[brendamyheart]

Originally Posted by nursy711

I HAVE A QUESTION. PAGE 3-100 IN THE UPDATED MDS MANUAL, THE EXAMPLE (RES PERFORMED ALL THE TASKS OF PERSONAL HYGIENE EXCEPT SHAVING. THE BARBER VISITED HIM ON THE UNIT 3 TIMES A WEEK TO SHAVE HIS THICK BEARD) THEY HAVE IT CODED AS A 3 2. I WOULD HAVE FIGURED SINCE HE DOES ALL OF HIS OWN PERSONAL HYGIENE I WOULD HAVE CODED IT AS A 2 2. THE SAME SENARIO. A WOMAN DOES ALL OF HER OWN CARE AND DRSG AND ONLY NEEDS HELP BRUSHING HER LONG HAIR, AND ITS ALSO CODED AS A 3 3. AGAIN I WOULD HAVE CODED IT AS A 2 2. IN YOUR OPINION, WHAT WOULD YOU HAVE CODED THESE 2 PEOPLE?

THANKS ,
CHRISTINE

3/2. Rules of three

[nursy711]

i understsnd the rational behind coding a 3 2 for the woman that needs her hair brushed every day, but for the man that only needs to be shaved 3 times a week? Limited assist on the actual MDS = .......or other non-weight bearing assist 3 or more times. Shaving is a non-weight bearing act. At first I thought it was just me, then I gave all the unit managers the senario, 4 out of 5 said they would code it a 2 2. . I dont mean to be a pain, im just trying to understand and do the best job i can. Even the current MDS Coordinator said she would have coded it a 2 2. Thank you for taking the time to answer my questions...

[nursy711]

i answered my own question after i thought about it... its still physical assist and that meets the criteria

[Rizpah]

Originally Posted by Nascar nurse

I would have coded both as a 3/2 (because that is the right way to do it AND it's the way the RAI - AKA MDS bible - states to do it!)

I teach this way:
Supervision (#1) = talk
Limited (#2) = touch only with an opened hand. (Like w/ the weeble-wobbley little ole lady walking down the hall - open hand just guiding them to keep their balance)
Extensive (#3) = closed hand &/or your muscles are involved (but resident also participates at least w/ something)

Therefore it would take a closed hand to hold and "power" the brush/razor. This makes it an extensive assist.


I find to many people that think limited = "little bit of help", extensive = "lot of help". This is wrong!

WOW! this is great........I've been doing MDS's for 10 years now and never had the coding explained in this way. I printed it off and took it to work and plan on talking to my director, who also does MDS's. It's a huge help in trying to figure out exactly how to code something. Got any hints on section E? Sections E and G on new admits... I hate 'em! But I know, it all boils down to the documentation we have to follow up on and if the staff nurses don't understand the coding criteria, we have to decipher it, but then our deciphering doesn't match the charting......

[Nascar nurse]

Originally Posted by Rizpah

WOW! this is great........I've been doing MDS's for 10 years now and never had the coding explained in this way. I printed it off and took it to work and plan on talking to my director, who also does MDS's. It's a huge help in trying to figure out exactly how to code something. Got any hints on section E? Sections E and G on new admits... I hate 'em! But I know, it all boils down to the documentation we have to follow up on and if the staff nurses don't understand the coding criteria, we have to decipher it, but then our deciphering doesn't match the charting......

Glad I could help. Sorry, no good hints for section E - it is what it is and the most difficult task is just getting someone to document what they see. I'm always teaching/preaching to throw comments like "A&O x's 3 w/ some confusion present" out of their charting. I want specific memory/mood/behavior examples and DIRECT quotes in the chart. ie: Resident stated "Go to hell" when I asked them to get up for breakfast. Now I can count bad am mood and verbal abuse w/ just a 3 word quote.

The very worst part of the job is the constant teaching/preaching.. training and reminding with the staff. We have recently started going with the CNA documentation for ADL's and the aides are doing a much better job then most of the nurses ever did. (Not really all that surprising since they actually provide the care and really knows what goes on).

[Nascar nurse]

Originally Posted by nursy711

i answered my own question after i thought about it... its still physical assist and that meets the criteria

[2longasn]

Originally Posted by Rizpah

In my definition - the MDS is a total look at the resident - head to toe, inside and out, strengths and weaknesses. Generates the reimbursement for Medicare residents, helps to design the care plan for all residents - a tool to make one really look at the resident - I've had some real "ah HA!" moments when doing some MDS', kinda makes you use your critical thinking skills more. Just my 2 cents worth.....

And his where abouts on the grid. it captures his admission, discharges, falls, chage in status, change in meds, new diagnoses, how good or bad the facility is taking care of this resident. and communicates to the surveyors where the facility's strengths and weaknesses are and .........

[2longasn]

Thanks Talino this is the best advice ever. I was concerned about my poor pay, but decided to stay. When I took over this position the late transmissions were at 25% and now it is @ 11.34 % less than a year a later. There are also improvements noted in scheduling of the MDS assessments. What a mess I inherited. I'm thankful for the experience. I read your thread on one of those " this is not for me days". I'm thankful I did not leave and know that I played a sizable part in the overall improvement of the MDS process in my facility. This will be beneficial at evaluation time. Thanks

[2longasn]

Love This. Thanks

[Nascar nurse]

Originally Posted by 2longasn

When I took over this position the late transmissions were at 25% and now it is @ 11.34 % less than a year a later. There are also improvements noted in scheduling of the MDS assessments.

Wow! This would be TOTALLY unacceptable in my facility. It is an absolute expectation that there be no late assessments ever w/ no excuses. How late are they? Aren't you getting default rates for all the days you are late? What are your scheduling issues? Maybe one of us could help with this.