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amylpn24 2,119 Views

Joined: Mar 28, '08; Posts: 30 (37% Liked) ; Likes: 35

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  • Mar 16 '10

    Lets look at this another way. For instance, what if the patient has had severe pain in the limb from gangrene? Pain after the surgery could actually be LESS than when he had his leg. Also, emotionally he may be BETTER off now that he is out of pain. And for some, this amputation could lead to a prosthesis that will now make him less dependent than before.

  • Nov 20 '09

    Hi. Maybe I'm just not reading this right...but the question and responses seem to say that we write care plans based on what we think the state surveyors will look for, not based on actual resident problems?

    Behaviors may be a STAFF, not a RESIDENT problem. A disease is not a resident problem--managing the lifestyle/physical changes may or may not be...Is a "status" a problem? Or a medication?

    Am not sure we will ever truly understand, plan, or provide "resident-centered" care if we continue to write "surveyor-centered" care plans. YES--surveyors see a plan--but does the staff know, or carry out, all of the possible approaches?

    All that work--but not a plan that actually works for, or helps, anyone...And there just isn't enough time or brain power left to analyze all the pieces--to fit each into a few clearly defined resident problems--actually problematic to the resident...Tis frustrating to professionals--and tis not "quality". Somehow, we need to turn it around again...

  • Oct 23 '09

    Since the rate doesn't change until the first of the month following the ARD, one thing we do is this: If you have a resident that has an assessment due on say 10/5/09, most people would set the date a little earlier rather than later so as to avoid potential compliance issues. However, if you set the ARD for 10/1/09 rather than 9/30/09, you have kept this resident in a Higher Rug for an additional 30days at the new lower rate will now change as of 11/1/09 rather than 10/1/09. Creative scheduling and you have to really watch to make sure these are closed on time since you are completing so close to when your R2b has to be. With that said, just by doing this and tracking for 2 years the results just at my building, we have created an additional $300,000+ dollars in two years alone. I developed this along with a few other creative scheduling things and have created so much additional money that our corporation has implemented this corporate wide for states with Case Mix. Hope that helps... Any questions, feel free to e-mail me at