Why would you do a significant change once therapy starts if there has
been no significant change in functioning?  I understand you are trying
to do this to capture the therapy minutes, but this does not constitute
a significant change.  If she does an admission assessment, and if
nothing else occurs that impacts the residents status, there will likely
be no reason to do a significant change just because therapy is
starting.  

The way to handle this is to try to start therapy (when indicated) at a
time when you can capture this during an assessment period.  If you
cannot and there has been no decline/improvement to indicate a
significant change is needed, then you will just have to eat the payment
to rehab out of your current rugs level and do what is best for the
resident.

Brenda W. Chance, RN, RAC-C
MDS Coordinator
 
 
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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] 
Sent: Saturday, January 17, 2004 9:01 AM
To: [EMAIL PROTECTED]
Subject: Skill or not

I am sorry I misunderstood.I would skill and 
[as someone said}capture the IV on both the 5 and 14 day.In the
situation you mention,I would do an omra sig chance when therapy
starts.I don't see how you could say that a sig change is not necessary
[if you meet the criteria]
as the person has never had therapy in your building.I agree when rehab
starts one expects improvement but in this case rehab hasn't started
yet.

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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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