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201705138

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UWHC,

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Criteria for Inpatient Daily Care Level 5 Charge – Gynecology Oncology Surgery Patients (F66 Only) (9.14)

Criteria for Inpatient Daily Care Level 5 Charge – Gynecology Oncology Surgery Patients (F66 Only) (9.14) - Policies, Administrative, UWHC, Department Specific, Nursing Administrative, Patient Charges

9.14

POLICY & PROCEDURE





Effective Date:
May 1, 2017

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.14

Original
Revision

Page 1
Of 2

Title: Criteria for Inpatient Daily Care Level
5 Charge – Gynecology Oncology Surgery
Patients (F66 Only)

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 (V) charge applies only to the F6/6 Gyn/Urol/Plastics and
Otolaryngology inpatient unit.
B. These patients require multiple nursing interventions as described below, and to qualify for
the higher charge must have Gynecology/oncology surgery and meet 2 or more or the
following criteria:
1. Epidural or Patient Care Analgesia (PCA) for pain control. Requires assessment
minimally every two hours for duration of therapy.
2. Require insulin gtt to maintain stable glucose. Requires hourly accuchecks.
3. Require central venous pressure monitoring every 4 hours or more frequently.
4. Require 2 or more electrolyte replacements and subsequent lab monitoring.
5. Telemetry monitoring.
6. Require more than 2 staff for transfers and repositioning.
7. Continuous pulse oximetry.
8. Require Heparin gtt for blood clot.
III. PROCESS:
A. Upon Admission:
1. If patient meets the criteria section listed above then they should receive an Inpatient
Daily Care Level 5 (V) - Gynecology/oncology surgery charge until such time as the
charge criteria is no longer met. The admitting nurse will communicate to the HUC
the need to implement the Level 5 (V) daily care charge. The HUC will enter the
charge into Health Link. Charges must be entered into the system before midnight
on the day of admission.
2. Each unit using charge criteria will have a unit reference binder with the criteria
clearly listed.
3. The admitting Nurse on every shift is responsible for evaluating if there are any new
patients that require the Level 5 (V) charge and for communicating this information
to the HUC for entry into Health Link.
B. Days following admission date:
1. The Level 5 (V) Gynecology/oncology surgery charge will be 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 will communicate with the HUC when the Level 5 (V) -

POLICY & PROCEDURE





Effective Date:
May 1, 2017

Administrative Manual
 Nursing Manual
 Other _______________

Policy #:
9.14

Original
Revision

Page 2
Of 2

Title: Criteria for Inpatient Daily Care Level
5 Charge – Gynecology Oncology Surgery
Patients (F66 Only)

Gynecology/oncology surgery charge should be discontinued.
2. On a daily basis, the Care Team Leader/STM on the Day shift is responsible for
reviewing all active charges. The Care Team Leader/STM will consult with the
nurse caring for the patient to verify the continued necessity of the charge, and if no
longer appropriate communicate with the HUC to confirm the charge has been
discontinued in 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.

IV. AUTHORED BY
Director, Nursing Finance and Staffing Effectiveness

V. REVIEWED BY
A. Director, Surgical & Psychiatric Nursing, May 2017
B. Nurse Manager, F6/6 Gyn/Urol/Plastics and Otolaryngology, May 2017
C. Nursing Administrative Policy & Procedure Committee, May 2017

SIGNED BY:
Beth Houlahan, DNP, RN, CENP
Senior Vice President
Chief Nurse Executive