Re: Facility chooses not to show services?

[Janster49]

I agree that all criteria must be met to count and code restorative nursing, but in some states (specifically PA.) restorative nursing is counted at 5 days a week in the PA. State Case Mix and I do not want people to feel they must have 6 days in order to count. (The 6 days are necessary to get credit and RUG out for Medicare PPS under Rehab Low, but not necessarily in all case mix states) You will need to know your state guidelines as well as Federal. In PA.for example, the Restorative nursing is a split for the lower three  categories(impaired cognition, behavior problems and reduced physical function) and will affect (increase) the PA. State Case mix if your assessment is comprehensive. (AA8a = 1, 2, 3 or 4).    The RAI states to count the number of days, but does not specify 6 days.      Also keep in mind that in order to remain skilled for Medicare, you must have daily skilled services such as respiratory therapy.       Jan Stewart   In a message dated 1/3/2004 7:16:26 PM Eastern Standard Time, [EMAIL PROTECTED] writes: I have noted among some of my clients and participants in educational sessions around the country that many facilities are providing services that they call restorative programs.  In most cases, they are even delivered by specially trained Restorative Nursing Assistants.  However, they do not qualify to be documented on the MDS, because the programs do not meet all of the requirements spelled out in the RAI manual.  Generally, in my experience, the limiting factor is either the programs are not available six days per week (as is the case here with the original question) or their licensed nurses are not routinely monitoring each resident's progress and documenting it in the chart. Rena Rena R. Shephard, MHA, RN, FACDONA, RAC-C Chair, American Association of Nurse Assessment Coordinators [EMAIL PROTECTED] Subj: Re: Facility chooses not to show services? Date: 1/3/04 4:04:03 PM Pacific Standard Time From: [EMAIL PROTECTED] Reply-to: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent from the Internet IT would seem to me that the facility should take credit for the restorative minutes that it does give.  Facilities are required to keep the resident at his/her optimum level of functioning.  Restorative nursing is a very important part of that process.  It doesn't make any sense to not take credit for restorative nursing that was done.  I know in PA, the UMR survey team does give deficiencies if they find that the facility has done restorative and not entered the minutes on the MDS. ----- Original Message ----- From: Corey Ali To: [EMAIL PROTECTED] Sent: Friday, January 02, 2004 5:27 PM Subject: Facility chooses not to show services? This is a new one for me.  I have a facility that has decided to not show any Restorative Services (due to inadequate number of staff to provide services 6 days a week, although restorative is provided 3-4 days a week) and to not record any Respiratory Therapy services provided from trained nurses (ile.; nebulizer therapy, postural drainage, etc.) because it is too difficult to get the minutes recorded.  Assuming that the MDS nurse follows unwritten directions to not include the restorative or respiratory therapy minutes, is the nurse liable anywhere here?