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2014 OBRA Assessment Scheduling Calendar for MDS
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The 2014 OBRA Assessment Scheduling Calendar for MDS shows the next quarterly or annual assessment date for each one of the 365 days of the year.
Long term care Restorative Nursing programs will see some big changes with the expansion of Medicare to cover Maintenance Therapy.
“Coverage of skilled nursing and skilled therapy services does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care.” CMS announced this week.
“Skilled care may be necessary to improve a patient’s current condition, to maintain the patient’s current condition, or to prevent or slow further deterioration of the patient’s condition. The concept of skilled therapy services can similarly involve not only services that are restorative in nature but, if certain standards are met, maintenance therapy as well.”
Maintenance Therapy is justified, says CMS, to prevent or slow a decline in condition.
Previous standards required that skilled nursing services result in an improvement to a resident’s condition to qualify for Medicare reimbursement.
Maintenance Therapy and Restorative Nursing Manual Updates to Clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) Coverage, Department Of Health And Human Services, Centers for Medicare & Medicaid Services, Implementation Date: January 7, 2014
FAQ: Medicare Beneficiaries May See Increased Access To Physical Therapy Or Some Other Services, Kaiser Health News
The nursing care plan goal can be to prevent a potential problem from occurring, to maintain a present status or level of functional ability, or to resolve a currently existing problem. Goals are usually stated in terms of an action the resident will perform. Elements to focus on in writing the goal are that it is:
Appropriate – for the resident’s needs, strengths, abilities, and cultural background
Realistic – reasonably attainable
Measurable – able to be objectively observed and evaluated
Resident centered – stated in terms of the resident’s actions
Time framed – gives a target date or time estimate for attainment of the goal
Individualized – to the resident’s unique deficits, traits, and preferences
Specific – each problem has a goal specific to it, although each problem may have more than one goal
Resident will wash face and hands during morning care every day.
Resident will verbalize understanding of the need to comply with diabetic diet.
Resident will lose one pound per week over the next thirty days.
Read more about how to write nursing care plans in the book Complete Nursing Care Plans for Long Term Care - 143 nursing care plans in the book and on the CD can be made resident specific and converted to I-care plans in one click.
Nursing care plans are blueprints for residents’ entire care needs, and direct the actions of all health care team members. Written nursing care plans are usually arranged into the three parts of Care Plan Problem, Care Plan Goal, and Care Plan Interventions.
Problem statements are traditionally based on a nursing diagnosis. The nursing diagnosis is a problem that nurses can identify and treat. Medical diagnoses can be part of the nursing care plan problem statement, but not the actual problem itself. The most commonly used nursing diagnoses are the ones approved by NANDA, the North American Nursing Diagnosis Association, and are grouped by functional health patterns.
The goal can be to prevent a potential problem from occurring, to maintain a present status or level of functional ability, or to resolve a currently existing problem. Goals are usually stated in terms of an action the resident will perform.
Interventions describe specific actions taken by the staff to achieve the stated goal, and are based on standards of clinical practice. Like the goals of nursing care plans , interventions need to be specific, measurable, appropriate, and realistic. Interventions are worded in terms of what the staff will do to assist the resident to meet the stated goals for the problem.
Evaluation is an ongoing activity that examines the problem itself, the goals, and the interventions to determine if they are still applicable or if changes to the care plan need to be made.
See how these principles are applied by viewing these sample care plans: