Re: Dave Audit

[BRSAMI]

Coding pneumonia on the 14-day assessment:    The 14-day assessment using day 11 as the ARD would cover days 5-11 (7-day look back period).    A patient admitted with pneumonia on antibiotic therapy x 7 days, oxygen therapy, nebulizer treatments, with skilled assessments of lung sounds and occupational therapy for energy conservation and work simplification due to dyspnea and decreased activity tolerance in my opinion would continue to meet coding definitions using day 11.    All of these interventions play a factor in ADL's, medication use. nursing monitoring and risk for death.  RAI instructions state "do not include conditons that have been resolved or no longer affect the resident's functioning or care plan.  Nursing monitoring includes clinical monitoring by a licensed nurse.    Of course, this needs to be evaluated for each specific patient.  Some patient's pneumonia will have resolved by day 5, but many others may not.  I think a blanket statement that pneumonia should not be coded on the 14-day assessment is not accurate.