coding restorative and rehab for Med. A

[golflinda2214]

Can a resident be receiving restorative nursing (section P3) along with skilled OT, PT, ST, and/or Resp Therapy) and all of the time coded in section P ? My restorative nurse feels that restorative can't begin until skilled therapies have finished, I say "'not true". Can someone enlighten us? Thank you.

[Talino]

this is what the rai says...

"generally, restorative nursing programs are initiated when a resident is discharged from formalized physical, occupational, or speech rehabilitation therapy."

"rehabilitation/restorative care - included are nursing interventions that assist or promote the resident's ability to attain his or her maximum functional potential. this item does not include procedures or techniques carried out by or under the direction of qualified therapists, as identified in item p1b."

if a formalized rehab program does not cover other areas a resident may benefit from, then a rehab nsg. program can be initiated during the same period.

example:

resident receives pt for transfer and mobility training and st for communication techniques.

rehab nsg. provides rom exercises and skills practice in bed mobility, toileting, dressing, etc.

in a med a scenario, rehab nsg programs become essential when formalized therapies are only provided 3 days/week (minimum 45 mins). it does not improve the rug score when therapies are already provided 5 days/week (150 mins minimum).