Medicinal Nursing Needs Melissa A. Fritzman Program Administration Supervisor II Division of Long-Term Care and Quality Assurance Department of Medical Assistance Services Virginia Department of Medical Assistance Services
Slide 2Medical Nursing Needs You evaluate the youngster for what at present is happening. DMAS is seeing that most kids are meeting the practical criteria. Medicinal Nursing needs with the danger of position into nursing homes is the zone we hear and see individuals experiencing issues with.
Slide 3Medical Nursing Needs Different things we have seen while exploring enlistment bundles No documentation of need healthy reported Provider evaluation saying no restorative nursing needs Stating no danger of nursing office situation
Slide 4Medical Nursing Needs There are times that individuals are giving such incredible care to their youngsters that they get got in conundrum since they don't have skin breakdown, weight reduction, contractures and so on. We compliment these individuals for their dedication and diligent work.
Slide 5Documentation Examples of Medical Nursing Needs Seizures Is there pharmaceutical changes? Is there labs being drawn for solution levels? Any late seizure action both terrific mal or petite mal? Family noticed any clear gazes?
Slide 6Documentation Examples of Medical Nursing Needs Potential Nutritional Problems Documentation of weight reduction/pick up? Documentation of drying out? Is individual seeing a dietician or other wellbeing proficient on customary premise? Taking any supplements, Ensure, Boost, Gatorade, Pedialyte, booked snacks, and so forth?
Slide 7Documentation Examples of Medical Nursing Needs Potential for skin separate Documentation of red regions? Any open zones as of now? Utilization of restrictions or other gear that has in past brought about breakdown? Any unique things guardian might do, turning q2hrs, applying treatments, utilizing weight mitigating gadgets?
Slide 8Documentation Examples of Medical Nursing Needs Therapies Documentation of all treatments and where happening. On the off chance that kid is getting at school these are alright. If it's not too much trouble let families who may as of now have Medicaid realize that these treatments should be possible when not in school if requested by specialist.
Slide 9Review Process Screenings are audited by the DMAS earlier approval temporary worker. The contractual worker will enter all preadmission screening bundles into the MMIS framework taking into account passage into the waiver. Any screenings that the temporary worker feels did not meet criteria are sent to DMAS.
Slide 10Review Process DMAS will audit the preadmission screening parcel and make the last assurance on enlistment into waiver. DMAS may call you, suppliers or even visit a beneficiary. The strategy for doing this is done on a case by case premise.
Slide 11Review Process For 2004 Reviews finished 27,993 Enrollments 12,151 Changes 13,293 Approvals 20,156 Denial 494 Overall rate of dissent 2.34 Rejects excluded
Slide 12Questions
Slide 13Thank You As we voyage through life we will pick diverse ways that lead us in various bearings. The bearings and the ways are not critical but rather how we utilize our one of a kind capacities to accomplish our individual successes,whether they be vast and excellent or basic is at the heart of the trip .
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