Ask Diane: How do I code pain managed with prophylactics?
Q: I am having a hard time understanding why we are coding for pain when nurses are managing pain by administering prophylactics PRN (“as needed”) in anticipation of pain. In this instance, does the MDS nurse have to code pain daily?
Diane: Coding pain frequency under the MDS 2.0 is based on how often the resident complains or shows evidence of pain. Coding for frequency is not affected by the way pain medications are administered, e.g., as a prophylactic.
It’s important to remember to ask all residents about their pain. With the new pain management guidance and investigative protocols under F309, which CMS is expected to release at any moment, surveyors will soon be investigating whether nursing facilities are assessing pain accurately in all residents. We’ll post more information about F309 as it becomes available at MDSCentral.
« Nursing home specialists: Can they improve care? | Home | Updated MDS 3.0 timeline appears briefly on CMS Web site »
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Diane Brown
Diane Brown is a long-term care regulatory specialist and lead educator for HCPro's MDS 3.0 Boot Camp and Medicare Boot Camp-Long-Term Care Version. She is also a long-term care consultant with over 25 years of operational experience in healthcare. For Diane's complete bio, visit the About page.
Diane has written 240 posts.
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Interviewing Essentials for MDS 3.0 and QIS
This 48-page training guide cuts through the theory and delivers step-by-step ways to build and improve interviewing skills. Whether your staff members have prior interviewing experience or interviewing for the first time, they’ll enjoy author Diane L. Brown’s interactive approach to interviewing.
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Competency Management in Long-Term Care: Skills for Validation and Assessment
Competency Management in Long-Term Care: Skills for Validation and Assessment is the perfect solution to your competency challenges. This practical, easy-to-use manual and CD-ROM set provides the logic behind competency validation and offers guidance to instructors about how to test staff competencies effectively and efficiently. Each competency can be found on the companion CD-ROM for quick, on-the-go access.
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Comments
In reference to the ARD date question: it makes sense to me to allow the day after. You may capture info up to the 12 MN time by interviewing the day after that otherwise would have been missed. The day after, information you are obtaining is usually still pretty intact (in the minds of the cognitively intact, at least – any longer can get foggy), and it is information clearly referring to the ARD observation period. Your documentation should clearly reflect this, also. As well, I’m sure CMS recognizes that it may not always be possible to get that interview on those two days every time due to MDS coordinator (and other disciplines)work challenges. That extra day gives that leeway without compromising information obtain, at least typically unless they have cognitive issue that would require alternate information gathering anyway. That’s my take on it, anyway. Have a Great day!
if the Nurse for Restorativce is Rehab certified (CRRN) do she need to take the Restorative nurse 60 hrs certification to be the restorative nurse in a Nursing Home
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