Re: Section K

[Janster49]

Please read p 3-149 in the revised RAI manual of December 2002 concerning coding of chewing and swallowing problems.  The manual clearly states to code both chewing and swallowing problems even when the interventions have been successful.    The MDS is a "Bird of its own kind" and many questions are answered per the guidelines in the RAI and not with the rationale you would consider as a nurse. An example is use of the foley-in our rationale (at least mine), you might consider the resident to be incontinent, yet if it is not leaking, the resident is considered to be continent by the RAI coding standards.    A similar example in coding  for chewing and swallowing. Consider that if the resident did not have the mechanically altered diet, would they have a chewing or swallowing problem? The answer is usally yes-thus the reason for the diet alteration and the need to code it as a problem.. Just wanted to clear things up.    Do not go back to previous Q & A's as the updated RAI supercedes all previously posted items. They have been incorporated into the updated manuals. Follow the updated 2002 RAI and the updates from Aug. 2003. This item has gone around several times, but the correct answer is in these new manuals.   Jan Stewart AANAC Master trainer     In a message dated 2/20/2004 11:36:07 PM Eastern Standard Time, [EMAIL PROTECTED] writes: Dawn you are correct. If the diet is changed/ Mech etc, then it is d/t a chewing or swallowing problem. On our state site for transmittals, this statement continues to be posted, around 2 years ago I believe in July. Not at work, so can't give exact date. I personally feel that if the diet is altered so that the resident doesn't experience difficulty w/eating their foods and the intervention worked---there is not a problem. Claudia >From: "dawn" <[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: <[EMAIL PROTECTED]> >Subject: Re: Section K >Date: Fri, 20 Feb 2004 21:31:24 -0500 > > >     I seem to recall a Q&A last year...maybe 2 years ago. You code chewing problem on MDS if on a mechanically altered diet, regardless. Anybody out there, please correct me...... Of course I keep all that at work. > >     dawn > > > >     ----- Original Message ----- >     From: Brenda Chance >     To: [EMAIL PROTECTED] >     Sent: Friday, February 20, 2004 10:59 AM >     Subject: RE: Section K > > >     Your director needs to talk with a speech therapist.  Mechanically altered diets include Mech Soft, Pureed, etc. and can be as much for swallowing problems as for chewing.  I would not code chewing unless there was a chewing problem.  This would be like assuming just because a resident has difficulty lying flat they have copd. > > > >     Brenda W. Chance, RN, RAC-C > >     MDS Coordinator > > > > >