Q&A: Can I notify a resident representative of discharge from skilled services by phone?

Question: Can I notify a resident representative of discharge from skilled services by phone? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: According to NOMNC Form Instructions: If the provider is personally unable to deliver a NOMNC to a person acting on behalf of an enrollee, then the …

Q&A: I have a resident taking a medication that is classified as an antineoplastic. Can I code chemotherapy at MDS item O0100A?

Question: I have a resident taking a medication that is classified as an antineoplastic. Can I code chemotherapy at MDS item O0100A? Answer from Forrest Deimel, RN: If the antineoplasm medication is used to treat active cancer, yes, code it. For example, I had a patient receiving an antineoplastic for …

Q&A: I was recently instructed to dash item K0100 if a resident has a PEG tube. Is this correct?

Question: I was recently instructed to dash item K0100 if a resident has a PEG tube. Is this correct? Answer from Janine Cortesa RN, BSN: The RAI User’s Manual does not state to dash if a PEG tube is used. It does state to evaluate for each of the issues listed. I …

Q&A: Can IV fluids administered in the emergency room (ER) or during surgery be included in Section K, items K0510 or K0710?

Question: Can IV fluids administered in the emergency room (ER) or during surgery be included in Section K, items K0510 or K0710? Answer from Carol Maher, RN-BC, CPC, RAC-MT: IV fluids given in the ER can be coded if given for nutrition or hydration, since the resident is still considered …

Q&A: Is there specific guidance regarding staff working in multiple facilities?

Question: Is there specific guidance regarding staff working in multiple facilities? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP: Currently, there are no federal guidelines specific to staff who work in multiple facilities. However, facility leaders should check with their state and local entities as well to see if …

Q&A: What are the requirements for restorative program notes?

Question: I was recently told that our restorative nursing programs needed monthly progress notes/assessments, but I have only been completing these quarterly. What are the requirements for restorative notes?  Answer from Melissa Brown, OTR/L, RAC-CT, CDP, CSRS: There actually isn’t any prescribed frequency for supervisory nursing summary notes. The RAI …

Q&A: Is a physician note of the diagnosis enough to support coding the diagnosis in the medical record?

Question: The physician listed avascular necrosis of the hip in a progress note but did not address this diagnosis in a treatment plan. The resident is receiving PRN pain medication for this, which has been administered in the look-back period. Is the physician note of the diagnosis enough to support …

Q&A: Is it acceptable to answer the PHQ-9 Mood questions directly in MDS section D if the signatures are prior to the ARD date?

Question: Is it acceptable to answer the PHQ-9 Mood questions directly in MDS section D if the signatures are prior to the ARD date (they usually complete the interview before, but code the MDS and sign after the ARD date)? Do we need to have separate documentation of the PHQ-9 …

Q&A: How can I be part of the Director of Nursing Services – Executive Advisory Panel (DNS-EAP)?

Question:  How can I be part of the Director of Nursing Services – Executive Advisory Panel (DNS-EAP)? Answer from AAPACN: If you are interested in contributing to AAPACN and serving on the DNS-EAP, please send a resume and letter of intent to Alexis Roam at [email protected] Want to read more Q&As? …

Q&A: Can daily monitoring of a wound vac fall under indirect skilled nursing services for observation and assessment of resident’s condition?

Question: Can daily monitoring of a wound vac fall under indirect skilled nursing services for observation and assessment of resident’s condition? Answer from Darlene S. Almand, RN, LNC, RAC-CT: In over 30 years of utilization review, I have never looked at a wound vac in an “isolated” manner. While a …