BED MOBILITY
Mr. Claus is resting in bed and has been laying on his right side for the past 2 hours. According to his care plan, he is to be encouraged to reposition approx. every 2 hours. On your shift, you reminded him to turn to the left side 1 time and to his back 1 time. How do you correctly code self-performance and support for bed mobility?
What is supervision/no set up or physical help Rationale: Resident completed the ADL with oversight, encouragement or cueing; eyes are on the resident, only talking (cueing) was provided & no touch or hands on the resident.
During your shift, across the room, you observed your resident, Mr. Banks rising from his dining room chair and leaving the dining room table without any team member assistance. How do you correctly code self-performance and support for transfers?
What is independent/no setup or physical help from staff. Rationale: Resident completed the ADL with no help or supervision from staff; no hands on resident/no touch/no oversight provided.
During your shift, Mr. Smith was independent with brushing hair & teeth, shaving, washing face & hands. He required extensive assist with peri-care. How do you correctly code self-performance and support for personal hygiene?
What is independent/no set up or physical help? Rationale: The resident was independent in tasks of personal hygiene. Peri-care is capture/documented in the ADL of toilet use.
Mr. Austin has Parkinson's disease and needs weight bearing assist of 2 team members to transfer using the sit/stand lift. During your shift, you and another team member transferred Mr. Austin from his bed to the wheelchair using the sit/stand lift. He was able to hold the hand grips during the transfer. How do you correctly code self-performance and support for transfers?
What is extensive/2+ persons physical assist? Rationale: Extensive assist is defined by the resident involved in the activity; the resident was able to bear weight and hold the hand grips on the lift during the transfer; (HCR policy requires 2 team members assist when using any mechanical lift)
The team member supports some of the weight of the resident's hand while helping the resident to eat (e.g. lifting a spoon or a cup to the mouth), or performs part of the activity for the resident. How do you correctly does self-performance and support for eating?
What is extensive/one person physical assist? Rationale: One team member is supporting some of the weight which meets the definition of extensive; limited assist is non-weight bearing.
At breakfast, Mrs. Wyldestyle is anxious to go to the dining room for her bacon. You must bring the wheelchair next to the bed and then remind her to hold on to the wheelchair and position her body slowly. How do you correctly code self-performance and support for transfers?
What is supervision/set up help? Rationale: Resident completed the ADL with staff cueing; no touch or hands on resident; team member "set up" the wheelchair next to the resident for the transfer.
Mrs. D. receives all of her nourishment via a gastrostomy tube. She did not consume any food or fluid by mouth. How do you correctly code self-performance and support for eating?
What is activity did not occur: Rationale: The resident did not participate in eating and/or administering of her tube feedings. She required full staff performance of these functions. The nurse provides the tube feeding.
Mrs. Hill is able to transfer from the bed to the chair when she uses her walker. The team member places the walker near the bed & then assists the resident by guiding her (non-weightbearing) as she transfers. How would you correctly code the self performance and support for the ADL of transfers?
What is limited assist/one person physical assist Rationale: Resident requires team member to set up her walker & provide non-weightbearing assistance when she is ready to transfer.
Mr. Solomon begins eating each meal daily by himself. After he had eaten only his bread, he stated he was tired and unable to complete the meal. One staff member physically supported his hand to bring the food to mouth and provided verbal cues to swallow the food. The resident was then able to complete the meal. How do you correctly code self performance and support for the ADL of eating? How would you code the ADL of eating?
What is extensive assistance/one person physical assist? Rationale: Resident partially participated in the task, however one staff member provided weight bearing assistance with some portion of the meal.
Resident Katy Miller is physically debilitated due to her diagnosis of multiple sclerosis. Two team members must physically lift and transfer her from the bed to a reclining chair daily using a mechanical lift. Katy is unable to participate in any way. How do you correctly code self performance and support for transfers?
What is total dependence/two person physical assistance Rationale: The resident was unable to assist and two team members provided total weight bearing assistance for the ADL task of transfers.
It is 2am and you have just assisted Mrs. Brown to/from the bathroom. She is back in bed and you have offered her a drink. You needed to hold the glass and position the straw in her mouth while she drinks. What is the correct code for the ADL of eating?
What is total dependence/one person physical assist? Rationale: Full staff performance was required to hold the glass and position the straw for the entire task.