HmarieD

HmarieD

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All Content by HmarieD

  1. Is it legal to alter RN documentation?

    HmarieD replied to groverslisa's topic in Home Health

    Just addressing the incontinence issue... incontinence is incontinence is incontinence, doesn't matter if it's stress, urge, around the clock, etc. I would document in my narrative what type and with...

  2. Falsification of records?

    HmarieD replied to Super Nurse JoshuA's topic in Home Health

    That would be fantastic, unfortunately, it is a CMS rule that the OASIS assessment be based on the actual visit by the last OASIS qualified clinician to see the patient. Here's a quote from a CMS...

  3. Adult diaper with additional pad for night use??

    HmarieD replied to ambil's topic in Home Health

    "...As for the van Gogh effect, it may be a solution to use extra-long t-shirts that can be snapped or Velcroed at the crotch so that they can't get their hands inside their pants..." LOL, I never...

  4. Falsification of records?

    HmarieD replied to Super Nurse JoshuA's topic in Home Health

    Actually, the DC OASIS in this situation must be completed by the last OASIS qualified clinician to have seen the pt, and is based on that visit. So, in other words, if an RN saw a pt with a Foley on...

  5. How does this job look?

    HmarieD replied to nursalicious's topic in Home Health

    You should jump on it before someone else

  6. 2011: Update: New to Homecare? Info to get you started

    HmarieD replied to NRSKarenRN's topic in Home Health

    A great website for new home health nurses is homehealth101.com. Sorry, I don't know how to do a

  7. Discharge oasis vs Admission oasis discrepancies

    HmarieD replied to AnnemRN's topic in Home Health

    CMS (Center for Medicare and Medicaid Services) says you should not reference the prior assessment when completing a new assessment. In practice, everybody does it, and most agencies do review the DC...

  8. No longer homebound

    HmarieD replied to AnnemRN's topic in Home Health

    LUPA's are still being utilized. Your manager either needs a Home Health 101 class or they are trying to manipulate their staff into doing something fraudulent without your

  9. Pleural Catheters

    HmarieD replied to ski-nurse563's topic in Home Health

    HHA's are required to provide Medicare patients with all non-routine supplies except DME. This would come from the home health agency's budget. if you are hospital based, not sure how budgeting would...

  10. No longer homebound

    HmarieD replied to AnnemRN's topic in Home Health

    One of two things is going on - either your manager has a poor understanding of home health or they are trying to game the system. You absolutely can discharge this pt by phone. The only time that not...

  11. Talk About Your Feel Good Experiences!

    HmarieD replied to kilgorern's topic in Home Health

    I experienced the most amazing coincidence of my life working in home health. I was sent to admit a patient with terminal end-stage lung CA. There was discussion in the office prior to the visit that...

  12. Help me with a portacath question

    HmarieD replied to nsgnva's topic in General Nursing

    Check your state's Nurse Practice Act. Facility policy is one thing, but if you are restricted from performing a task in the NPA, you absolutely cannot do it regardless of agency policy. You should be...

  13. Odd question about death/deceased person's body

    HmarieD replied to kellyc034's topic in General Nursing

    I think that must be hospital policy. The only time this would have been an issue in my hospital career was one very sad and touching case. A woman in her 40's passed away with liver CA. She had been...

  14. Environmental Advice Needed

    HmarieD replied to ame222's topic in Home Health

    Have you considered making a referral, either to your local Agency on Aging if the pt is over 65, which can help the pt obtain homemaker services (and sometimes offer financial assistance with these...

  15. night shift advice...

    HmarieD replied to oncologynurse77's topic in General Nursing

    I worked straight nights at the beginning of my career (as most of us do) and it was difficult for me, but eventually I sort of got used to it. Then I switched to a day/night rotation and it was...

  16. Missed visits/no answer

    HmarieD replied to doxielady's topic in Home Health

    My company pays a nominal reimbursement for a no-show appt, but does not pay additionally to deliver specimens to the lab etc (other than mileage

  17. New to home care and need help!

    HmarieD replied to Second's topic in Home Health

    Hang in there, it will get better with time! I would recommend completing as much of the paperwork in the home as possible. In terms of the OASIS assessments, it may take some time to find a system...

  18. Homebound

    HmarieD replied to CapeCodMermaid's topic in Home Health

    I work in Illinois, but I think that Medicare guidellines should be universal for every state. Homebound as defined by Medicare means that you leave your home infrequently, for short periods of time,...

  19. How Safe is Home Health

    HmarieD replied to missea39's topic in Home Health

    I live in Southern Illinois. Loaded guns in the home are very common here, we just insist that the guns are kept "out of sight" during our visit. The only time we DC'd a pt r/t a gun was a very...

  20. How Safe is Home Health

    HmarieD replied to missea39's topic in Home Health

    I actually had to DC a pt because their rooster attacked a nurse causing an injury and the pt refused to put the rooster in a coop during our visits. Needless to say, I live in a pretty rural area. I...

  21. Client death and funerals

    HmarieD replied to SandBetweenMyToes's topic in Home Health

    I have attended a number of funerals and have always been welcomed with open arms. Most people seem especially touched that you care enough to go. Often in the last days or weeks of life we have more...

  22. mileage issue/home health issues

    HmarieD replied to icare4icu's topic in Home Health

    What? Are they providing a company car and paying for the fuel? If not... :redlight: RUN!!!

  23. Please Help Me With Questions asap.....

    HmarieD replied to Jan RN's topic in Home Health

    You will want to know: - What the geographic coverage area is and if you will be localized in one area or all over the place, how many miles nurses typically travel in a day or week (can make a big...

  24. Have you ever...

    HmarieD replied to alcrab01's topic in Nursing Humor

    In home health, my patient was resting in her tiny bedroom and didn't feel like getting up...no problem, we'll do the assessment here. I sat in the floor to do my charting, was getting up to get...

  25. Charting Bloopers

    HmarieD replied to AHarri66's topic in Nursing Humor

    In home health, I once charted "pt discharged home from hospital with assistance of "souse"...wearing "thigh high RED hose" (typos on computer charting) It sounded like those two had quite a night...