[Rexie68]

I don't know if it's the same in every state, but here in PA, case mix has a lot to do with out medicaid reimbursement. Restorative nursing programs can help. We just hired a new nurse supervisor who used to be a LTC educator (you know, did all the inservices) and she is also in charge of RNP. I'm going crazy with all the RNP programs she's cutting, not only because it's going to drop CMI and that will fall on us, but because the residents BENEFIT from these programs. I've even shown her the RAI manual, but she believes that maintenance or preventative programs do not belong in RNP. Today I spoke with the DON who said that it's not my job to second guess the RNP nurse (and I guess she's right....) and that whatever she decides is what we'll go by. The DON said that the RNP nurse would have to "fall on her face" a few times and be held accountable before she'd get the picture. I just find that unfair to our residents...and to our facility. Everyone thinks that the RNAC department is just after the money, but I wouldn't want someone to be on a program that isn't appropriate, and I wouldn't commit fraud. Darnit, if my MA resident needs that $700 med, she's going to get it....but if we can get a little more reimbursement with a RNP program that's appropriate and beneficial, then we should be doing it!! *sigh* I've been told to let it go...it's not my problem. Guess I have a hard time with that. (I held RNP together for 3 months while waiting for them to hire someone, and thought I had it running well, but....)

[noc4senuf]

Our restorative program does have residents that are on maintenance ambulation, ROM, ect. Even if they are only able to get 5-10 feet twice a day, they are still able to walk. The regs state to keep the resident at their highest practicable functioning level. If you don't keep these residents on a program, they lose the ability to walk. You will also lose dollars and cents on your case mix without those residents on programs. In MN we are also case mix and I don't know of any facility that is not going to have a many residents on the program that they can get.