Nancy, Here's the problem. Stop counting the occurrences on each day. Look at the particular activity. On each performance of THAT ACTIVITY, what the patient do, and what did the staff have to do? Code your answers on that, not on how many days a week a bath occurred, or if they ate dinner in the dining room 3 times that week, but the lunch 7 days. Look at the ability and support of the activity. While the activity occurred, how much of it did the staff have to help. For transferring, obviously this patient transferred more than 2 times. On the 2 days it did occur, the transfer had to occur TWICE: Once to get out of bed, and once to get back in. Same for day two. So, on these four occasions, it would appear that the patient needed wt. bearing assist by one person on each transfer, yes? If so, then your score is "3/2?
Corey ----- Original Message ----- From: "Nancy Deonarine" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, October 29, 2003 1:35 PM Subject: RE: section G issue > 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 > > 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. > > > > >>> [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 > > 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 > -----------------------------------------------------------/ > /---------------------------------------------------------- > 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 -----------------------------------------------------------/
