MDS Alert

But before you code, double-check the definitions of each Rx.

Skin ulcers of any stage over two or more sites coded in M1--or a single Stage 3 or 4 pressure ulcer coded at M2a--will RUG a resident into Special Care if he has an ADL score of at least 7 and two or more of the following treatments.

M5a. Pressure relieving device(s) for chair - Includes gel, air (e.g., Roho), or other cushioning placed on a chair or wheelchair. Include pressure relieving, pressure reducing, and pressure redistributing devices. Do not include egg crate cushions in this category.

M5b. Pressure relieving device(s) for bed. Includes air fluidized, low air loss therapy beds, flotation, water, or bubble mattress or pad placed on the bed. Include pressure relieving, pressure reducing and pressure redistributing devices. Don't include egg crate mattresses in this category. Note: Count M5a and b as one treatment if you provided both.

M5c. Turning/repositioning program. Includes a continuous, consistent program for changing the resident's position and realigning the body. "Program" is defined as "a specific approach that is organized, planned, documented, monitored, and evaluated."

M5d. Nutrition or hydration intervention to manage skin problems. Dietary measures received by the resident for the purpose of preventing or treating specific skin conditions, e.g., wheat-free diet to prevent allergic dermatitis, high calorie diet with added supplements to prevent skin breakdown, high protein supplements for wound healing. Vitamins and minerals, such as vitamin C and zinc, which are used to manage a potential or active skin problem, should be coded here.

M5e. Ulcer care. Includes any intervention for treating skin problems coded in M1, M2, and M4c. Examples include use of dressings, chemical or surgical debridement, wound irrigations and hydrotherapy.

M5g. Application of dressings with or without topical medications other than to feet. Includes dry gauze dressings, dressings moistened with saline or other solutions, transparent dressings, hydrogel dressings, and dressings with hydrocolloid or hydroactive particles.

M5h. Application of ointments/medications other than to feet. Includes ointments or medications used to treat a skin condition (e.g., cortisone, antifungal preparations, chemotherapeutic agents, etc.) but not ointments to treat non-skin conditions (e.g., nitropaste for chest pain).

Source: RAI manual, chapter 3.