CHANGING TIMES
This is the industry standard when orders should be signed by the physician or non-physician provider.
What is 30 days?
Physician orders, services rendered in a patient’s place of residence, Homebound, Skilled Intermittent Need and Reasonable and Necessary, are examples of these.
What are Medicare Coverage Criteria or Eligibility criteria?
These 2 items on the POC should correlate
What are medications and diagnoses?
MSW and HHA are considered to be this type of service
What are non-qualifying services?
These are the M0 items on a SOC OASIS that contribute to agency reimbursement
What are M1033 – Risk for Hospitalization
and the M1800s functional questions?
This is the frequency for performing HHA supervisory visits
What is at least every 2 weeks?
Observation and Assessment, Teaching and Training, Performing Skilled Procedures and Management and Evaluation of the Plan of Care are examples of these
What are Skilled Nursing Services?
This item provides primary support for the most intensive service and justifies reasonable and necessary on the Plan of Care. It also is used for Clinical Groupings under PDGM
What is the Primary Diagnosis?
- Requires assistance of 2 to leave home
- Lives in second floor apartment without elevator access and unable to navigate stairs,
- Experiences severe dyspnea upon ambulating 10 ft and must rest are examples of these
What are homebound status'?
Pt has a new Colostomy and is sent home for colostomy-related care. How should the nurse answer the OASIS question M1340 “Does the patient have a surgical wound?”
What is “No”?
This is the minimum suggested frequency in which length, width, depth and wound characteristics should be measured.
What is weekly?
The verbiage “No answer to locked door” is used when documenting these.
What are Attempted visits?
This section of the POC justifies homebound status and supports Aide and therapy services
What are Functional limitations and Activities Permitted?
RN, PT, ST are examples of these
What are skilled, qualifying disciplines?
This number represents a patient’s clinical profile, based on Timing, Referral source, Clinical Grouping, Functional Status and Co-Morbidities. It is used to calculate agency’s reimbursement.
What is the Case-Mix Weight?
This is the minimum time when a Notice of Medicare Non-Coverage (NOMNC) should be issued
What is at least 2 calendar days?
Sudden weight gain, increased blood pressure, changes in mental status, or a newly discovered decubitus are examples of these
What are changes in condition?
This must be specific regarding your best guess as to how well the patient will achieve return to his previous level of function
What is rehab potential?
This is when the comprehensive assessment/OASIS must be completed when recertifying a patient
What are the last 5 days of the episode or days 55-59?
A patient is transferred to the hospital on day 38 of their episode and does not return back home. Which OASIS time point and other documentation needs to be completed?
What are an OASIS Transfer (TIF) and DC Summary?
This is how often the medication regimen must be reviewed
What is at least every 60 days or as often as a change occurs?
Case conferencing, HIPAA-secure texting, telephone calls to physicians and other providers are examples of these
What is Care Coordination?
This is the process of creating the most accurate, complete list of all medications a patient is taking and comparing it against current orders to ensure everything is correct, consistent, and safe.
What is Medication Reconciliation?
These are 4 items to include when writing a resume care order
What are:
Pt had a Right total knee replacement 8 days ago. During the initial assessment, it is noted that the incision has 14 staples, is clean, dry, intact and open to air. How should M1342 “Status of Most Problematic Surgical Wound” be completed?
0 – New or worsening (increased in size, depth, drainage, or new signs/symptoms of infection)
1 – No observable signs/symptoms of infection; clean, healing as expected
2 – Early/partial granulation
3 – Fully granulating
4 – Not healing
NA – No observable surgical wound
What is:
“1” No observable signs/symptoms of infection; clean, healing as expected?