Question

The charge nurse in a long-term care facility has been asked by the facility administrator to be sure that the staff documents in a way that will help ensure appropriate reimbursement for services provided. The charge nurse should instruct the staff to chart using what system as a guide?

a. Minimum data sets (MDS)
b. Charting by exception (CBE)
c. DARE (data, action, response, education)
d. Problem-oriented medical record (POMR)

Answer 1

The charge nurse should instruct the staff to chart using the Problem-oriented medical record (POMR) system as a guide. Option d.

Step-by-step explanation:

The charge nurse should instruct the staff to chart using the Problem-oriented medical record (POMR) system as a guide.

The POMR system is a method of organizing patient information in a systematic and problem-focused manner. It involves creating a problem list, developing a plan of care, and documenting progress notes.

This system helps ensure appropriate reimbursement for services provided by clearly documenting the patient's problems, treatment plans, and outcomes.

The charge nurse in a long-term care facility should instruct the staff to chart using the Minimum Data Sets (MDS) as a guide to ensure appropriate reimbursement for services provided. The MDS is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes.