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coding isolation

MDS   (5,746 Views | 9 Replies)

crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

10,697 Profile Views; 904 Posts

I am back in the MDS game! I guess I am not obsolete after all, lol. So, of course, I have questions with these changes. I have a resident on isolation because of a c diff infection that was found last week. She is symptomatic with severe diaherra, charting and orders are in place, she is in a private room and she is on contact iso. From everything I've read in the manual and online this would be coded as isolation on the new MDS. The problem is my partner says no, we can't code because she is only on contact isolation? I also talked with our corp. MDS person and she says the same thing. Can't be coded because its only contact. What am I missing here?

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Talino specializes in ER CCU MICU SICU LTC/SNF.

946 Posts; 16,025 Profile Views

The key is "strict isolation" and meets all 4 conditions. The 4th one is usually the clincher -

4. The resident must remain in his/her room. This requires that all services be brought to the resident (e.g. rehabilitation, activities, dining, etc.)

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crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

904 Posts; 10,697 Profile Views

This resident is recieving all services in her room including rehab.

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Talino specializes in ER CCU MICU SICU LTC/SNF.

946 Posts; 16,025 Profile Views

Then it's time to show which of the 4 conditions they think the resident failed to meet. RAI pp O4 - O5

Based on your evidence, I am inclined to believe the resident met the criteria.

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113 Posts; 3,589 Profile Views

Question: residents with c diff and on contact prec do leave their room where i work and does rehab outside their room . They join other residents during meals. Does this depend on policy? I'm missing something here..

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PsychNurseWannaBe has 7 years experience as a BSN, RN and specializes in Psych, LTC, Nursing Management, WCC.

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If the resident leaves the room for any reason... then it can not be coded as isolation. Standard precautions do not count as isolation. Everything must be provided to the resident in strict isolation. I run into a problem on my unit because 2 rooms share a bathroom. Therapy must be provided to the resident in their room. Meals must be provided to them in their room and I do not believe they can even come out for a shower. They would get bed baths. PPE outside of room for staff.

C diff never leaves their room where I am at. They are room trays and get paper plates that get bagged and chucked. Special linen requirements with bagging linens up. Therapy in room with contact isolation. Allowing residents with C diff to do rehab in the gym is disgusting. If the resident has poor hand hygiene they will spread it every where.

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crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

904 Posts; 10,697 Profile Views

Spoke with another person higher in the company yesterday about this. She says, and I quote "we never code contact isolation because it is just standard ppe". I am just not getting this! Why don't they want the extra money

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imkaren2 has 21 years experience and specializes in MDS/Medicare.

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It's standard precat in our facility too, and some of our folks have ESBL, VRE or MRSA with it and its still standard. Basically if it's strict isolation, they go back to the hospital for reverse iso. is what we are told. Otherwise we do everything else standard.

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crissrn27 has 8 years experience as a RN and specializes in nursery, L and D.

904 Posts; 10,697 Profile Views

So why have this item on the MDS at all? If contact, droplet, etc don't meet the criteria then the only people who could code it possibly are the ones in swing beds.

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PsychNurseWannaBe has 7 years experience as a BSN, RN and specializes in Psych, LTC, Nursing Management, WCC.

745 Posts; 8,886 Profile Views

So why have this item on the MDS at all? If contact, droplet, etc don't meet the criteria then the only people who could code it possibly are the ones in swing beds.

If you meet all the criteria of strict isolation according to the RAI manual, then you could code. I don't know why your company does not jump on that.

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