Help With Supporting Documentation.

[gonenutz]

i work as a coordinator in indiana and for the payable items on the mds i have to have supporting documentation to validate. i do monthly in-services to address these issue and the documentation will get better for a few days and then goes back to slim to nothing. the don will not hold them accountable! any suggestion on how to get the line staff to document what i need? i will try anything!

[edhcinc]

Have you discussed this with your administrator? Maybe he/she can help...it is a facility revenue issue if RUGS/PPS reimbursement does not meet budget.

[gonenutz]

i have spoke with the adminrator on several occasions i have even done in-services for our corporate administrator meetings and since my cmi is realtively high and our reimbursement rate has increased drastically it doesn't seem to affect her or corporate. i can't seem to get them to understand that if the nurses document more effectively our cmi would increase even more. this is making my job extemely difficult and i just can't get anyone to understand!

[KristenLPN]

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.

[achot chavi]

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 did MDS alone on 320 bed facility and guess what- no documentation- no code- took much less than 3 months for proper documentation to appear. If its not perfect- stop coding!

Even the dry cleaners knows "no tickey no washee"

[gonenutz]

I can't code if the documentation isn't there and in this last wuarter my CMI has dropped signifignantly. the DON and administrator has chalked it up to we have lost a few of our long termers with higher rugs and no we have a lot of walky talkies. True but not that extent. Even with the residents with lower adl scores if you have the proper documentation a decent rug cna be obtained if you set the ard at the right times, but that is a whole nother set of issues. I think my DON and administrator should have to try and do a mock MDS just to see what I have to work with.

[flashpoint]

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).

[achot chavi]

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).

GOOD 4 U!!!

[Callinurse]

Man if you held down a 320 bed facility does that mean 4 assessments a day with every 4th one a comprehensive???

My hats off to you !

Calli