if you plan to D/C resident from Med A prior to the 30 day, and prior to the 10th day after D/C of rehab services, you don't have to do both the 30 day and the OMRA. the Therapy RUG stays. if the MD refuse to sign the bath & shower order, i would not count it as physician's order. besides, it is more of a nursing measure. i would not code care of stoma as surgical care if the site is healed. i believe it is when the resident just had a tracheostomy or gastrostomy placed that we count the site as surgical wound.
--- [EMAIL PROTECTED] wrote: > My mind is blanking today - could someone give me > input? > > First, resident had last covered day of Therapy on > 4/28. We continued to cover this resident for > Medicare due to the skilled need of IV Lasix daily > (push). I set the OMRA for 5/6 and combined it with > the 30-day. Today the IV Lasix is discontinued, > resident stable, so made today the last covered day > of Medicare. OMRA does NOT need done, right? And > if I do not do it, does the Therapy RUG score stay > until that last covered day? > > Secondly, when an order is written to change bath > and shower days from one to two per week or two to > one per week, do we count that as a Physicians order > under P8? Today's rounding doctor said he will not > sign them as there should be a policy on > baths/showers so that these orders could more or > less be written as a nursing measure. (?) > > And a gray area - resident had a tracheostomy. > Currently has no trach, only the stoma. We can't > count trach care so do we capture the care that we > do under "surgical wound care"? > > I have been working TOO many hours and this info is > all running together. Thanks for ANY help you could > provide. > > Bonnie > /---------------------------------------------------------- > 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 > -----------------------------------------------------------/ ===== Melinda de la Cruz, R.N., B.S.N., RAC-C MDS Coordinator *******CONFIDENTIALITY NOTICE******* This message and any attachment are confidential and may be privileged or otherwise protected from disclosure and solely for the use of the person (s) or entity to whom it is intended. If you have received this message in error and are not the intended recipient, please notify the sender immediately and delete this message and any attachment from your system. Please be advised that any use of this message is prohibited and may be unlawful, and you must not copy this message or attachment or disclose the contents to any other person. __________________________________ Do you Yahoo!? Win a $20,000 Career Makeover at Yahoo! HotJobs http://hotjobs.sweepstakes.yahoo.com/careermakeover /---------------------------------------------------------- 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 -----------------------------------------------------------/
