Gaby63

Have to wonder what kind of budget allows a "Med A documentation nurse".....never heard of one either.... still, if a job description and duties are not being followed, then address, correct, educate, fix or terminate.

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.

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?

I work as an RNAC in LTC and would appreciate feed back on a wound issue that has come up. We have a resident that has had a chronic pressure wound that was initially staged as a 4, about 2+ years ago. Now measures 0.2x0.2x0.2 and hasn't changed for the past year. Typically wound rounds are done weekly by wound team and wound consultant and tracked accordingly. The team and consultant have now classified this wound as "resolved with a defect" and will no longer track. I'm struggling with this description and not comfortable coding it on a MDS as "healed" since that means completely epithelialized.... is "resolved with a defect" accepted terminology in the wound world? thanks!

Thank you, Talino....I'm grasping here at the word "entitlement".... This resident became eligible for Medicare in 2000, wasn't aware of it till recently, after being cut by an HMO in another facility after only about 19 days, then came to our facility.....so MC effective 4/1/14 is the date we have to go by, not the year 2000 eligibility, correct? I'm just trying to help out a family whose finances are worn thin .....

A recent admission Medicare became effective 4/1. Qualifying hospital stay 3/5 till 3/11. Please help clarify which is correct. 1) no, because hospital stay must be AFTER Medicare becomes effective. 2) yes, because it is within a 30 day window of hospital stay. thank you, and it would help also if anyone could point out this is covered. G