"Top of the Charts"
"Nursey Nurse"
"I Would Not Do That If I Were You"
"As Referred to"
"Because I Said So"
100
If an RN opts out of using the documentation templates, they may omit this information in their note.
What is nothing? (Everything in the template must be included in a freeform note.)
100
John's throat is a "little sore" and he wants the RN to look at it. She does and notes it is really a stage 4 pressure injury. Since she can't "un-see" this, she will need to have the person do this.
What is have the person call their clinic and speak to a nurse or a physician while the RN is present?
100
Beth has MS and has a few bad days a week, typically two, where she needs help with her bath. She manages fine the other days. This is the number of days you should mark "needs help with bathing" on the PCST.
What is zero? (Since her need is intermittent and you can't staff around it, she will need to use SHC for this care.)
100
Mary has no workers and wants to begin the assessment process for SDPC. This is when Mary might be seen.
What is when she has a worker in the hiring process?
100
These are the few things the RN must see at every assessment visit to ensure that cares may be completed in that area and that these objects are safe.
What is the bathroom, bedroom and equipment?
200
As a busy RN there are times when charting may be late. This person must be notified in writing if any notes are to be late (over 48-hours).
Who is the RN Supervisor?
200
Jack now has HTN and wants education on this. The RN used to be a home health RN. She is so helpful she provides education and ideas on lowering Jack's B/P, but she should have referred him here for education.
What is his primary care clinic?
200
**DAILY DOUBLE** A person reports they have to stay with their son through all of the meals as he will not eat and pitch his food and they need to cue him at times. You mark this on the PCST.
**DAILY DOUBLE** What is a B?
200
Mitchell likes to hop between SDPC and MAPC. He was recently disenrolled due to having fraudulently filled out timesheets for SHC. This is how long Mitchell might have to wait to get back into SDPC.
What is forever? (History of fraud precludes you from SDPC services.)
200
Laurie moved into an AFH that is owned by her Adoptive Mom. The RN has to determine if this is allowable under the 1915 J waiver. This is what she will tell the Adoptive Mom.
What is not allowable? (It is not a blood relative so she may not reside in the AFH and have SDPC.)
300
During an audit the State noted that there was nothing charted for an overdue visit. The RN reports to her Supervisor that she did go on the visit but just has not charted. Sadly, the State will say this.
What is the visit never happened?
300
Betty has active TB and admitted to her RN that she is very contagious. The RN leaves the visit and does this.
What is call HR and her Supervisor? (They will follow up with public health, etc.)
300
Joe has dialysis and needs to have assistance with his shower on Tuesdays, Thursdays and Saturdays following his dialysis. Based on this, Joe's RN may mark this many days of care on his PCST.
What is three days a week?
300
Carol left SDPC to get assessed by MAPC. She is not happy with the hours she was given, calls the RN and wants to resume services. The RN will have to know this to determine if Carol needs a referral or when she may start back.
What is did they screen her and/or did they submit a PA?
300
Lloyd is staying out of state for three months. He may be able to get permission to use SPC if he is on 90-day visits and he doesn't miss one of these events.
What is his annual or his oversight?
400
When I worked at the hospital I was completed at the end of the shift and here I have to be completed within 48 hours. (What am I?)
What is charting?
400
As a nurse I like to know the medical status of everyone I see, and I also take their vitals. Besides a discussion with her supervisor, this savvy RN will most likely have this happen.
What is be written up? (This is a big liability and way out of our scope of practice.)
400
An RN suspects that a person is not being honest with what they can and can't do. The RN should require the person to do this to verify need.
What is demonstrate the task?
400
Anita wants SDPC in her home but will not agree to visits in her home. This might be the only way to placate Anita.
What is do the annual visit at home and her OV where she would like?
400
The SDPC representative can't attend the Initial Visit as they are out of town. The RN needs to deliver this news to the participant.
What is they can't be assessed?
500
I called to set up a visit; I went to the visit; I faxed an order; I called the IC to make a collateral; I calculated the PCST; and I requested a Prior Authorization - Whew! How many contact notes will I have to complete?
What is six?
500
Someone is using an unsafe transfer and not using equipment as ordered. The RN is legally responsible and has to provide education and this to the participant and/or worker.
What is training on the transfer?
500
Bill wears a depends at all times which staff change every two hours. He also is toileted every two hours but is dry. This is how the RN should mark this as he wears a depends all the time.
What is D? (Bill is not incontinent, he only wears the depends.)
500
There are two of me and we are here in case the participant needs help when their scheduled worker is gone on the lam.
What is a backup plan or workers?
500
Bob has moved from a house to a one room hotel and has meals on wheels. His hotel is considered an apartment. He has to be reassessed as his hours will need to be this.
What is reduced?
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