MDS Coordinator sub-forum - page 2

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  1. 0
    Hello to all. I am thinking of changing career path in 1-2 years. I have been working as a medicare RN auditor. I am looking towards a geriatric specialty. What facilities can I work , what is an MDS , the patient ratio in these facilities? Should I get a geriatric cert or go ahead w/ the gerontology masters? Help please ?

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  2. 0
    I am an old nurse, but new MDS Coordinator. I have a question about the pain section. Sorry, I don't know the exact section, but it has No pain, Daily pain or pain less than daily and goes on to mild, moderate etc. I have been coding it as daily pain if a resident is on a scheduled pain med, and mild or moderate depending on whether it was a med like Tylenol or a narcotic. My corporate advisor recently came and she thought it was only for breakthrough pain. That would put somone with no pain at all and no meds in the same class as one getting Lortab TID. Is she right about this? She also said she could be wrong and to bring it up at our next corporate meeting. I've read the manual and didn't find anything like that.
  3. 0
    Hi--you do NOT code that the person has pain unless he/she tells you so, or responds yes if you ask. If the person is on an effective pain med program, the answer might be daily, but should not be "horrible." Normally you would code this for breakthrough pain, once the regimen is established and "works."
    good luck!
  4. 0
    If someone is on a pain medication and it is working, then they have no pain. I've had more than one discussion about this with my MDS person because she was coding severe pain for anyone with an order for Percocet.
  5. 0
    Your rehab manager probably has a chart with the rehab RUGS, and unless you can carry everyone's ADL score around in your head, I doubt a mnemonic would be of any value. The minute breakdown for rehab RUGs is 150/325/500/720, and as long as your ADL score is above 7, you're in the rehab category. By the 14 day I can't remember whether extensive services are being done, so I check my flow sheet when we do PPS, hope this helps.
  6. 0
    Hello. When I ask the resident if they have had any pain in the last 5 days I always code what their answer was. Just because they are recieving pain meds doesnt mean they are/ are not in pain. The pain meds they are recieving are most likey working if the resident is answering "no" to the pain question. You should only code what the resident says not what you think. I could be wrong, but while reading your question it looks to me like your answering the pain question for the resident.
    I have residents who are on A LOT of pain meds which include oxycontin BID and dilaudud for breakthrough. But everytime I ask the question about pain their answer is always "10". In this type of situation I always chart in a Nsg. note or CAA (If appropriate) something like "despite 20mg oxycontin ER BID and dilaudid q4 prn for breakthrough resident cont. to c/0 pain 10/10. resident propells self throught facility throught the day, goes out on LOA with family/friends several times a week. Resident able to transfer in / out of car independently , no s/s pain or discomfort observed. We actually have several residents who complain of 10/10 pain despite all interventions. In facility I work for we happen to have a lot of the younger residents who seem to be drug seeking..Some of them actually dit outside and talk about how much pain medication they are on, how often they recieve it and what kind... I could go on and on about this. But we need to remember pain is subjective despite what we may think.
    Back to the original question...your answers to section J of the MDS should ALWAYS be what the resident tells you, not what you think. Unless you have to do the staff assessment ( section J0700) . But again, even that section is what you observe, not what you think. Hope this helps.

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