Beruflich Dokumente
Kultur Dokumente
NRS221
1/24/18
Case Management
photographs and measurements (per consent). Likewise, re-evaluate any prior wounds and their
status including documentation. Review patient’s eating habits and access to appropriate foods-
seek resources if needed (food bank, government supplementation (EBT) and help establish a
menu for the week based off patient’s choice of foods with discussions about food likes/dislikes
and how they pertain to his suggested dietary restrictions.
Frequency:
SNF- minimum 30 days with re-evaluation at days 15 and 25 before discharge. Medicare
will cover 1st 30 days 100%, days 31-90 are $40/day deductible. PT while at SNF 5
x’s/week @ 30 min/visit. OT while at SNF 2 x’s/week @ 30 min/visit.
Home Health Nurse- 2 x’s/week for one month, graduating to 1 x/week until patient can
demonstrate independent management of medications and confident safe navigation of
home environment and teaches back safety measures to prevent future hazards or
compromising situations.
Anticipated time necessary to achieve results is approx. </= 60-90 days post hospital
discharge. Regular evaluations at each interaction will determine progress achieved and extend
or shorten the goal timeframe as necessary.