Hello,
I have a couple of thoughts about this :
- Sounds like the patient may have plateaued and no longer requires the skills of a nurse. It does not require the skills
of a nurse to cleanse a bili tube with soap and water apply a gauze dressing.
- I may not have the whole story here but thinking this is a stable/custodial patient. If the daughter won’t learn is
there another person who can be trained? Or does she want to hire someone to do this simple task?
- Hospice appropriate-make a referral?
Good Luck
Your partner for good
Paula Berger PHN, RN, COS-C
Regulatory Compliance Supervisor, Home Care
Tel. 952-993-3669 | Fax 952-977-0622
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From: medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
Sent: Thursday, March 28, 2024 2:25 PM
To: medicarewkgp@list.mnhomecare.org
Subject: [EXTERNAL]RE: Question
External Email: Don't click links or attachments unless you trust the email.
Hi. I can start the conversation.
My first question is how often are the services required? If they are “intermittent” would refer to Chapter 7
Medicare Benefit Policy Manual (cms.gov).
40.1.1 - General Principles Governing Reasonable and Necessary Skilled Nursing Care
40.1.3 - Intermittent Skilled Nursing Care
Happy Thursday!
Katie
Katie Troumbly,
BSN, RN, PHN, CNML
| Home Care Manager
Grand Itasca Clinic & Hospital part of Fairview Health Services
Grand Itasca Professional Building | 111 SE 3rd Street | Grand Rapids, MN 55744
katie.troumbly@fairview.org
|
www.granditasca.org
Office: 218-999-1047 | Cell: 218-259-1383
From:
medicarewkgp@list.mnhomecare.org <medicarewkgp@list.mnhomecare.org>
On Behalf Of Brianna Lindell
Sent: Thursday, March 28, 2024 12:58 PM
To: medicarewkgp@list.mnhomecare.org
Subject: FW: Question
Hey, Does anyone have thoughts on the below question we can relay to Charlye? Brianna Lindell Regulatory Affairs & Advocacy Manager Minnesota Home
Care Association 1265 Grey Fox Road, Suite 2 | Arden Hills, MN 55112-6929 Direct: 651. 240. 3380
ZjQcmQRYFpfptBannerStart
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Hey,
Does anyone have thoughts on the below question we can relay to Charlye?
Brianna Lindell
Regulatory Affairs & Advocacy Manager
Minnesota Home Care Association
1265 Grey Fox Road, Suite 2 | Arden Hills, MN 55112-6929
Direct: 651.240.3380
| Main: 651.635.0607
www.mnhomecare.org
|
blindell@mnhomecare.org
From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org>
On Behalf Of Bruneau, Charlye - Home Care
Sent: Wednesday, March 27, 2024 5:14 PM
To: medicarecompliance@list.mnhomecare.org
Subject: Question
Hello,
We have a patient (medicare) that is an 89 year old woman with a bili tube. We just received an order from her MD that they would like indefinite tube care as patient is
going to have tube for the span of her life due to not being a surgical candidate. She lives alone, but does have a daughter that is very involved. The RN attempted to discuss education of tube management with the family, but the family wants us to continue
coming out there. I am not sure if this is appropriate. She does have a skilled need, and she is not teachable, but the daughter is (just unwilling). Can we keep her open indefinitely under Medicare? I hope this question makes sense.
Thanks,
Charlye
Charlye Bruneau, MSN, RN
Director of Home Care and Hospice
Northfield Hospital + Clinics
2000 North Ave.
Northfield, MN 55057
507.646.1458
bruneauc@northfieldhospital.org
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