counting MD orders for Section P

[Borkowski, Linda D.]

Title: Message

Our UMR team (the Medicaid survey team who checks for supporting MDS documentation in Pennsylvania) will not count MD orders for things which don't require an order.  For example, an order to begin a Restorative Nsg. Program wouldn't be counted because an order is not required for RNPs;  an order to use siderails wouldn't be counted unless the siderails constituted a restraint because use of siderails otherwise is considered a "nursing measure" not requiring an order.  A recent issue of PPS Alert for Long-Term Care specifically states that RNP orders CAN be counted.  The MDS user's manual doesn't clarify this issue.  Can anyone address this or offer suggestions?  Thank you.