Help With Supporting Documentation.

I had a similair problem with my facility. I stopped coding for things not proven. No documentation, no money for the facility. Took about three months for corporate to see the significant drop in $$. Did not take long after that when it finally caught the administrators and DON's attention. Needless to say, charting is much better around here....not perfect (could be better), but better than it was...I know that at some facilities that are as big as mine (149 bed), there are shared responsibilities, possibly even 2 MDS personnel, but here, there is just me and me alone. I do not have enough time in my day with 122 residents and 20-25 medicare to run around doing what other people should be doing. If it is not done on their part, it does not get done.

I started posting a list of what everyone's actual RUG was...and what it potentially could have been had supporting documentation been present. My DON and administrator got the hint pretty quickly. Seven days before their ARD is up, I post a list of whose assessment is due...either the day shift or the night shift is assisgned to chart on each resident every day during the seven days. I posted a list of the things they need to note in their entry (everything in sections B, E, F, and G). I put bright yellow stickers on the charts to give an extra reminder that they need to be charted on. Our RUGs have dramatically improved (at least when the nurses actually do the charting).