Nail Down How to Code ADL Help Provided With Mechanical Lifts
Find out when you would not code total dependence in G1. Suppose a resident requires a Hoyer lift for transfers. How would you code this ADL in Section G1 of the MDS 2.0? When using a Hoyer lift, "someone usually operates the lift and another person helps position the resident in the sling," says Christine Twombly, RN, a consultant with Reingruber & Company in St. Petersburg, Fla. "Both of those staff members are physically assisting the resident. Thus, you'd code for two people" in Column B. "There's also a standing lift which requires the person to participate," says Twombly. Key: "If the person participates at all in using the lift, code extensive assistance [for weight-bearing support provided three or more times] -- not total dependence." Coding rationale: Coding total dependence requires "full staff performance of the activity during the entire seven-day period," states the RAI User's Manual. Thus, "if staff performed an activity for the resident during the entire observation period, but the resident performed part of the activity himself/herself, it would not be coded as a "4 (total dependence)," the manual instructs. Watch out: Overcoding ADLs can cause residents to go in the wrong RUGs, leading to payment recoupments, not to mention survey and compliance woes.
