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Section Navigation Part 7 of 15 1. General Section 2. 1. Purpose and clinical relevance 3. 2. What to assess, technique, and required data 4. 3. Normal findings — documented with skill justification 5. 4. Abnormal findings — the necessity chain 6. 5. Skilled interventions and teaching 7. 6. Red flags — escalate / transfer 8. 7. Skilled-need justification (SNF) 9. 8. MDS & care-plan linkage 10. 9. Weak vs. strong documentation 11. 10. Audit and denial risks (Medicare Part A) 12. Smart phrases 13. Daily-note bank — routine skilled days 14. Daily-note bank — change-of-condition / at-risk days 15. 12. Sources and clinical references Previous Next 6. Red flags — escalate / transfer 🚩 Red flags
Acute respiratory distress / failure — severe dyspnea, SpO₂ below the ordered threshold unresponsive to treatment, accessory-muscle use with fatigue, or an inability to speak in full sentences — emergency evaluation/transfer.
Altered mentation with hypercapnia — increasing somnolence/confusion (CO₂ retention) — do not over-oxygenate; escalate/transfer.
Suspected pneumonia/sepsis — fever, worsening purulence, or systemic signs — escalate.
Cyanosis or a silent chest (no air movement) — emergency evaluation/transfer.
Section Navigation Part 7 of 15 1. General Section 2. 1. Purpose and clinical relevance 3. 2. What to assess, technique, and required data 4. 3. Normal findings — documented with skill justification 5. 4. Abnormal findings — the necessity chain 6. 5. Skilled interventions and teaching 7. 6. Red flags — escalate / transfer 8. 7. Skilled-need justification (SNF) 9. 8. MDS & care-plan linkage 10. 9. Weak vs. strong documentation 11. 10. Audit and denial risks (Medicare Part A) 12. Smart phrases 13. Daily-note bank — routine skilled days 14. Daily-note bank — change-of-condition / at-risk days 15. 12. Sources and clinical references Previous Next 