Restorative Program -- Help!

[Wiscrestore]

I've been the Restorative LPN ever since the inception of the Resotrative Program at our 350+ bed facility in Wisconsin a year and a half ago. Things were going rather well with our Level II programs and we had formed a very effective link between our therapy and nursing departments. Then, just as we were gearing up to formalize the Level III, or maintenance, program, our DON (who had initiated the Restorative Program) quit without notice. Incredibly, no one else at our facility knew anything about restorative nursing and I am left holding the ball at a time when our facility is looking to make major cuts across the board due to a budgetary crisis, and our current DON has been quite clear about her disinterest in the program.

So now I find myself in the position of having to justify our program strictly in terms of monetary reimbursement. Other than a few Rehab Low categories that have involved our program, our benefit to the facility, though very clear to all but those weilding the budgetary knife, is far too indirect to convince those who will make the ultimate budgetary decisions. And though I'm getting incredible support from our MDS coordinators, the unit nurses and all of our therapists, they all have different ideas of how the Restorative Program should operate, and I have nothing but my own gut instinct to counter with.

So all that said, my problem is two fold: I'm in desperate need of more general knowledge. My only guide is an old publication by Collard, and I am desperate for some resource to turn to for simple questions such as "can an RNA work with more than one resident simultaneously in a dining program" or "can some simple PROM exercises be counted as part of an ambulation program." Are there any publications that any of you could recommend, or are there online resources available? Second, does anyone out there have any recommendations for securing more Medicare and Medicaid reimbursement for restorative nursing, or at the very least, how to make the argument for it's existence in an environment of budgetary slashing?

Finally, since July Wisconsin has enacted a PPS system of reimbursement for Level III or maintenance programs. I'm under incredible pressure to come up with some kind of numbers for just how much a facility might get reimbursed for each program developed. Does anyone have any rough figures for this? So far I've been unable to find anything at all.

Any and all help would be much appreciated!

Bruce

[takenbyjoy]

Hi Bruce,

While I am (and have been for eons!) a Rehab Nurse, I'm not that familiar with Resorative Care Programs. I would suggest you post your question to the list serve for rehab nurses....available at the Association of Rehabilitation Nurse site, under the Professional Resources heading. You would probably get some wonderful feedback there. Good LUCK!

[CoffeeRTC, BSN, RN]

Try posting in the geriatric forum too.

[nurseangel31_03]

From what I have learned with working on bulding up are program you can only have 4 in a group to 1 RA.A good way to make your restorative program gain money is to get with the person that does the MDS and find out who has there MDS when so that you can be sure that they get all the restorative they require for the 7 day peroid of the MDS. In order for it to count and be payed you have to be sure that they get at least 15 minutes of restorative time per day, but it doesnt have to be every day it just has to be 15 minutes.I am working on getting are program up and going here in rural kansas for are LTC. Check out the Association of Rehabiliatil nusring. As we build are program I wil try and give you some ideals.