RE: how do I score this??

[Vogt, Kathy]

I think I would code for his ability when not having these episodes.  But thenexplain it in the RAP and care plan for the episodes.     Kathy Vogt -----Original Message----- From: Sara Hayden RN,C [mailto:[EMAIL PROTECTED] Sent: Thursday, December 18, 2003 10:11 AM To: Undisclosed-Recipient:; Subject: how do I score this?? I have a resident on Medicare A that is a hospital return following surgery for an above the knee amputation due to irreversible critical ischemia.  In the 7 day window, since his return, he has had 4 periods of complete unresponsiveness with flaccidity.  These periods have lasted from 2 hours to 16 hours.  When he comes out of these episodes, he is totally alert and oriented, communicates clearly, makes his own decisions, feeds himself, jokes with staff, etc.  My question is on scoring section B - cognition and memory.  Do I score the way he is when he is unresponsive or do I score for the alert and oriented, awake person?  The episodes of each is about 50% of the window period so neither one is a true picture of the resident throughout the window as they are so completely polar of status.   Sara Hayden RN,C St. Mark's Lutheran Home Austin, MN   Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.     NOTE: This e-mail message may contain information that is privileged, confidential, and exempt from disclosure. It is intended for use only by the person to whom it is addressed. If you have received this message in error, please do not forward or use this information in any way. Delete it immediately and contact the sender as soon as possible by the reply option or by telephone at the telephone number listed (if available). In the event you cannot fulfill your obligation or there has been any improper release of this information, please contact the Privacy Officer at Carondelet Health at (816) 943-4611.