MDS Questions??????????? | allnurses

MDS Questions???????????

  1. 0 I was looking for some useful information on continuing education for MDS Nurses. I am looking to promote some RNs into an MDS Coordinator role within long term care facilities and hopw to get some information on classes or inservices that are held in the Indiana are to give them more knowledge regarding the MDS process?....Can anyone help!!!

    Thanks
    Laurel
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  2. 30 Comments

  3. Visit  Talino profile page
    #1 0
    Indianapolis MDS training...
    http://www.ihca.org/content/PDFs/200...vanced_mds.pdf

    Online MDS training...
    http://www.aanac.org/

    MDS Users Manual... (The MDS Coordinator's Bible)
    http://www.cms.hhs.gov/medicaid/mds20/man-form.asp?

    CMS MDS site...
    http://www.cms.hhs.gov/medicaid/mds20/

    My take -- no training sessions would be beneficial without a follow-through of an actual on the job, hands-on MDS involvement.

    Good luck!
  4. Visit  CapeCodMermaid profile page
    #2 0
    Just when I was about to post my own question about the MDS....do any of y'all have suggestions for how to keep track of the dumb thing? I am new to the job...have between 25 and 30 Medicare residents at any given time. Most of them are rehab so the RC picks the ARD. I get MY part done the same day, but it seems I am forever chasing the rest of the team, and then I forget to pick the old ones up and almost miss the 14 day cut off for the Triggers and Raps. Anyone have a good form or method ??? HELP!
  5. Visit  Talino profile page
    #3 0
    interactive calendar for tracking mds crucial days...
    http://www.empiremedicare.com/transf...webversion.xls

    getting other disciplines to complete their portion of the mds on a timely manner is the most difficult task.

    suggestions:

    1. knowing the ard ranges for each pps mds is imperative. give ample notice and time for disciplines to complete it. if you alert disciplines by providing them a calendar of the expected due dates of upcoming pps and giving them at least five days to complete it from the last allowable ard, you may be able to get them to comply.
    example:
    pps/mds 14-day ---> ard range is from day 11 to 14
    disciplines will complete mds between day 14 - 18. (except when a 14-day is also an mds requiring raps, day 14 would be the last day to complete it).

    regardless what your rehab. choose (from day 11 to 14) as the ard, a discipline can safely complete his/her portion of the mds starting on day 14.

    2. pps/mds dictates your revenue and is constrained by a timely assessment. get administration involved. poor compliance should be made a big concern. do a monthly audit on which disciplines are delinquent. submit it to your administrator and have it discussed during the next qa meeting. if you're not present, don't forget to politely inquire of the outcome.

    happy hunting!
  6. Visit  CapeCodMermaid profile page
    #4 0
    Thanks for the tips and the web site. I have a PPS 100 day scheduler I use which is very similar. I think I'll just have to either come up with my own form or get a big stick to get the other disciplines to do the MDS when it's due...and, maybe, THEY could carry it down to the data entry office if they are the last ones to do it....
  7. Visit  catlady profile page
    #5 0
    Quote from talino

    1. knowing the ard ranges for each pps mds is imperative. give ample notice and time for disciplines to complete it. if you alert disciplines by providing them a calendar of the expected due dates of upcoming pps and giving them at least five days to complete it from the last allowable ard, you may be able to get them to comply.
    example:
    pps/mds 14-day ---> ard range is from day 11 to 14
    disciplines will complete mds between day 14 - 18. (except when a 14-day is also an mds requiring raps, day 14 would be the last day to complete it).

    regardless what your rehab. choose (from day 11 to 14) as the ard, a discipline can safely complete his/her portion of the mds starting on day 14.
    if i'm using grace days on that 0/7, i certainly would not want another discipline starting their section on day 14.

    i keep a special medicare assessment list and distribute it as needed, usually once or twice a week. i give the disciplines four calendar days, which gives me a day or two to chase them down as needed. particularly as rehab usually picks day 7 or 8 for the 1/1 (we do all our admission assessments with the 5 day, not the 14, in case we need grace days on that 14 day) and i have to have everything completed by day 14. if i'm approaching month end and need those assessments, i might only give them a day. better that than take pending days unnecessarily.

    i don't know what size building the op has or what their med a census is, but if my med a mdss aren't completed when i want them, i yank the mdss from the chart, march the pile down to the respective office, and hand them to the department head. it ain't pretty, but it's effective, and i never have a late assessment.
  8. Visit  CapeCodMermaid profile page
    #6 0
    Thanks for the advice CatLady. I have started to get "cranky" with the other disciplines which seems to work. Our rehab department is almost always using grace days and our dietician is part time and I never know when she'll be coming in. She says she has 14 days to do her assessment...I usually end up doing her section...and my building most often has between 25-32 Med A's and 4 or 5 Managed.
  9. Visit  Talino profile page
    #7 0
    Quote from catlady
    If I'm using grace days on that 0/7, I certainly would not want another discipline starting their section on day 14.
    Grace days are used on a "prn" basis, not as a routine. In which case you need to notify disciplines on a prn basis as well. The poster was looking for ideas on how to get disciplines to be more punctual and compliant in completing MDSs.


    Quote from catlady
    If but if my Med A MDSs aren't completed when I want them, I yank the MDSs from the chart, march the pile down to the respective office, and hand them to the department head. It ain't pretty, but it's effective, and I never have a late assessment.
    MDS Coordinators have resorted to a multitude of strategies to get disciplines to be more compliant. Fortunately for us, the quarterly QA "reality check" works since a Dept. Head can just be put on the spot by the Admin. Aggravation does not befit the MDS Coordinator, let it be the negligent department's enigma.

    If it's an ongoing problem, maybe the strategy needs to be redressed?
  10. Visit  CapeCodMermaid profile page
    #8 0
    Does it cause trouble if grace days are used ALL the time? 98 percent of the time our rehab staff uses some if not all of the grace days for the 5 day assessment.
  11. Visit  Talino profile page
    #9 0
    grace days should be used sparingly, e.g., when resident missed a day from therapy, a holiday, a loa, an off-site md visit or rx, etc. when used routinely, you will be raising a flag. have you heard of dave?

    confer with your rehab. staff on their intentions for using grace days.

    1. do they want to place the resident on a very high or ultra high rug category?

    to achieve this, section p1b: therapies should equal 500-720 minutes of therapy within the ard of the 5-day medicare pps assessment. to be in compliance, a minimum of 100 mins. of therapy/day should be started on day of admission up to day 5. habitual use of grace days for this matter on a 5-day pps is an absolute red flag.

    2. or, they simply want to put resident in a rehab. rugs score?

    to get a rehab high category, all you need is a minimum of 65 mins. in p1b. therapies (can even be a combination of therapies) and, the 15 day estimate should equal a minimum of 520 mins., and at least 8 days of therapy.
  12. Visit  catlady profile page
    #10 0
    Quote from Talino
    Grace days are used on a "prn" basis, not as a routine. In which case you need to notify disciplines on a prn basis as well. The poster was looking for ideas on how to get disciplines to be more punctual and compliant in completing MDSs.

    MDS Coordinators have resorted to a multitude of strategies to get disciplines to be more compliant. Fortunately for us, the quarterly QA "reality check" works since a Dept. Head can just be put on the spot by the Admin. Aggravation does not befit the MDS Coordinator, let it be the negligent department's enigma.

    If it's an ongoing problem, maybe the strategy needs to be redressed?
    I'm the clinical reimbursement coordinator. My job is to make money for the facility and reduce expenses. The most obvious way is through PPS. We also have an MDS coordinator.

    Certainly I don't often use grace days on a 14-day assessment, but it happens. For the five-day, usually therapy will request grace days because they rarely see the patients on day one, and they don't have a full treatment staff on weekends. If they are only going to make medium or high, I will tell them to move the ARD back to day five or earlier, because they can get it with an estimate. If I can get an SE3 based on hospital data and rehab can't do better, I will set the ARD at day one to avoid a rehab estimate. Therapy almost always picks day 8; I have educated the program manager that if she achieves actual minutes prior to day 8, she should choose the date where she makes the desired RUGs category. More than a few times I am given an ARD of day 8 and find out on day 9 that the resident didn't quite get enough minutes for Very High, so I have to move the ARD back to day 5, or day 1.

    On the later assessments, if they are not rehab, I will initially set the ARD to the first day of the window. But that may not turn out to be the optimum date for maximizing their score. Perhaps they need a few more doctor's orders, or a week into the window they have an IV started. I keep the MDS open until the last grace day or until I am sure I have maximized the RUGs score. (I just raised an 0/4 from below-the-line to above-the-line by rescheduling the ARD from day 80 to day 92, when we got a second doctor's visit.) The other disciplines aren't going to be up on what I am doing; they just need the date.

    There is no way the other disciplines are going to know what dates I've picked. Nobody tracks the PPS schedule but myself and the program manager. It's only fair that I give them a calendar. There are often changes, which I highlight in bold type so they know it's a change. I don't use an actual calendar, but rather a list of names, type of assessment, the ARD, and the due date which I have set. I revise it and distribute it as needed.

    For the non-PPS assessments, we distribute a more traditional calendar. The MDS coordinator will announce in the morning meeting whose MDSs must be completed that day. But there is always chasing to be done.
  13. Visit  mystichi profile page
    #11 0
    If you are looking for continuing ed, try ceanswers.com
    They helped me!
  14. Visit  ADON132 profile page
    #12 0
    I am a MDS Consultant. I go to different SNF and teach the MDS process to employees that do not have any training at all. I also fill in as Interim MDS nurse at several dfferent facilities when their's has quit or gone on vacation or just when and where I am needed. I would be interested in talking to you about some MDS Training in your facility.You can e-mail me privately at adon132@aol.com.

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