RE: how do I score this??

[Nathan Lake]

Title: Message

As for B1, I would code B1=0. If you coded him as comatose, you would be unable to code a number of other items (B2-F) at all. That would not be correct. Also, the definition of B1 is "persistent vegetative state"..This is apparently not the case here.   As for B2 & B3 (Memory), you need to code him as he is when awake. Do other residents get their memory coded as it would be on the night shift while asleep? Just because a resident is asleep (or unconscious) does not mean there is a memory problem.   I would code B4 = 2 or 3 since for long periods of time throughout the day he is unable to make decision on his own.   I would code B5b, e and f  = 1 or 2 depending on whether this is new behavior.   If you code B5b, e and f = 2 then you probably will code B6 = 2      Nathan -----Original Message----- From: Sara Hayden RN,C [mailto:[EMAIL PROTECTED] Sent: Thursday, December 18, 2003 11:11 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.