[sassyASC]

I was looking for some useful information on continuing education for MDS Nurses. I am looking to promote some RNs into an MDS Coordinator role within long term care facilities and hopw to get some information on classes or inservices that are held in the Indiana are to give them more knowledge regarding the MDS process?....Can anyone help!!!

Thanks
Laurel

[Talino]

Indianapolis MDS training...
http://www.ihca.org/content/PDFs/200...vanced_mds.pdf

Online MDS training...
http://www.aanac.org/

MDS Users Manual... (The MDS Coordinator's Bible)
http://www.cms.hhs.gov/medicaid/mds20/man-form.asp?

CMS MDS site...
http://www.cms.hhs.gov/medicaid/mds20/

My take -- no training sessions would be beneficial without a follow-through of an actual on the job, hands-on MDS involvement.

Good luck!

[CapeCodMermaid]

Just when I was about to post my own question about the MDS....do any of y'all have suggestions for how to keep track of the dumb thing? I am new to the job...have between 25 and 30 Medicare residents at any given time. Most of them are rehab so the RC picks the ARD. I get MY part done the same day, but it seems I am forever chasing the rest of the team, and then I forget to pick the old ones up and almost miss the 14 day cut off for the Triggers and Raps. Anyone have a good form or method ??? HELP!

[Talino]

Interactive Calendar for tracking MDS crucial days...
http://www.empiremedicare.com/TRANSF...webversion.xls

Getting other disciplines to complete their portion of the MDS on a timely manner is the most difficult task.

Suggestions:

1. Knowing the ARD ranges for each PPS MDS is imperative. Give ample notice and time for disciplines to complete it. If you alert disciplines by providing them a calendar of the expected due dates of upcoming PPS and giving them at least five days to complete it from the last allowable ARD, you may be able to get them to comply.
Example:
PPS/MDS 14-Day ---> ARD range is from day 11 to 14
Disciplines will complete MDS between day 14 – 18. (Except when a 14-day is also an MDS requiring RAPs, day 14 would be the last day to complete it).
Regardless what your Rehab. choose (from day 11 to 14) as the ARD, a Discipline can safely complete his/her portion of the MDS starting on day 14.

2. PPS/MDS dictates your revenue and is constrained by a timely assessment. Get Administration involved. Poor compliance should be made a big concern. Do a monthly audit on which disciplines are delinquent. Submit it to your Administrator and have it discussed during the next QA meeting. If you’re not present, don’t forget to politely inquire of the outcome.

Happy hunting!

[CapeCodMermaid]

Thanks for the tips and the web site. I have a PPS 100 day scheduler I use which is very similar. I think I'll just have to either come up with my own form or get a big stick to get the other disciplines to do the MDS when it's due...and, maybe, THEY could carry it down to the data entry office if they are the last ones to do it....

[catlady]

Originally Posted by Talino

1. Knowing the ARD ranges for each PPS MDS is imperative. Give ample notice and time for disciplines to complete it. If you alert disciplines by providing them a calendar of the expected due dates of upcoming PPS and giving them at least five days to complete it from the last allowable ARD, you may be able to get them to comply.
Example:
PPS/MDS 14-Day ---> ARD range is from day 11 to 14
Disciplines will complete MDS between day 14 – 18. (Except when a 14-day is also an MDS requiring RAPs, day 14 would be the last day to complete it).
Regardless what your Rehab. choose (from day 11 to 14) as the ARD, a Discipline can safely complete his/her portion of the MDS starting on day 14.

If I'm using grace days on that 0/7, I certainly would not want another discipline starting their section on day 14.

I keep a special Medicare assessment list and distribute it as needed, usually once or twice a week. I give the disciplines four calendar days, which gives me a day or two to chase them down as needed. Particularly as rehab usually picks day 7 or 8 for the 1/1 (we do all our admission assessments with the 5 day, not the 14, in case we need grace days on that 14 day) and I have to have everything completed by day 14. If I'm approaching month end and need those assessments, I might only give them a day. Better that than take pending days unnecessarily.

I don't know what size building the OP has or what their Med A census is, but if my Med A MDSs aren't completed when I want them, I yank the MDSs from the chart, march the pile down to the respective office, and hand them to the department head. It ain't pretty, but it's effective, and I never have a late assessment.

[CapeCodMermaid]

Thanks for the advice CatLady. I have started to get "cranky" with the other disciplines which seems to work. Our rehab department is almost always using grace days and our dietician is part time and I never know when she'll be coming in. She says she has 14 days to do her assessment...I usually end up doing her section...and my building most often has between 25-32 Med A's and 4 or 5 Managed.

[Talino]

Originally Posted by catlady

If I'm using grace days on that 0/7, I certainly would not want another discipline starting their section on day 14.

Grace days are used on a "prn" basis, not as a routine. In which case you need to notify disciplines on a prn basis as well. The poster was looking for ideas on how to get disciplines to be more punctual and compliant in completing MDSs.

Originally Posted by catlady

If but if my Med A MDSs aren't completed when I want them, I yank the MDSs from the chart, march the pile down to the respective office, and hand them to the department head. It ain't pretty, but it's effective, and I never have a late assessment.

MDS Coordinators have resorted to a multitude of strategies to get disciplines to be more compliant. Fortunately for us, the quarterly QA "reality check" works since a Dept. Head can just be put on the spot by the Admin. Aggravation does not befit the MDS Coordinator, let it be the negligent department's enigma.

If it's an ongoing problem, maybe the strategy needs to be redressed?

[CapeCodMermaid]

Does it cause trouble if grace days are used ALL the time? 98 percent of the time our rehab staff uses some if not all of the grace days for the 5 day assessment.

[Talino]

Grace days should be used sparingly, e.g., when resident missed a day from therapy, a Holiday, a LOA, an off-site MD visit or rx, etc. When used routinely, you will be raising a flag. Have you heard of DAVE?

Confer with your Rehab. staff on their intentions for using grace days.

1. Do they want to place the resident on a Very High or Ultra High RUG category?

To achieve this, Section P1B: Therapies should equal 500-720 minutes of therapy within the ARD of the 5-Day Medicare PPS assessment. To be in compliance, a minimum of 100 mins. of therapy/day should be started on day of admission up to day 5. Habitual use of Grace Days for this matter on a 5-Day PPS is an absolute Red Flag.

2. Or, they simply want to put resident in a Rehab. RUGs score?

To get a Rehab High category, all you need is a minimum of 65 mins. in P1B. Therapies (can even be a combination of therapies) AND, the 15 day estimate should equal a minimum of 520 mins., and at least 8 days of therapy.