How to chart to increase payment.

[june2009]

Here is my example: resident is independent in wheelchair and propells themselves about the facility ad lib. We chart that they are independent. However, sometimes a CNA might be headed in the same direction as the resident so they push the resident to where they are going. This is an assist and can be charteed as such. This will increase payment for the facility. A lot of the staff do not know this and won't chart the assist. I know that there are ways to chart other things like this that will help to increase payment. Is there some kind of website I could go to to learn about ways to chart to increase payment for that resident? I am not talking about any kind of fraudulent charting, just taking credit for the things we do. Any info would be helpful. I've asked my Mrs coordinator but she is new and not sure about this either.

[chrisrn24]

I'm not a MDS person but if you're trying to get payment increased because someone is nice and pushes an independent resident, it seems phony to me...

You say you don't want to defraud anyone but then you say you deserve to be paid for it...

[amoLucia]

I'm not a MDS person but if you're trying to get payment increased because someone is nice and pushes an independent resident, it seems phony to me...

You say you don't want to defraud anyone but then you say you deserve to be paid for it...

I don't do MDS either. But this was my thought also.

I would also be concerned that could this drop in independence be considered as a major decline in status??? You know those ugly statistics that governing bodies keep that measure things like pts becoming incontinent after admission and developing decubiti after admission and losing weight ...

In your effort to gain some reimbursement, you've diminished (sp?) the status of your facility, at least on paper. Like you've just said that your pts are likely to decline.

And then wouldn't you have to get Therapy involved for change of statusfor this pt? Then when they evaluate, the pt can still independently wheel himself. Therapy eval doesn't match your classification. Then what?

(I hope others out here understand what I'm trying to explain.)

[june2009]

Settle down guys. I'm only talking about taking credit for the things you do, not realizing that if you chart it the facility can get reimbursed for it. And yes, if I am nice and push a resident to the dining room, that is an assist.

[Gaby63]

Correct, take credit for what is done, regardless of reasons. However, only late loss adls affect reimbursement , bed mobility, transfer, eating and toileting. That being said, we do actual coding training with each new hire and pair them with a seasoned cna and periodic in servicing . We still come up with errors and we do go back and check with the team about the actual level of assistance provided. As far as QM goes, you wouldn't suddenly drop the whole population to trigger, would you?

[Gaby63]

Quick ex: independent for eating, night shift cna holds their water cup for them to drink , no longer independent....this came from one of our cna that we talked to because we thought she was coding incorrectly as dependent. She said that after having to change sheets for this patient x2 because of spilled water she now holds it for her. She was correctly coding and taking credit for it.

[june2009]

Gabby63,

I'm not sure of what you mean when you say "drop the whole population to trigger." Sorry but I'm not an Mrs nurse and haven't had much DON training either?