Re: Facility chooses not to show services?

[Debbie Ohl]

When coding P3 services given all the requirements are met for the program as outlines in the MDS manual, go back to the basic MDS instruction "P3 Nursing Rehabilitation/ Restorative Record the number of days each of the following Rehabilitation or Restorative techniques or practices was provided to the resident for more than or equal to 15 minutes per day in the last seven days. Enter 0 if none or less than 15 minutes daily." For MDS coding purposes there is NO REQUIREMENT ABOUT NUMBER OF DAYS.   Documentation Recommendations and requirements:   The MDS 2.0 section on ADL/Rehabilitation is or can be initial screen for identifying functional status. The current standard mandated by the MDS 2.0 is that residents "anything less than independent in the performance of ADL�s" can benefit from a restorative or maintenance ADL program. The type of services and programs that can be of benefit comes out of completing the ADL Resident Assessment Protocol, which is a required action when triggered by the MDS.   The RUGs III Medicare Case Mix Reimbursement system also recognizes the restorative nursing category in three of the seven primary categories used to classify residents. In order to group in these classifications it is necessary to provide at least two programs, a minimum of 15 minutes, six days a week. These programs can be maintenance or restorative in nature. In order to "capture the credit for Medicare RUGs", certain pieces of documentation must be in place. Assessment: MDS, Triggered RAP. Care plan: Defined functional problem, measurable goal(s) and time frames, intervention include specific approaches, frequency of service and service provider. Delivery records reflecting provision of service, service provider and time spent. Periodic progress notes.(This is not defined by rule. Therefore the facility sets the standard for frequency of entries. Keep in mind that these are NOT paper programs, rather programs with a purpose. Therefore, documentation is a tool to reflect and prompt needed actions to ensure the best results) The MDS 2.0 section on ADL/Rehabilitation is or can be initial screen for identifying functional status. The current standard of practice mandated by the MDS 2.0 is that residents anything less than independent in the performance of ADL�s can benefit from a restorative or maintenance ADL program. The type of services and programs that can be of benefit comes out of completing the ADL Resident Assessment Protocol ( this is GREAT tool to help identify the type of program(s) that can be of value for the reason.) , which is a required action when triggered by the MDS.   Debbie Ohl RN, NHA LTC Consultant & Educator, Ohl & Associates 613 Compton Road, Cincinnati, Ohio 45231 Phone / Fax 513-522-6041 [EMAIL PROTECTED]  www.greatcareplans.com -----