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High Sherri,
I agree with your frustration re the LOW RUG. Is there a way you can
advocte with corporate? Can you share what corporation or perhaps e-mail me
privately regarding this.
As far as having difficulty locating an SLP for swallowing, I recommend
training the OTRs and COTAs in swallowing. This is in their national scope
of practice but also need check the state practice act to be certain there are
no restrictions. This is also true for PTs. As far as coverage goes, PTs, OTs
and SLPs can provide dysphagia treatment as long as they have had the training
to provide safe and effective treatment.
Gail Neustadt, NHA
----- Original Message -----
Sent: Monday, March 22, 2004 4:34
AM
Subject: Re: rehab low
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 -----
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
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