I reviewed her chart and there was a day when she used the Oxygen, and with that being checked on section P, it will give us a RUG score of CA1. Now, we can say we are following the "rule" appropriately. That was my first concern.
Anyway, thanks for all your thoughts and help! You are all such a big help.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of M.
Wilson
Sent: Friday, December 19, 2003 6:57 AM
To: [EMAIL PROTECTED]
Subject: Re: would you put them on PPS?
MANY good questions posed in that last statement but
the simple fact that the resident will not RUG into
the upper 26 RUG categories prohibits them from
presumption of coverage (PA1 as the original question
mentioned). My thoughts revert back to the angina
sending her to the hospital in the 1st place. Since
she was sent out with chest pain, she likely got IV
meds (NTG). Get the proof of IV's and she CAN be
Medicare at least to the 5 day assessment under
presumption of coverage @ a SE_ RUG.
--- [EMAIL PROTECTED] wrote:
> My concern is not just your case, but long term care
> in general. Are we
> missing something, in this case - what is causing
> the chest pain? Is the resident
> frequently in pain? What was the resident doing just
> before the chest pain?
> Were any kind of tests done at the hospital? Did you
> get any reports from the
> hospital that would help you care for your residents
> needs? Did they not give any
> IV fluids or IV med pains at the hospital? Do you
> have trouble getting
> information from the hospital? Is the resident on
> nitroglycerin? Does the resident
> have any fever? Are you monitoring the BP? Is the
> resident on any
> anticoagulants? Is your staff documenting
> observations, such as persistent dyspnea,
> cyanosis, decreasing blood pressure, rising
> temperature, and arrhythmia's? I am sure
> you are doing all of this. I just want everyone, not
> just you to be sure they
> are doing everything they can for our residents.
> If one of our residents died tomorrow would we be
> comfortable with knowing
> that everything was done that could have been done?
>
> Sorry for the soap box, it's not your fault for sure
> - it's just seams like
> sometimes (me included) we forget there is more to
> our residents than what goes
> on paper.
>
> Sorry again everyone.
> my first question would be, why did they go to the
> hospital? Went out bec. of
> chest pain.
> Is the resident stable? She has been stable since
> re-admission.
>
> If rehab is not needed, we usually cover them for
> skilled observation
> (following the "presumptive coverage rule" ) BUT in
> this case I am not so sure..now
> that RUG score will possibly be at PA1 again
>
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