7th Case of the Week-Medicare Case; Due 9/27/18, by 1pm EST

Clinical Review: SNF CCR 1. 86 y/o F. Readmitted to hospital from SNF. DX: Exacerbation of CHF w/Pulmonary edema, UTI. First SNF admission for therapy d/t OA and pain.

Target LOS: 21 days provided to facility based on DRG number: NA. TGD: 10/07/18.

Expected DCP: Date TBD. Home w/ family support, private 24/7 caregivers & HHC. 2 Level home, 8 ste.

Number of Skill Days used out of 100 days: 10 eviCore days.

PMH: Angina, Arthritis, Asthma, HTN, Dementia, chronic back pain, depression & anxiety.

PLOF: patient lives w/spouse in 1 story home w/8 steps to enter, patient has 24/7 CG, was non ambulatory (w/c bound) but could stand & pivot transfer. Husband and Caregiver able to assist with care.

*Skilled Medical Needs: PT Goal: Return home. OT Goal: Increase strengthening & transfers.

*Current Mental Status: A&O x 2.

*Bed Mobility: Mod A. (unchanged Initial Review)

*Transfers: Max A for sit to stand. (unchanged Initial Review)

*Ambulation: Unable (unchanged Initial Review)

*Stairs: NA. (unable Initial Review)

*Bathing & Dressing: UE Max A, LE Total A. (unchanged Initial Review)

*Toileting: Mod X 2 PA. (not found in documentation)

*Toilet transfers: Max A. (not found in documentation)

*Speech Tx: Answers complex ended questions w/ 50% accuracy. Recall routine/personal information w/ 25% accuracy. (NA Initial Review)

Interqual met for SNF for therapy.


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