Which of the following unique aspects of home care do Medicare ...

[moongchi]

Which of the following unique aspects of home care do Medicare reimbursement regulations require that the nurse include in documentation?
 
  a. Patient assessment data and interventions performed
  b. Patient response to care and assessment of environment
  c. Evidence of homebound status and continued need for skilled care
  d. Skilled care delivered and communication with other providers

Question 2

A patient has been taking herbal remedies to decrease blood pressure. The patient is convinced that this has reduced his blood pressure and he refuses to take a prescribed antihypertensive medication.
 
  The nurse checks his blood pressure reading during an office visit, with the following results: Left arm: 130/94, 140/86, and 160/90 mm Hg. With this information, what is the nurse's best response to the patient's refusal to take antihypertensive medications?
  a. I see that you are correct; your blood pressure readings do not indicate hypertension.
  b. Your blood pressure is elevated, so you will need to take a prescribed antihypertensive.
  c. Your blood pressure is within normal limits and does not need anything for it.
  d. Your blood pressure is elevated. It is important to discuss this with your doctor.

[eliasc0401]

Answer to Question 1

C
All of the aspects mentioned should be documented. However, the unique requirements of home care include documentation of homebound status and the continued need for skilled care.

Answer to Question 2

D
The nurse identifies that these blood pressure readings are elevated and correctly suggests the discussion with the physician. The nurse is not the person to determine potential therapies for the patient. The nurse cannot tell the patient he is correct and does not have hypertension because his vital signs do not support that. The patient's blood pressure is not within normal limits.