing. We give full body bath/shower twice weekly, so it would have only occurred 2 out of last 7 days, so if it was a 4/2, why would I code it 0/2 on the mds? If it was a 4/2 "every time" it occurred? It doesn't make sense. Nancy Nancy Deonarine RN MDS Coordinator Barclay Friends West Chester, Pa 19380 Confidentiality Notice: This message may contain Protected Health Information (PHI) or other information which may be confidential or legally priveleged. If you are not the intended recipient, you may not use, copy, disseminate or disclose this communication or its contents to anyone. If you have received this message in error, please advise the sender by reply and delete the message. Thank You. >>> "Gola, Tammy" <[EMAIL PROTECTED]> 10/29/03 11:34AM >>> How would you code this in your thinking. I think this chart is more for the scenario where you are not using 8/8's say 8 out of say 10 times, with 2 episodes of 3/2's. Is this a longterm patient or one on skilled therapy? If on skilled therapy does any of their documentation help you out. Sometimes I only have 2 occurrences of 3/2 on my NA flowsheet, but therapy has extensive assist of 1 documented during the observation period, and I use that as my third occurrence for coding the MDS. Tammy Gola BSN, RN, CRNAC Wilkes-Barre General Hospital Transitional Care Unit 575 North River Street Wilkes-Barre, PA. 187641-0001 570-552-5417 [EMAIL PROTECTED] -----Original Message----- From: Nancy Deonarine [mailto:[EMAIL PROTECTED] Sent: Wednesday, October 29, 2003 10:33 AM To: [EMAIL PROTECTED] Subject: RE: section G issue Tammy, It's the ADL self-performance chart on page 3-90. When my corporate compliance people were in my "fishbowl" this last time , they told me that I was coding incorrectly according to the new manual. But it doen't seem right to me. How is everyone else coding this situation? Nancy Nancy Deonarine RN MDS Coordinator Barclay Friends West Chester, Pa 19380 Confidentiality Notice: This message may contain Protected Health Information (PHI) or other information which may be confidential or legally priveleged. If you are not the intended recipient, you may not use, copy, disseminate or disclose this communication or its contents to anyone. If you have received this message in error, please advise the sender by reply and delete the message. Thank You. >>> "Gola, Tammy" <[EMAIL PROTECTED]> 10/29/03 09:35AM >>> Can you direct me to the page that you are referring to that it tells you to code 0/2, I am coding I think the same way you are, if you have all 8/8's and 2 episodes of 3/2, I would code 3/2. So, I must be coding incorrectly also, Tammy Gola BSN, RN, CRNAC Wilkes-Barre General Hospital Transitional Care Unit 575 North River Street Wilkes-Barre, PA. 187641-0001 570-552-5417 [EMAIL PROTECTED] -----Original Message----- From: Nancy Deonarine [mailto:[EMAIL PROTECTED] Sent: Tuesday, October 28, 2003 4:34 PM To: [EMAIL PROTECTED] Subject: section G issue I have a question now about how to code in section G based on the new manual. In a situation where most of the week an activity did not occur except for 1 or 2 times. We use an adl flow sheet, so the entire 7 days will be 8/8 except for 1 or 2 times where there is a 3/2, for example. According to the new manual, on the mds I would put "0/2". I have been told by our compliance officer to "use the ADL self-performance chart". But the chart says "does on own, OR aided 1 or 2 times only". Aided 1 or 2 times only and activity occurred 1 or 2 times only are 2 different things. This has me confused. So if a resident is totally independent with transfers and had help only 1 or 2 times during the week, it would be coded "0/2" on the mds. And a resident who is bedfast (for whatever reason) but they had total staff assist to transfer out of the bed 1 or 2 times during the week , they would also be coded "0/2" on the mds. This doesn't seem right. Anyone? Thanks, Nancy Nancy Deonarine RN MDS Coordinator Barclay Friends West Chester, Pa 19380 Confidentiality Notice: This message may contain Protected Health Information (PHI) or other information which may be confidential or legally priveleged. If you are not the intended recipient, you may not use, copy, disseminate or disclose this communication or its contents to anyone. If you have received this message in error, please advise the sender by reply and delete the message. Thank You. /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
