we have changed the name to CNA mobility program due to recent
downsizing.
our CNA's are trained by PT staff after therapy ends. the
CNA's have a log in sheet showing progress, refusales and some document tation
why, how far,etc. so far it has worked out ok. new staff are inserviced
by PT and CNA's trained. my rai coordinator and I capture these items on the
MDS sec.p3. any feedback would be helpful.
thanks
[EMAIL PROTECTED]
lpowell,lpn
>From: "Debbie Ohl" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: Re: Facility chooses not to show services?
>Date: Sun, 4 Jan 2004 17:08:47 -0500
>
>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.
> 1.. Assessment: MDS, Triggered RAP.
> 2.. Care plan: Defined functional problem,
measurable goal(s) and time frames, intervention include specific approaches,
frequency of service and service provider.
> 3.. Delivery records reflecting provision of
service, service provider and time spent.
> 4.. 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
> -----
