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Section G

Posted

This may be a stupid question but here goes. When coding for ambulation or locomotion on an ambulatory wandering pt. can you use "supervision". They don't need supervison for walking, they need cueing because they don't know where they are going and as wanderers they really need to be supervised. Can someone shed a little light.

gonenutz

Specializes in LTC/SNF.

I was taught to code independent ambulatory residents on or off the unit as 0/1 because they are ambulating indepedently but if you or your staff observe them while ambulating at least once during that shift you can code as supervision. Just be sure and watch how you code the locomotion in resident room if no one is actually seeing that resident ambulate in the room. Hope this helps. Remember staff support only has to occur once during the assessment window.

So, basically, no one should really be coded Independently for ambulation as long as staff sees them one time per shift? Never knew this, thanks for the info.:yeah:

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

Seeing someone in the hall is not the same as supervision.

I would only code supervision if a staff person had to give direction, verbally cueing or motioning with thier hands(guiding without touching.

KristenLPN

Specializes in Geriatric/LTC. Has 4 years experience.

If they are a wanderer, then the risk is identified. Which means that they are probably on a 15 minute check, and that justifies as supervision, according to the MDS seminars. That is also your "proof". If they are in a walking restorative, or a walking activity, that also classifies as "supervision". As long as you are not hands on.

Seminars can teach/reinforce many things, but our main source must be the RAI Manual. Pg. 3-84 indicates how a person who requires cueing/supervision in ambulation should be coded. 1/0 not 0/1.

Walk in Room

Resident is able to walk in room, but staff member is available to cue and stand by during ambulation since the resident has had a history of unsteady gait.

Self Performance = 1 (requires supervision) Support Provided=0 (no physical)

Coding rationale: Resident requires staff supervision, cuing and reminders.

Walk in Corridor

Staff member must provide continual verbal cuing while resident is walking down hallway to insure that the resident walks slowly and safely.

Self Performance = 1 (requires supervision) Support Provided=0 (no physical)

Coding rationale: Resident requires staff supervision, cuing and reminders.

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