Restorative nursing programs are not a skilled need by themselves. Nursing
could have skilled for observation and management or careplanning if
documenting the daily skilled services they are providing regarding
assessments and nursing intervention and restorative nursing can be part of
it. Restorative nursing is part of the skilling services in Rehab Low when
in combination with therapy services as legislated; however, by itself
restorative nursing would not be a skilled service. 

-----Original Message-----
From: Tracy Adkins [mailto:[EMAIL PROTECTED]
Sent: Monday, January 19, 2004 1:19 PM
To: [EMAIL PROTECTED]
Subject: Rena: Restorative as Med A Skilled Need?


Rena,
I am a MDS consultant in the state of Indiana. CMS is pre-pay reviewing 
Medicare A claims in one of my buildings. They call it progressive 
correction action plan. They usually request 1 to 2 claims and I prepare 
these Medicare A charts and send them in for review. They will either 
accect, re-rug or deny each claim. I recently sent in a claim in which the 
resident stayed in our facility after all therapy discontinued. Therapy has 
set up a restorative program for this resident and we held this resident for

6 days after all therapy had discontinued due to observation of the 
restorative program. Administar called the facility last Friday and spoke 
with the DON and stated that restorative nursing is not a skilled need. Now,

I'm confused, because I thought it was. Now they want to know where I got 
the idea that restorative is a MEdicare A skilled needs and they want the 
answer by 5pm today.
Can anyone tell me where I may find in writing that restorative is a skilled

need.
Thank You,
Tracy

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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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