The nose drives or complicates a skilled course in several concrete ways. Epistaxis — particularly in the anticoagulated resident — can be significant and requires skilled management and bleeding surveillance. Post-nasal or sinus surgery involves packing management and complication surveillance. A nasogastric tube or nasal cannula requires skilled nares care to prevent pressure injury and maintain the device, and after neurosurgery, clear nasal drainage may signal a CSF leak. The skilled work is the bleeding/airway surveillance and the device and post-operative care.
This module proves, on the days it applies, that skilled nasal observation, packing/nares care, or teaching was reasonable, necessary, and part of the daily skilled need under Pub. 100-02 Chapter 8. The nasal exam is the same as in home care; the coverage spine is re-pointed. NG feeding routes to Nutrition; oxygen delivery to Respiratory.
