imkaren2

I would consider keeping the patient on skilled also to prevent/manage skin issues, pain, physical and/or emotional, to name a few.

yes, thats exactly what the RAI says, I didn't have my hands on it at the time but knew that...so my question was how are other facilities handling that? I know I am not working around the clock!

As a rule only our admin and admission director can accept admissions, they accept them VERY quickly before someone else gets them!! I review online the preadmission screening, then when they are admitted, I look at the d/c summary sent from the hos...

I do all the medicare MDSs in the building and today my medicare census is 21. The facility has 154 beds so I also do about 30 long term care MDSs. I attend daily PPS, care plan meetings 2x weekly and several other weekly meetings and other jobs as w...

Medicare will cover her for rehab 3x/wk and 2 restoratives, I'd look into pain and if we are how often do we need to change her meds to manage her pain, how about the bleeding and what is being done with that and how often in a weeks time? All are s...

I thought so too but after reading the RAI in ch 2, it appears that the ARD needs to be set prior to d/c. Our company has stated that and I'm reading it that way also. Only then you are able to modify the ARD to the d/c date. The RAI is saying that ...

I'm wondering what other MDS and CCMs are doing in the case where your medicare patients are admitted late friday after you go home and are discharged to the hospital or expire before you return on monday and you aren't able to set and ARD. Are you ...

I'm just reading this now, We need to be closed by the 3rd of the month, mincluding those that came in at the end of the month. It doesn't make sense to us to hold up billing and bill the next month when the patient didn't come in that month. I am an...

I was managing 20-28 medicare and 6-10 managed care pts. and that was way to overwhelming and attending multiple meetings nearly daily. Our SNF is 154 pts and the rest are LTC, I have 1 other MDS person who did the rest of it. About 2 months ago the ...

My feeling is the eval counts as a day, and the next 2 days make 3 days without therapy. The person who said this rule doesn't apply to the 5 day, not so, if there is no therapy for 3 days, including weekends regardless if you are a facility with/ou...

We'd be admitting him too. I'd use the d/c date as the 5-day and combine them. 11/8/11. You'll want the RUG to cover for a day is what I'm told even though we don't charge for day of discharge.

It's standard precat in our facility too, and some of our folks have ESBL, VRE or MRSA with it and its still standard. Basically if it's strict isolation, they go back to the hospital for reverse iso. is what we are told. Otherwise we do everything e...

Our building is 154 pts. myself, RNAC, and a MDS person, we attend al of the careplan meetings, there are 3 at risk meetings, I attend 1 of them, she attends 2, I attend PPS daily, and keep up the management board daily, Monthly PI, and of course, we...

I love that goats smile! LOL:)

Hi Sheryl If I understand you correctly, your pt. went out to the hospital and returned, the day he returns is day 1 of his medicare stay. So now that 5day is set for the day the pt. went to hospital and is also the discharge assessment. Both of tho...

I will, I will be there on Monday, forgot to get it today. But no problem.

Ok, so maintain the RUG and no EOT or COT is required.

I have to say now with the new changes come oct 2011, my regional team has finally heard me. I now only have about 20 medicare, about 24 long term, I attend all of their care plan meetings weekly, attend daily medicare meetings. Attend what we call ...

I actually have one that I've used for years and still use. The alphabet is a little off but it works for me, now its been working for the H.I.M. who does the ICD-9 coding. Some are too old now but I will take down your email addy and send it to you....

Hi Karen What RUGs are you getting from those's assessments? You may/may not want to combine them. Your EOT trumps the COT.

This sounds like 2 questions so... 1) No COT required..same RUG. 2) Yes COT required, an increase in RUG, likewise, a decreased RUG would also require a COT assessment. Of note, the ADL score has no berring on the COT decision.

Well, doing an EOT will only depend on what that first RUG is, if it is a rehab RUG then yes you will need it, if there aren't enough minutes, or the ADLs are low the initial RUG may be a nursing one, in that case, an EOT to switch from rehab to nurs...

Wait! Is the amputation new? If it is, therapy shouldn't be out, they need to be shrinking it and doing rehab! Ok, good luck there.

If you anticipate therapy coming out very soon, I would look at setting an ARD on a day 1-6 to capture the highest RUG be it nursing or rehab. Then the clock starts. If you get a nursing RUG, you will probably keep it due to the IV and wound, and ski...

The COTs doesn't make the grace days obsolete exactly, depends on where they fall. If the RUG drops, you would want to set an ARD if possible in the window on a day before the COT to capture the downgrade, providing you can anticipate this. Lets say ...