Ok, skip the bathing, wrong example.   
Transfers....   all 8/8 during the week but transfered only twice
during the week, 3/2.  (complete bed rest, went to MD visit, hospital,
xray, whatever)  so this is what it looks like:
8/8  8/8  3/2  8/8  8/8  8/8  3/2 
5 days it did not occur
2 days it did occur
what do I put on the mds,   3/2 or 0/2 ??



Nancy Deonarine RN
MDS Coordinator
Barclay Friends
West Chester, Pa 19380

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>>> [EMAIL PROTECTED] 10/29/03 01:10PM >>>

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

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>>> "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

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not
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>>> "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
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anyone.  If you have received this message in error, please advise the
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The Case Mix Discussion Group is a free service of the
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Be sure to visit the AANAC website. Accurate answers to your
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/----------------------------------------------------------
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
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