down coding?

[crissrn27]

So, I was supposed to have Meyers and Stauffer in last week, but got postponed. My question is, do you guys down code for them (or the agency that comes in to try to take the tiny bit of money you get?, lol). If you have a hole on an ADL sheet do you automatically code a 3 instead of a 4, etc. Or do you code what you know the resident to be? I thought when we did an assessment we were supposed to code what we know to be true and accurate, not what might lose money at some point when the mds police come in?

[Nascar nurse, ASN, RN]

AHHHHHHHHH!!! So what are you guys doing, real practice? At this point I am down coding, and explaining in my raps, but this just doesn't feel right. The system is supposed to work, you do an accurate assessment that portraits the resident, then you do accurate raps, then an accurate care plan. How is that supposed to work when you down code because of a hole but they are really total care, or extensive, etc. We have many holes, I've been there a year and it has not gotten any better. I like the idea of making the ones leaving the holes write a clinical note that the resident was ______ on that day, if they have to do that enough maybe they would just chart. Oh how I wish for Icare or some type of computer charting.

I am not "down coding".. I'm just marking what I can validate as the truth. I also educate, educate, educate. If that doesn't work (and it won't with some staff) then I start writing em up. I don't like that, but it's gotta be right & they know I'm going to be looking and following up so i really don't have to much trouble.

[Bella'sMyBaby]

What state are you in?

Indiana :)