A merry walker is supposed to enhance the resident's mobility, but, if the resident cannot open the gate and exit, then it does restrict freedom of movement. In other words, it restricts the residents ability to exit and transfer out of the merry walker if he/she cannot open the gate. The MDS manual gives clear guidance on this matter. On pg. 3-199 - 3-200 if clearly defines how to code the merry walker. It states, "If these devices (merry walkers) assist ambulation for a particular resident, they should be coded as a cane/walker/crutch at Item G5a, whether or not they are coded as a restraint. ... "(1) Coding When Not a Restraint: If a resident is able to easily open the front gate and exit the device, the device should not be coded as a restraint for the particular resident. If would be coded at Item G5a as a Cane/Walker/Crutch. ... (2)Coding When a Restraint (a) Only if the device has the effect of restricting the resident's freedome of movement, should the device be considered a restraint. If the resident's freedom of movement is restricted because the resident cannot open the front gate and exit the device (due to cognitive or physical limitations that prevents him or her from exiting the device), then the device should be coded as a restraint in P4 of the MDS. (b) The current version of the MDS does not contain a category for a restraint in which this device obviously falls. ... Until CMS releases the next version of the MDS, when the device restricts freedom of movement, code the device at item P4e, Chair prevents rising..."
I would do the proper correction, if needed, related to the above to ensure that I had covered this item adequately if it is a restraint for this resident. 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: Stacee Kunse [mailto:[EMAIL PROTECTED] Sent: Friday, April 09, 2004 9:40 AM To: [EMAIL PROTECTED] Subject: merrywalker as a restraint... I have a resident who uses a merrywalker for independent mobility and ambulation in the halls. He is too weak to use a regular walker. In the MDS manual, a merrywalker is an example in the restraint section. I have difficulty coding this as a restraint because it does not pevent him from rising, does not impede but enhances his mobility. I have it sufficiently covered in my RAPS that it enhances mobility, etc. Do I still code it as a restraint in MDS, and should it be reflected on the roster. I have put it on the roster--I would rather have state look into it and see our documentation, than have them see him in the hall and have it not be on the roster and be questioned as to why. Any input???? This e-mail and any attachments are confidential information intended for the sole use of the addressee listed. If you are not the intended recipient, please notify the sender immediately via return e-mail, or call our Management Information Systems Coordinator at (989)673-4117, and delete the e-mail. Unauthorized use, dissemination, distribution or copying of this e-mail or attachments, in whole or in part, is strictly prohibited and may be unlawful. Stacee Kunse, RN MDS Coordinator Tuscola County Medical Care Facility 1285 Cleaver Road Caro, MI 48723 Phone: (989)673-4117 Fax: (989)673-6665 Email: [EMAIL PROTECTED] /---------------------------------------------------------- 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/
