I would have to look at whether the pain med was holding her, or if you need
to be calling the doc for increases, etc.  Also, if she's still bleeding,
are they doing labs to check on hgb. & albumin?  I guess the key is:  Do you
think this patient is now stable?  If yes, don't skill past the 5 day.  If
no, go until she is.
----- Original Message -----
From: "Billy Jo Stewart" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, February 18, 2004 8:21 AM
Subject: RE: medicare skilling


This resident is alert and oriented x3, she requires minimal assist with
her ADL's when she allows staff to help her.  She is independently
ambulatory (therapy did not pick her up).  She takes herself to the
bathroom.  She is able to feed herself.  She is having rectal pain on a
daily basis and is receiving tylenol #3 for it.  She did have a couple
of episodes of rectal bleeding noted but she has no labs ordered.

thanks,

billie stewart
[EMAIL PROTECTED]

-----Original Message-----
From: Corey Ali [mailto:[EMAIL PROTECTED]
Sent: Tuesday, February 17, 2004 8:14 PM
To: [EMAIL PROTECTED]
Subject: Re: medicare skilling


What are you doing for her?  Does she need help w/ her ADL's?  What
about
pain control?  Is she cognitively intact, etc, etc.,
----- Original Message -----
From: "Billy Jo Stewart" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, February 17, 2004 1:04 PM
Subject: medicare skilling


Hello Everyone,
I have a resident that was admitted to the nursing unit on
2/12/04.  Prior to coming into nursing she had a 3 day hospital stay.
When the MD from the hospital discharged the resident they discharged
her to our personal care department with the understanding that when a
bed became available in nursing that she would be transfered to that
bed.  She was admitted with rectal ca and comfort measures.  It is noted
that  she occasionally has vaginal and rectal bleeding.  Her vital signs
are stable, no s/s of dehydration noted. At first I placed her on med A
for 7 day observation period.  she is having rectal pain and is
receiving tylenol #3 prn.  Would you continue to skill her after the
first 7 day?

Thanks,

Billie Stewart, RNAC
[EMAIL PROTECTED]
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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
-----------------------------------------------------------/
/----------------------------------------------------------
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
-----------------------------------------------------------/

/----------------------------------------------------------
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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