/policies/,/policies/administrative/,/policies/administrative/uwhc/,/policies/administrative/uwhc/department-specific/,/policies/administrative/uwhc/department-specific/nursing-administrative/,/policies/administrative/uwhc/department-specific/nursing-administrative/patient-charges/,

/policies/administrative/uwhc/department-specific/nursing-administrative/patient-charges/907.policy

201507212

page

100

UWHC,

Policies,Administrative,UWHC,Department Specific,Nursing Administrative,Patient Charges

Criteria for Inpatient Daily Care Level 5 Charge: Pediatric Compromised Airway Patients (9.07)

Criteria for Inpatient Daily Care Level 5 Charge: Pediatric Compromised Airway Patients (9.07) - Policies, Administrative, UWHC, Department Specific, Nursing Administrative, Patient Charges

9.07

POLICY & PROCEDURE





Effective Date:
August 3, 2015

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.07

Original
Revision

Page 1
Of 3

Title: Criteria for Inpatient Daily Care Level
5 Charge: Pediatric Compromised Airway
Patients



I. PURPOSE:
A. Patients will be charged a higher daily care rate when they are admitted to selected
inpatient units and meet certain criteria as specified in the Policy section below.

II. POLICY:
A. This Daily Care Level 5 Pediatric Compromised Airway charge applies only to the
Pediatric Inpatient Units
B. To receive this charge, patients require multiple nursing interventions as described below,
and to qualify for the higher charge must have a compromised airway and meet two or
more or the following criteria:
1. Compromised ability to protect airway relating to age, cognitive impairment and
or nature of secretions
2. Requires a tracheostomy
3. Requires suctioning at least every 2-4 hours
4. Requires continuous respiratory monitoring

III. PROCEDURE:
A. Upon Admission:
1. If patient meets the criteria section listed above then they should receive an
Inpatient Daily Care Level 5 – Pediatric Compromised Airway charge until such
time as the charge criteria is no longer met. The admitting nurse communicates to
the Health Unit Coordinator (HUC) the need to implement the Level 5 daily care
charge. The HUC will enter the Level 5 accommodation code into Health Link
(HL) in order to change the daily care charge. The correct accommodation code
must be entered into the HL system before midnight on the day of admission in
order for the patient to receive the charge applicable to the first day of the stay.
2. It is the responsibility of each Nurse Manager to specify which staff member is
accountable for charge entry when a HUC is not working. Generally, the task of
assuring correct charges are reflected in the system will be assigned to either the
Care Team Leader or the admitting nurse when a HUC is not available. The
assigned staff member is responsible for entering the Level 5 accommodation
code into Health Link
3. The defining criteria for a level 5 Pediatric Compromised Airway charge will be

POLICY & PROCEDURE





Effective Date:
August 3, 2015

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.07

Original
Revision

Page 2
Of 3

Title: Criteria for Inpatient Daily Care Level
5 Charge: Pediatric Compromised Airway
Patients



available 24/7 on uConnect for use by staff.
B. Days following admission date:
1. The Level 5 Pediatric Compromised Airway charge is evaluated for
appropriateness on each Day shift following admission, and will be discontinued
when the patient no longer meets the charge criteria listed above. The nurse
assigned to the patient communicates with the HUC when the Level 5
Tracheostomy charge should be discontinued. To discontinue the Level 5 charge
will require changing the accommodation code to General Care.
2. It is the responsibility of each Nurse Manager to specify which staff member is
accountable for charge entry when a HUC is not working. Generally, the task of
assuring correct charges are reflected in the system will be assigned to either the
Care Team Leader or the admitting nurse when a HUC is not available. The
assigned staff member is responsible for entering the Level 5 accommodation
code into Health Link.
C. Daily Patient Charge Review:
1. On a daily basis, the Manager or Manager’s delegate (e.g. Care Team
Leader/Senior Team Member (STM) or Health Unit Coordinator) is responsible
for reviewing all active charges before midnight and for assuring that all patient
charges are correct for the midnight charge capture. Data pertinent to the daily
care patient charges can be found in either the home page patient list or the unit
census snapshot report in Health Link.
2. On a daily basis, the Manager or Manager’s delegate (e.g. Care Team
Leader/STM or Health Unit Coordinator) must review the Daily Activity Journal
report (DAJ) which lists all charges posted for a patient the previous midnight. A
comparison of the DAJ with the unit census snapshot run for the previous 24
hours will be conducted. Any patient charge errors discovered as a result of this
review will be corrected immediately. If the patient is not yet discharged,
corrections can be made in Health Link by the unit staff. If the patient has been
discharged by the time the error is discovered, the unit staff will notify the
Admissions Department. Admissions will then correct the charge error when
feasible to do so.



POLICY & PROCEDURE





Effective Date:
August 3, 2015

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.07

Original
Revision

Page 3
Of 3

Title: Criteria for Inpatient Daily Care Level
5 Charge: Pediatric Compromised Airway
Patients



IV. REVIEWED BY
A. Nurse Manager, P8, July, 2015
B. Financial Officer for Nursing & Patient Care Service, July 2012
C. Nursing Administrative Policy & Procedure Committee, July 2015

SIGNED BY:
Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services, Chief Nursing Officer