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.