RE: Tube feed old vs. new

[Brenda Chance]

Title: Message

If she had a 60 day period of wellness between the discharge from your facility and the admission to the hospital for the hip fx, then she qualifies for a new benefit period again.  If she is being skilled for the hip fx, ie pt, ot, etc, then you will have no problem.  If they have been d/c’ed and you are wanting to skill her for the peg, I would say that since she has had leakage, etc. with insertion of a new peg, then she is skillable.  I would monitor her weights, any s/s of leakage, etc. and then proceed from there.  she may truly end up having a weight loss related to the leakage.    Brenda W. Chance, RN, RAC-C MDS Coordinator     CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: Joyce, Monica [mailto:[EMAIL PROTECTED] Sent: Monday, April 05, 2004 10:44 AM To: 'Karen Berry' Cc: '[EMAIL PROTECTED]' Subject: RE: Tube feed old vs. new   She was admitted from the hospital, prior to that from home.  She has been here in the past for the tube, but home from here, then back in for the current admission (we are a Hospital-based short term unit; nobody "lives here").  Prior admission for the tube probably used about 14 days.  She has been out of skilled for a while.  At this admission she is eligible for all 100 days of skilled care.  She is definitley receiving the calorie and fluid intake; the tube is her primary source; PO is for pleasure foods only and Specch is tapering that because she is not demo-ing safe swallow.  All sounds good for skilled criteria, but her baseline is home with daughter administering feeds. It is not "new" in that sense; they have been educated and can provide care at home; she doesn't need skilled care for that reason.  I don't think ther calories alone are enough to skill her given the total picture...or are they?  I'm thinking that because of the leaking and new tube placement that we can keep her for monitoring, but for how long?   thanks for your input.  Sorry to bombard you with all these details! Monica -----Original Message----- From: Karen Berry [mailto:[EMAIL PROTECTED] Sent: Monday, April 05, 2004 10:33 AM To: [EMAIL PROTECTED] Subject: Tube feed old vs. new Was this resident in your facility prior to the recent hospitalization? Has she used Medicare time with the old tube, and if so, how many? Has she been receiving the amount of calories and cc's to meet the skilled criteria under Medicare Part A? All these need to be taken into consideration, as dependence on the tube feeding is a skilled service and if it has not been interrupted there is no new benefit period available under Medicare Part A, even with a new diagnosis. Please NOTE: This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not distribute, copy or use this e-mail in any way. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. If verification is required please request a hard-copy version. Pittsburgh Mercy Health System, 1400 Locust Street, Pittsburgh, PA 15219 Attn: Chief Information Officer