I understand where your case manager and director are coming from, having been a nurse manager of a hospital based skilled. They aren't use to having patients there that long, and it is expensive. However, the patient has the right to use his 100 days as long as he meets the criteria. Here are some questions to ask, that Medicare will ask during a review? Are the IV antibiotics daily, BID, TID, Or QID? and if they are daily then Can the IV antibiotics be done in a clinic daily -- and if so does the patient have access to the clinic? What type of dressings is he receiving -- are they dressings that a home health nurse can perform?
The reality is that he is still skillable, and unless you can give answers that would satisfy a Medicare reviewer, your patient should stay right where he is until the IV antibiotics are completed or his hundred days are up whichever comes first ---------- Original Message ---------------------------------- From: karen white <[EMAIL PROTECTED]> Reply-To: [EMAIL PROTECTED] Date: Thu, 1 Apr 2004 14:22:30 -0500 >I have a question for the group. Hopefully I did not make it too >confusing.... >Resident is here coming up on 60 days.(we are scu in hospital this length of >stay highly unusual) >For the 60 days he has received IV ABT,(MRSA) and bid dressing changes to a >stasis ulcer on ankle. >Here is the problem. >The director and case manager are working on discharge for this resident. He >would go home with his wife.He is alert and oriented and independent in all >adls.He does have severe COPD and O2 dependent. > He and wife are very reluctant to leave they want to stay here and continue >with IV abt and bid dressing changes.They know they have 100 days. I have >discussed with them the pro's and con's of using all 100 days. >Director and case manager have given them a number of options, and all >include cont his IV abt and dsg changes. >I am uncomfortable with this , and have had my say because he is still >skilled in my eyes. Are they able to force the issue and insist he leave as >he can get the same level of care at home going to outpatient care for the >IV abt and dsg change. I have told my director that I feel they cannot force >him to leave as long as he remains skilled in medicare's eyes. Even if he >can get the care as outpatient. > They tell me we send people home all the time with IV meds, dsgs etc. And I >agree but because that resident wants to go home.... This resident does not >want to leave. Am I off base on this one. Please clarify this for me . >THANKS KAREN > > > > >____________________________________________________________ >Find what you are looking for with the Lycos Yellow Pages >http://r.lycos.com/r/yp_emailfooter/http://yellowpages.lycos.com/default.asp >?SRC=lycos10 >/---------------------------------------------------------- >The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" >Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org >-----------------------------------------------------------/ >CONFIDENTIALITY NOTICE: The information contained in this e-mail is >confidential and may be proprietary information intended only for the use of >the individual or entity to whom it is addressed. If the reader of this >message is not the intended recipient, you are hereby notified that any >viewing, dissemination, distribution, disclosure, copy or use of the >information contained in this e-mail message is strictly prohibited. If you >have received and/or are viewing this e-mail in error, please immediately >notify the sender by reply e-mail, and delete it from your system without >reading, forwarding, copying or saving in any manner. Thank you. > Confidentiality Notice: The information contained in this e-mail is confidential and may be proprietary information intended only for the use of the individual or entity to whom it is addressed. If the reader of this message is not the intended recipient, you are hereby notified that any viewing, dissemination, distribution, disclosure, copy or use of the information contained in this e-mail message is strictly prohibited. If you have received and/or are viewing this e-mail in error, please immediately notify the sender by reply e-mail, and delete it from your system without reading, forwarding, copying or saving in any manner. Thank you. /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
