medicare assessment

[graceRN67]

Have a resident who was on hospice went to the hospital for surgery had 3 midnight stay family wanted her medicare for pt/ot, resident returned to facility on 7/5 ot evaluated on 7/5, resident did not have therapy on the weekend 7/6 and 7/7, monday resident tells family she does not want to do therapy wants to go back on hospice. so resident goes back on hospice 7/8. can i do a 5day on this resident? does the resident go back to private pay dating back to 7/5. i dont see how i can skill this resident for medicare.

[Talino]

What type of surgery?

Skilled observation and monitoring of the patient for possible adverse reaction to the operative procedure, development of phlebitis, skin breakdown, or need for the administration of subcutaneous Heparin, is both reasonable and necessary.

30.2.3 - Specific Examples of Some Skilled Nursing from p23

[graceRN67]

broken femur about a month ago then had to go back into the surgery beginning of July because x ray showed screws were not holding.

[Talino]

You're covered. More than likely it involved internal fixation (re-pinning). MD simply certifies skilled nursing observation for adverse reaction from surgery. Nurses notes documents presence/absence of bleeding or clots on surgical site and s/s of infection.