Gail,
It sounds perfect to me.  When I first saw the RUGs I was very encouraged.  I thought that everyone got it that we now had a system covered by Medicare Part A benefits to treat residents at the level they required.  And that level could go up and down during the covered period according to resident needs.

Start slow on admission and build as endurance and strength increased and then taper down and smoothly transition to restorative nursing. 

What I get is same old same old.  I have been consulting since 1980  I have no idea why therapists don't just have rubber stamps made
Gait training
Transfer training
Strengthening exercises
Care giver training
5xwk for 30 days

And I almost never find documentation of WHO the caregiver is AND what TRAINING was done.

If restorative or mention of care giver is documented before the last two days I am elated.

I have given up, I rarely audit therapy as it only results in resentment from therapists. [although I give copious handouts on regs, documentation info from THEIR organizations, etc.] and administrators telling me they have never been denied and they think therapy is 'doing' fine.  I never said they were not 'doing' fine, they are probably providing great therapy but documentation stinks.  I have this sneaking suspicion that what is not documented IS NOT DONE.


Delores


Delores,

I think that the therapists have some problems understanding that Restorative plays an important role during ongoing rehab. Many therapists 1. fear for the safety of the resident but need to ask restorative nurses to carry out unskilled procedures that supplement what they are doing and 2. the therapists are afraid that if restorative can function independently then Medicare might question the need for skilled services. However the restorative nurses are under the direction of a licensed nurse and also taking direction from rehab. Does this sound logical or convoluted???!!!
 
Gail Neustadt, NHA



Delores L. Galias, RN, RHIT

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