TIP OF THE WEEK
Question and answer from the American Association of Nurse Assessment Coordinators - AANAC'S PPS Review
Q: When coding for pain, what point in time are we looking at--any time during the week of observation that the pain assessment is done? If the resident takes a PRN med that controls his pain several times during the week of observation, is he coded as having pain? If the PRN medication is effective, do you answer the pain question after the pain med takes effect or before?
A: What you must look at is the objective presence of pain and its level regardless of pain management interventions. The assessment covers 24 hours per day, 7 days per week, across all disciplines for the entire observation period. In MDS terms, that translates to this: During the 7-day observation period, if a resident has mild pain 5 days and moderate pain 2 days, the correct coding is "daily moderate pain." If the resident has no pain 5 days and moderate pain 2 days, the correct coding is "moderate pain less than daily."
Current clinical practice recognizes that people should not have to be in enough pain to have to ask for pain medication before interventions are implemented. The goal of pain management should be to provide a consistent level of comfort while maintaining as much function as possible. On the MDS, we are rewarded for our pain-management efforts by coding "no pain" or "mild pain less than daily" when our efforts are successful. We are rewarded professionally by providing compassionate care to our residents.
RESOURCE SPOTLIGHT
Pain Treatment Algorithm Cards (PDF)
This is a set of three laminated pain treatment algorithm cards for care planning. Includes algorithms for mild, moderate and severe pain treatment; a decision tree for pain care, reference card, and non-pharmacological approaches to pain management. Measures 5 1/2" x 8 1/2".
IN THE NEWS
THE RIGHT CURE FOR AILING ELDER CARE?
June 11, 2007 -- Business Week -- Nurse practitioners, already used to serving poor and rural populations where doctors are scarce, may be more inclined to take on the aged. "They are filling in the gaps and are pretty much on the front lines in taking care of elders," says Dr. Wayne S. Saltsman, chairman of geriatric medicine at the Lahey Clinic in Burlington, Mass. Read more >>
June 6, 2007 -- Kaiser Network -- Hospitals participating in a Medicare pay-for-performance pilot program were not significantly more likely than non-participating hospitals to provide better treatment, according to a three-year study published in the Journal of the American Medical Association, the Wall Street Journal reports. For the study, researchers at Duke University compared the treatments and outcomes for five conditions at 54 hospitals participating in a Medicare pay-for-performance pilot program with treatments and outcomes at 446 hospitals not participating in the program. Read more >>
ELDERLY DIABETICS RAPIDLY LOSE MUSCLE STRENGTH
June 5, 2007 -- Reuters -- Elderly people with type 2 diabetes have an accelerated loss of skeletal muscle strength compared with their counterparts without diabetes, Korean and U.S. researchers report in the current issue of Diabetes Care. Read more >>
ADDING MEDICATION IMPROVES RECOVERY FOR ELDERLY WITH DEPRESSION, SAYS PITT SCHOOL OF MEDICINE STUDY
June 1, 2007 -- EurekAlert -- Adding a medication to a standard treatment regimen for major depressive disorder in the elderly improves chances of recovery in those who do not adequately respond to the first-course therapy or who relapse from it, finds a University of Pittsburgh School of Medicine study published in the June issue of the American Journal of Psychiatry, the official journal of the American Psychiatric Association. Up to 84 percent of the elderly who experience depression either fail to respond to first-course treatment or relapse during the first six to 12 weeks of treatment. Read more >>
CMS PROPOSES LIST OF NO-PAYMENT CONDITIONS
June 1, 2007 -- AHQA -- The Centers for Medicare & Medicaid Services (CMS) suggests eliminating hospital reimbursement for a select group of preventable complications in a proposed rule published in the May 3 Federal Register. Read more >>
OHIO KEPRO EVENTS
THE GOOD APPLES: TIPS FOR ATTRACTING AND RETAINING THE RIGHT EMPLOYEES
In this half-day workshop, we will delve into key strategies for improving workforce retention in the nursing home, including:
- The impact of turnover and absenteeism on an organization and what you can do about it.
- Strategies to improve the hiring and orientation process.
- Motivating employees and improving staff satisfaction.
- Setting goals and measure improvement in workforce retention.
Who should attend: Directors of Operations, Directors of Nursing, Nursing Home Administrators, Staff Development, and Human Resources.
7/11 – Cincinnati | 7/24 – Wooster | |
7/12 – Springfield | 8/7 – Boardman | |
7/17 – Cambridge | 8/15 – Columbus | |
7/19 – Sylvania | 8/21 – Wellston |
Save these dates and register today!
INDUSTRY EVENTS
30th Annual Nursing Assistant Convention and Recognition Program
June 20, 2007, Akron, OH
Navigating the MDS Through the Ohio Medicaid Reimbursement System
Ohio Department of Job and Family Services
June 11, 2007 or August 23, 2007
Call Cheryl Robertson at (614) 466-9088 for more information.
Medicare Learning Network: Learning resources and products for the healthcare professional.
Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
Ohio Health Care Association Events
An archive of The Nursing Home Weekly Update is available on our Web site. Click here >>
