Re: rehab low

[Rnlncoh]

I agree that an MD order should be gotten also.  There was a meeting at our facility recently and our staff was told that we should not automatically be sending people to Restorative for the same programs that they are on in Rehab.  Instead, they should be gradually reduced to three days a week on Rehab and three days a week on Restorative and then cut when stable.  Apparently, our new district MDS Nurse was emphatic about not sending everyone off to restorative as skilled and then doing the OMRA's.  I like the idea of the gradual change though, instead of going from RH and RM to no Rehab category and strictly on to Restorative.  I think the RL category is very underused.  We are also having problems getting estimated days and minutes d/t lack of experience and employee shortage in our therapy dept.  So the MDS nurses have been doing it and got told not to do that.  We have not had a Speech Therapist in our facility for over a year now and we have many residents who need to have swallow evals done.  Some of our docs refuse to send them out to get it done.  These docs feel that by standing their ground, it will force the facility to bring in a speech therapist.  Well, corporate doesn't consider getting an ST a primary goal.  From a risk management point of view, I think they need to revisit that thought.  Just venting because this kind of stuff drives me crazy!  Would hate to get caught with a death d/t aspiration that could have been avoided.   Sherri     Yes, I would get a physician order since this is a skilled lovel of care.   Gail Neustadt, NHA ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Friday, March 19, 2004 9:57 PM Subject: rehab low My friend went to a meeting and the concultant told the group thta in order for restorative tocount for the rehab low catagory, there must be a physician's order for rehab nursing.  has anyoone heard this and where in the rules does it sat this? Thanks so much Joan M