[TINKER968]

This is not exactly an Oasis question, but I was hoping someone could help me with the correct way to document skilled nurse frequency. Our Biller tells us that the documentation is changing for the weeks with one to 3 days left over at the end of the calendar. For example I was taught to document 0D1 for 1 day left over with no visits . 1D1 for 1 day left with a visit on that day. 1D3 for one visit with 3 days in that last week. I am completely unsure of myself now. I would appreciate any explanation of the correct way to document the frequency.

[Chopper]

You should NEVER use a zero frequency. I would look at that last week and see how many visits you need and word it accordingly. Are you going to recert the person or are you closing them? Billers aren't exactly the best people to ask about when wording your orders...

Chopper

[TINKER968]

Thank you for responding. What if there are no visits in the last week? It is the end of the cert period with just 1 or 2 days remaining in that last week, for example Sunday and Monday with no visits scheduled because you have your nine weeks already.

[katwoman7755]

if i'm understanding you correctly, you wouldn't need to write any frequency for those 10 days left. I am assuming, for instance, that maybe you had 1W9, and so the recert was done sometime between thurs and sat, with sun and mon left over (really on what looks like the 10th week). If you need no visit for those 2 days, then you wouldn't have to write anything...the new frequency would be on the recert....so maybe it was 1W9 again...and you could go after monday if that was the last day of the episode. If for some reason you needed to make a visit on that sun or mon, it would be 1D1.

[TINKER968]

Thank You, it makes perfect sense to me. That way there is no chance for error.

[jeanneb1]

A lot depends on your surveyors -- surveyors in Texas (San Antonio, anyway) instruct to use 0 as a "placeholder". Illogical to me, but I've had them insist that all weeks in the episode are included -- therefore, there are instances, (particularly at the beginning of an episode, say on Friday or Saturday when a visit was made earlier in the week, in the old episode), where 0 is used to account for the week in the episode. Hope I didn't confuse the issue....... Jeanne

[TINKER968]

If the Surveyors in San Antonio require the 0 placement, then the ones out of Beaumont, Texas do also. I agree that it is very confusing and I don't see the need for it since the objective is to list the frequency of the actual visits being made by the nurse. I appreciate the information because we are expecting state any day now for our annual inspection.

[NRSKarenRN]

Not a requirement of Philadelphia area surveyors.

Now if visit pattern says 1w9 and you DON'T do a visit at all that week, better have a note in chart why visit not done.

[jeanneb1]

Wouldn't it be lovely if all state surveyors simply followed the Medicare guidelines and didn't lend their own interpretations to determine "findings"? Tinker, good luck on your survey -- We've been expecting ours since December........ running just a tad late! Jeanne

[Chopper]

There is a lot of info out there to support not using a zero frequency, and you could certainly justify the argument against them to a surveyor. It just doesn't make any sense. I know in all the teleconferences I have listened to and material I have read...NO "0" frequencies.

Chopper