There are seven (7) different careplan scenarios based on the answer to OASIS M1870 Feeding or Eating. If the patient is not independent in feeding her/himself (answer '0') , the patient should be any of the the following seven (7) careplans:
- assistance with feeding
- a nursing careplan for dysphagia
- occupational therapy for fine-motor rehabilitation
- occupational therapy for cognition therapy
- speech therapy for a chewing/swallowing disorder
- a nursing careplan for enteral nutrition OR
- a nursing careplan for Total Parenteral Nutrition (TPN)
The patient's ability to take adequate nutrition is a contingency for being able to stay home. Medicare asks this question to assure that the appropriate careplan is activated and hospitalization or other institutionalization is prevented.
0 - Able to independently feed self
If the patient can feed her or himself independently there's no need for intervention.
1 - Able to feed self independently but requires:
(a) meal set-up
The patient needs personal care assistance for meal preparation (careplan #1). This can be provided by a family member or paid help.
(b) intermittent assistance or supervision from another person
The patient needs personal care assistance for meal preparation (careplan #1). This can be provided by a family member or paid help.
(c) a liquid, pureed or ground meat diet.
The patient may need speech therapy for swallowing problems such as dysphagia (careplan #4) and/or instructions on how to prepare a pureed or liquid diet (careplan #2). The patient needs personal care assistance for meal preparation (careplan #1), provided by family or paid help.
2 - Unable to feed self and must be assisted or supervised throughout the meal/snack
If there is rehabilitation potential the patient may be a candidate from occupational therapy for cognition (careplan #3) and fine motor rehabilitation to assist with achieving independence in self-feeding. The patient needs personal care assistance for meal preparation (careplan #1), provided by family or paid help.
3 - Able to take in nutrients orally and receives supplemental nutrients through a nasogastric tube or gastrostomy
A nursing careplan for nasogastric tube or gastrostomy (careplan #5) is indicated.
4 - Unable to take in nutrients orally and is fed nutrients through a nasogastric tube or gastrostomy.
A nursing careplan for nasogastric tube or gastrostomy (careplan #5) is indicated.
5 - Unable to take in nutrients orally or by tube feeding.
A nursing careplan for Total Parenteral Nutrition (careplan #6) is indicated.
Does Your Home Health Orientation Include These 11 Policies?
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