Re: Expected Decline

[RRS2000]

This response is contrary to CMS policy in cases in which the resident has a terminal condition.  See page 2-11 of the RAI User's Manual.  Just because a new MDS is not required does not relieve the facility of the responsibility to ensure that the care plan is appropriate at all times.

However, in the case described by the questioner, the resident apparently does not have a terminal condition.  It would not be up to the nurse to determine whether the decline is an expected part of the course of the disease process.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]

Subj: RE: Expected Decline
Date: 3/6/04 3:07:34 PM Pacific Standard Time
From: [EMAIL PROTECTED]
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if the mds is supposed to reflect the resident then i would still do a sig change when the mds no longer reflects the patient status, i was hoping to use this to help stop some of the paper work , if the decline is expected we still have to do something to keep the resident comfortable, out of pain, maintain skin integrity etc

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From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of [EMAIL PROTECTED]
Sent: Thursday, March 04, 2004 6:22 AM
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Subject: Expected Decline


If a decline is expected in residentâs condition, how much and what type of documentation is needed in the RAPS, so that a significant change in condition assessment will not be necessary in the future?  I have struggled with this in the past and now I have a resident with a new hip fracture (2nd fx in 9 months) not eating (has had a history of poor eating habits and thought to be anorexic although never documented as so by doctor), my nursing judgement tells me he will continue to decline which leads me back to my original question.   Thanks in advance.