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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, denial and survey risks 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
Sudden functional decline (new inability to bear weight, a new one-sided weakness, a new inability to swallow) — assess for an acute cause (stroke, fracture, infection) and escalate/transfer per the clinical references.
A fall during an ADL or transfer — stop, assess per the Falls reference, and reassess the assist level.
New skin breakdown or contracture from immobility/dependence — intervene per the Skin/Restorative references and revise the plan.
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, denial and survey risks 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