Turn & reposition program

I'm not being a smarty pants, but isn't turning & repositioning considered a basic, fundamental standard of care??? Just like keeping the HOB elevated with enteral feedings?

I doubt that you're using any kind of special bed/equip.

As another example - some facilities have been dinged for trying to count their nebulizer tx unless the nurse stays with the pt during the neb duration with chest sounds and pulse oximetry before and after tx. (Some facilities seemed to have not been challenged yet.) A neb tx by nsg is part of the medication administration process which is also standard care.

I know we all do so much in LTC for which we get no reimbursement only to have all our standard care be clumped together like one big mish-mashed soup! Even if we have aggressive prophylactic or restorative programs. It's not equitable that nsg can't be costed out like therapy. Personally, I think you're trying to push for reimbursement too hard. It would be nice though!

Just my 3 cents.

I guess my question should have been, " What does it take in order to be able to count a turn & reposition program on the MDS ? Or is the section just asking if we do turn them or not ?

RAI, M38

]TURNING/ REPOSITIONING PROGRAM ]Includes a consistent program for changing the resident's position and realigning the body. "Program" is defined as a specific approach that is organized, planned, documented, monitored, and evaluated based on an assessment of the resident's needs.

Organized/Planned

• ]Turn and position every 2 hours when in bed @ the following times: 8pm-back, 12am-right, 2am-back, 4am-left, 6am-back. Apply pillows in between legs when on sides.
  
• ]Check former side for irritation or color change on pressure points (specify site)
  

]Documented/Monitored/Evaluated

• ]CNA signs/initials at each specified time, enter comments on skin color
  
• ]Nurse reviews each documentation of CNA at end of shift and signs/initial
  
• ]Nurse performs a full body check once a month and updates care plan - "No breakdown noted on bony prominences, continue with T&P program"