General Section
DIRACHART — SKILLED DOCUMENTATION · NURSING HOMES (DGEX-SNF)
DiraChart Clinical Reference · Read-only reference edition
Clinical Reference · 2.38
Male Reproductive System
Skilled documentation when the male reproductive/GU system is the reason for or a factor in a Part A stay — post-prostatectomy and TURP recovery with continuous bladder irrigation and hematuria/clot management, post-operative scrotal/testicular surgery, and genital skin care in the dependent resident. Post-urologic-surgery skilled care is a genuine SNF scenario. Catheter/UTI detail routes to Continence.
Module code | SNF-MALEREPRO |
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Version | 1.0 · Population: Adult · DiraChart reference edition |
Used alongside | Continence/Catheter/UTI · Genitourinary/Renal · Skin · Skilled-Daily · Post-Surgical and Anticoagulation overlays |
MDS section(s) | H (catheter/continence) · M (genital skin/wound) · I (prostate/urologic diagnoses; recent surgery) |
Skilled category (Ch. 8) | Covered skilled procedures (continuous bladder irrigation; post-operative urologic and catheter care) · observation & assessment of hematuria/post-operative bleeding · teaching |
Regulatory note | Coverage: Pub. 100-02 Ch. 8. Quality-of-care and continence references: F684/F690 — secondary to the coverage analysis. |
How to use this module Fill every model note and smart phrase with the shift’s actual values and the resident’s current orders — these are structured examples to edit, never phrases to copy. The universal writing rules in Foundations (the necessity sentence, quantified outcomes, teach-back, closed-loop coordination, MDS-supportive documentation, and care-plan linkage) apply throughout and are not reprinted here. Disease-specific days route to the overlays. Verify each threshold and citation against the current source before use. |
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