LTC documentation

I will not condone the MDS Coordinator nor will I condemn him/her.

This may be long, but I'll try to be brief with the explanation.

The purpose of the memo is to determine how much help a resident requires to perform an activity. In your case, Toileting -How resident uses the toilet (including urinal, bedpan, commode).

The type of assistance required by the resident is graded (looks like in your facility, by the MDS Coordinator), from 0 (Independent) to 4 (Total Dependence). This score combined with the scores garnered from all other ADLs (Eating, Walking, Dressing, etc) will sum up a value that will determine how much money Medicaid or Medicare will reimburse you for taking care of that resident. The higher the score, the more dollars you get.

The weekly doc'n may be necessary if this resident is new or unstable. He may be totally dependent one day, supervised only the following day, or require limited assistance the next. All these different performance scale will be calculated and assigned a value (0-4).

True, LTCFs are inundated with voluminous documentation. MDS did eliminate most of these requirements. Unfortunately some facilities have not utilized this tool to what it was intended for nor have they adapted their routines to blend with the MDS lingo.

Talk to your MDS Coordinator. Device a Resident ADL performance grading scale (0-4) that a CNA completes at the end of the shift. Sum it up at the end of the week. Or if this resident is stable, simply tell the MDS coordinator if you can document ONLY if there is a change from the last MDS assessment, otherwise MDSC assumes that there is no change.

Good communication between an MDS Coordinator and the staff (nurses, rehab, social workers, etc) will allow the facility to provide the best of care to the resident and reap the most revenue $$$ at the same time.

Most of us in the profession feel the same way, too. But hang in there! It sure is an ongoing battle! 'tho sometimes most things become routine. Enuf said before my activist colleagues get in the picture.

Good luck!

Makes sense if you look at it from another angle-have you any male para's of hemi's up in wheelchairs mobilizing independently during that day that maybe use a urinal and empty it themselves while up? Or empty their own foley when they are out of bed? You still want to document the most care this person needs in a day....to get the max reimbursment that you deserve...So many papers-so little time.....

Also too, if you have a RAI manual, I think it's 2.0 the newest version, that should help. It's also a good tool to help familarize yourself with for why/what triggers on your QI's.