IV fluids and section G

[TigerxLiLy]

Ok- I have a corporate person telling me that on our case mix score for RUGS 3 allows IV fluids to give is 3 extra points in the eating ADL... is this true? My coworker who has been a MDS nurse for 6 yrs never heard of it...

She also claims that IVfluids while not a resident still counts towards the Extensive (SE) for case mix---

[Talino]

If the IVF is provided for nutrition and/or hydration purposes, then it should be factored in ADL Eating. Hence...

• If a formerly independent resident with Eating is put on NPO and IVF is the primary source of nutrition/hydration, Eating will be coded as "Total Dependence"
  
• If resident is independent with oral intake but requires IVF as a supplement, Eating will be coded "Extensive Assistance"
  

RUG III allows for IVF capture regardless where it was administered. RUG IV has more stringent requirements.

[TigerxLiLy]

In the instance if the person ate, yet required it IV fluids for dehyrdration, do you code eating as extensive or does it automatically give you the points towards it? We have not been coding extensive....

In section K of the MDS it has "while not a resident " and "while a resident"-- Our case mix auditor says that the "while not a resident" IV does NoT count towards a SE in RUGS III. Interesting.

[Talino]

In the instance if the person ate, yet required it IV fluids for dehyrdration, do you code eating as extensive or does it automatically give you the points towards it?

Once IVF is used for nutrition/hydration, it becomes a component of ADL: Eating aside from the p.o. intake. Extensive is the correct code since the staff, not the resident, administered and managed the IVF intake.

Eating coding = ADL score (or points):

0/0 or 1/1 = 0

2/2 = 2

3/2 = 3

In section K of the MDS it has "while not a resident " and "while a resident"-- Our case mix auditor says that the "while not a resident" IV does NoT count towards a SE in RUGS III. Interesting.

I believe you have this in reverse. IVF received "while not a resident" is not factored in the case mix with RUG IV. RUG III does not have the same restriction, thus, allowing IVF capture regardless where it was given resulting in SE (ADL index met).