skillable services

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New to MDS/PPS....trying to decide if a patient can be skilled under nursing and do an omra or not......I don't have much experience in what is skillable or not....Have a patient coming off therapy, but can she be skilled for her stasis ulcers? What about skilling for nutrition? Any links to where I can get some of this info? Driving me crazy :uhoh3: I'm not up to par on medicare skillable services in LTC...did it in home health.

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what do you mean by "skillable"? Are you saying can the patient be charged for skilled nursing care?

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in order to be a "skilled" patient under Med A, the patient must need care that requires the skill of a licensed nurse or therapist daily. Daily wound care, IV therapy, observation and assessment of many diseases, etc. The key to getting paid is in the documentation.

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I am new to MDS Too! I would love to see more conversation about this challenging subject here at AllNurses.

I joined the AANAC (American Association of Nurse Assessment Coordinators) to participate in their training modules at a discount. I have decided to take the Certification Course too. Here is their website:

http://www.aanac.org/

Off the top of my head, I do not think that Nutrition is skilled but I am deffinitely NO expert. I have several people who I can refer to at work to ask. Perhaps you could ask the Registered Dietician or RD.

The AANAC does have a link to sign up for free discussions regarding MDS. You do not have to be a member to join the discussion group. I joined the membership to participate in the training modules.

We MDS Nurses have so many titles. I prefer to use the title, Resident Care Coordinator and I like to think, and so far I have been able to, make improvements in the lives of our residents. I enjoy our residents and find the role interesting.

Good luck to you and let us know how you are doing. Again, I would love to see more conversation here at AllNurses regarding thsi topic.

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Specializes in ER CCU MICU SICU LTC/SNF.

Refer to your MDS RAI Manual Chapter 6.

To be able to do an OMRA, the resident must meet one or more of the conditions identified in the Hierarchical Classifications. Only the top 26 Classification (no lower than RUGs = CA) will qualify resident.

BUT, these clinical needs must be related to the condition for which the resident was treated for during hospitalization.

Stasis ulcer, if only one site, must be a Stage III or IV PLUS 2 or more treatments (M5a&b, c, d, e, g, h = checked) to qualify.

2 or more sites across all stages PLUS 2 or more treatments can also be covered.

Altho nutritional interventions alone may not meet the criteria, the condition for which nutrition is an integral part of the care plan may qualify.

I strongly recommend reading the chapter. There maybe conditions in there for which your resident may fit in.

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Talino:

Thanks for your response. It sounds like you know the RAI Manual inside and out; I am very envious. How long have you been doing MDS?

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Specializes in ER CCU MICU SICU LTC/SNF.
Talino:

Thanks for your response. It sounds like you know the RAI Manual inside and out; I am very envious. How long have you been doing MDS?

It's an ongoing education nightngale. The more you do it the more you learn. I started in late '89 when MDS was first introduced in NY. The discussion group you mentioned is an excellent resource to have regarding MDSs queries.

Do not despair, this is a very rewarding position and definitely learnable!

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