MDS Alert
Cut Through the Confusion for Assessing, Coding Delirium
PDF
How would you code this resident's behavior at B5 (Indicators of Delirium -- Periodic Disordered Thinking/Awareness)? Mrs. K is a 92-year-old widow of 30 years who has severe functional dependency secondary to heart disease. Her primary nurse assistant has reported during the last two days that Mrs. K has "not been herself." She has been napping more frequently and for longer periods during the day. She is difficult to arouse and has mumbling speech upon awakening. She also has difficulty paying attention to what she is doing. For example, at meals instead of eating as she usually does, she picks at her food as if she doesn't know what to do with a fork, then stops and closes her eyes after a few minutes. Alternatively, Mrs. K has been waking up at night believing it to be daytime. She has been calling out to staff demanding to be taken to see her husband (although he is deceased). Finally, on three occasions Mrs. K was observed attempting to climb out of bed over the foot of the bed. Examples of behaviors to be assessed and coded at B5 include the following: a. Easily Distracted. b. Periods of Altered Perception or Awareness of Surroundings c. Episodes of Disorganized Speech d. Periods of Restlessness. e. Periods of Lethargy f. Mental Function Varies Over the Course of the Day Coding: Code for the resident's behavior in the last seven days regardless of what you believe the cause to be, focusing on when the manifested behavior first occurred. 0. Behavior not present 1. Behavior present, not of recent onset 2. Behavior present over last seven days appears different from resident's usual functioning (e.g., new onset or worsening) Source: RAI User's Manual, chapter 3
MDS Alert
- Medicare:
Leaving These Key RUG Drivers Behind Could Put Your SNF in a Fiscal or Survey Bind
Most SNFs home in on the IV fluids and IV meds in the hospital lookback. [...] - RUG Calculation:
Will the Resident Go Into SE1, SE2 or SE3?
Find out how the points add up If the resident is coded for receiving one [...] - Risk Management:
Shore Up Pressure Ulcer Care With 'Lessons Learned' From This Real-Life Scenario
Find out if your facility is wide open to a similar disaster A few common [...] - Quizzer (Answer page 23):
Cut Through the Confusion for Assessing, Coding Delirium
How would you code this resident's behavior at B5 (Indicators of Delirium -- Periodic Disordered Thinking/Awareness)? [...] - Quality Improvement:
Solid Case Management Can Move Your Rehab Program to the Head of the Class
These fail-proof strategies address what ails many rehab programs -- and will get your RUGs jumping. [...] - Resident Assessment:
This resident developed a Stage 4 decub.
A resident with a reddened area developed a Stage 4 pressure ulcer (see the case [...] - READER QUESTION:
Can SNFs Still Count Rehab Provided by Therapy Aides?
Question: Our facility has heard rumors that changes in therapist assistant requirements mean we can't [...] - ADL Assistance:
Turn Bath Time Into Quality-of-Life and Care Time
A combo of strategies can make a big difference in resident behavioral and satisfaction outcomes. [...] - Tool:
Check Out This Pressure Ulcer Risk Assessment
Determining a patient's pressure ulcer risk can start with a solid assessment form, although you [...] - Coding Tipster:
3 Strategies Help Error-Proof Pressure Ulcer Dx, Coding
Ease the pressure for getting it right. Accurately coding pressure ulcers in Section M is [...] - Coding Quizzer Answer :
Cut Through the Confusion for Assessing, Coding Delirium
Answer: a. Easily distracted: 2 (present, new) b. Periods of altered perception or awareness of [...] - MDS & Coding NEWS
Prepare for ICD-10 now to get a step ahead of the learning and software curve -- [...]