Rule of three

[glm777, BSN, RN]

How would you all code this scenario:

In the 7 day lookback period the resident's transfers are coded as such:

1 time - limited assist

1 time extensive assist

8 times supervision

4 times totally dependent

If I were to code the most dependent that occurred 3 times, I should code totally dependent. But I can't because it didn't happen every time. So would you code Supervision, since that is the only other code that occurred 3 times and basically ignore the totally dependent codes?

Or do you turn those totally dependent codes into extensive assist codes? (which I know we do when there are NO codes that are coded three times).

Looking forward to hearing everyone's opinion.

[Talino]

The following when factored:

• 8 times supervision
  
• 4 times totally dependent
  

... satisfy the instruction in p G-7

c. When there is a combination of full staff performance/weight-bearing assistance, and/or non-weight-bearing assistance that total three or more times—code limited assistance (2).

[glm777, BSN, RN]

But isn't that only if there are not three of any one code? In this case there are more than three instances of supervision.

[Talino]

If there are no three episodes (meaning each episode occured no more than 2x) at any given level, the code will be Supervision. Since there is 3 Total and 4 Supervision, the quoted rule applies.

Better yet, set aside the instructions. Go directly to the algorithm. The decision will only terminate into one level - Limited Assistance.