|Document ID:||Operational Directive OD 0082/07|
|Date of issue:||Thursday, 22 November 2007|
|Status:||NO LONGER APPLICABLE|
|Description:||The circular outlines the reporting requirements for boarders admitted in all public hospitals.|
|Applicable to:||All Public Hospitals|
|Period of effect:||from 1 November 2007|
|Review date:||1 July 2012|
|Authorised by:||Dr Neale Fong, DIRECTOR GENERAL, WA HEALTH, 09-Nov-2007|
|Print version:||View print version|
The purpose of this operational directive is to describe the reporting requirements for boarders.
Hospital boarder is a person who is receiving food and/or accommodation but for whom the hospital does not accept responsibility for treatment and/or care. Hospital boarders are not admitted to the hospital. However, a hospital may register a boarder. Babies in hospital at age 9 days of less cannot be boarders. They are admitted patients with each day of stay deemed to be either qualified or unqualified. (NHDD version 13, p 246)
3. Types of Boarders
There are many circumstances under which a health service is required to provide accommodation and meals to individuals who do not require formal admission to a hospital. The more frequent circumstances are listed below.
3.1 In some circumstances the need to have a boarder in hospital with a patient is necessary for the well being of the patient. In these cases the treating medical officer documents, that the sick person (patient) is accompanied by a ‘boarder.’ Examples of these types of boarders would be a breast-fed infant of a sick mother or the breast-feeding mother of a sick infant.
3.2 In remote parts of the State there may be the need for a patient to be accompanied by a family member who may not be able to obtain accommodation elsewhere. This is more likely in areas where the patient lives a considerable distance from the hospital.
3.3 There are circumstances when clients may be able to attend visiting medical officers’ appointments or follow up treatments or appointments more easily if accommodated at the hospital as a boarder. These include appointments early in the day when the home may be a great distance from the hospital.
3.4 Limited air flight and public road/train schedules to some remote areas may mean that patients travelling to, or returning from, a regional or city hospital may need to be accommodated at a hospital before or after receiving treatment. If accommodation but no treatment is provided these patients are classified as boarders.
3.5 In some cases the presence of a family member staying at the hospital as a boarder may assist both the care of the patient during the hospital stay and ensure that the patient is able to be discharged at the appropriate time. The hospital stay may be better managed by the presence of a boarder during the hospital stay to ensure there is no delay before discharge from the hospital.
3.6 In cases of extremely ill patients or terminal illness, members of the family may wish to be present at the hospital during the critical period. The treating medical officer may decide that the presence of some family members as boarders will be of benefit to the patient.
3.7 Patients who stay overnight for dialysis or similar treatment who are discharged the following day are to be classified according to the Australian Coding Standards (ACS), 2005. This standards states for that for same-day and overnight episodes of care, where the patient is discharged on the same date as the admission or on the next day after admission, code as principal diagnosis either the admission for chemotherapy, or dialysis or for other similar type case scenarios.
4. Guidelines for the Registration of Boarders
Documenting the presence of boarders should follow these guidelines.
There are two different ICD-10-AM codes for boarder:
1. Z76.3 Healthy person accompanying sick person – e.g. Mother is admitted with leg fracture and baby is admitted as a boarder as the baby is being breast-fed.
2. Z76.4 Other boarder in health-care facility – e.g. Patient has been admitted for cataract procedure as same day episode from a remote community and no transport is available till the following day is admitted as a boarder to await transport back to their community.
3. Babies who are admitted as boarders and are under the age of 10 days on admission are to be admitted with a care type of newborn and client type of unqualified newborn until they reach the age of 10 days. The ICD-10-AM code is Z76.2
On the tenth day of age these babies are to have a statistical discharge and readmission to boarder. The ICD-10-AM code is Z76.3
Dr Neale Fong
This circular last updated: Thursday, 22 November 2007 at 11:54am