amylpn24 1,785 Views
Joined Mar 28, '08.
Posts: 30 (37% Liked)
My opinion is this. The AANAC certification is great but.....I do not believe that if you do not have any experience in the MDS, you will understand it. The best thing for you to do before taking a class such as that is get yourself an MDS 3.0 manual. Make sure it is the 3.O and not the 2.O. Get a blank MDS and study the manual from front to back so you at least have a clue what you are doing before taking a course. Completing and MDS is easy. It is the rules and regulations that are hidden in the manual that are difficult. In addition, the most important thing is learning how to calculate RUG levels and how to get the highest one. The job is about making the almighty dollar.
If it's not too late, you can do either one. Being the person that I am, hating change. I would just do the 2.0 and get it over with.
Well, All I can say is be glad that you have any help at all!! The only reprieve we have been able to get is "don't put the MDS/PPS Coordinators on call for three weeks". Grrrr
Don't let the 3.0 scare the life out of you. When you look at the big picture, it is not really THAT different. What is different is that now instead of interviewing the staff and forming your own opinions about what you think the residents need...you will be asking them and inputting the info. The CAA's are still RAPS. Just keep in mind that we will no longer be able to close the door and do them by ourselves. They must be worked by the entire team. This is the main preparatory measure you should take, getting them on board before October 1. Another suggestion, back up every single assessment you can into September and just leave yourself a few for the first couple of weeks of October. Read the new manual, interesting reading I know.
There are some new rules but, not a lot. If you know the current system, you will do fine with the new one. Everyone is freaking out, we do not like change. I don't either but as I said, look at the overall picture, it's not that bad.
Supervision with set up. 1/1. Using your eyes is considered supervision.
I am an MDS nurse with several years of experience and thoroughly trained in the 3.0. Willing to travel, do freelance work for the right price. Hold compact license.
Time to get a new job!!! MDS Coordinators can and will have more of an opportunity in with the 3.0 to write their own ticket. Get out of there.
I believe the answer to this question depends on facility policy. We do keep the chart for 30 days and start over after that. As far as the MDS's being on the chart, I'm not quite sure what one has to do with the other. If the patient has been discharged, the file goes to med records where it is kept should the state want to pull the chart for some reason.
In this case, you would change the ARD to the day of discharge. There is nothing in the RAI that says that the MDS nurse must do an or the assessment. You just use what information that you have from his six day stay and hosptial records and answer the questions that best that you can. The powers that be are incorrect and as mentioned by someone else, they will be taking the default rate. Not wise.
All I can say is WOW! I too have a lot of additional responsibilities and it makes me crazy!! In my opinion, any administrator and DON should be well versed in MDS and realize that it is US who are generating the revenue. More time equals more time to generate revenue. I wish I knew what the answer was. Your responsibilities go WAY beyond anything I have ever seen. I say get a new job and fast!!
Yes, it does matter. This is how you make the money and if you understand nothing else about the MDS/PPS, learn this. Do you have a RUG crosswalk? If not, ask your corporate MDS nurse, she or he should have one. Think of this as the bookmark for your RAI bible.
Shouldn't the rehab staff be the ones writing the specific goals for each resident? I usually write "will return to highest level of function. See rehab cp for details.' Never got tagged on this.
Are staff/floor nurses responsible for MDSs at other LTC/sub acute facilities?
We were required to compete a certain number of MDSs per month. There is a MDS nurse on staff.
These assignments were often handed out arbitrarily - Requiring a nurse to do a MDS on unfamiiar residents. Considering how important MDSs are it seems counterproductive to have floor nurses perform these duties. counterproductive but cost cutting.
More often than not we did not have time to complete the assignments during our shift hours. we were told to stay late however overtime was frowned upon so some of the staff nurses complied with management's 'request' to punch out and finish the MDSs. (another issue and a biggie)
Is it a common LTC policy to assign MDS responsibiities to floor nurses?
just keep in mind that you may not move the ard date once an assesment window has closed, or if you have already picked an ard date and that date has passed.
last quarterly r2b was 2/1/09, rug = pa.
next quarterly r2b would be due on or before 5/3/09, probably w/ an ard set on 4/20 or later.
resident was seen by a dentist on april 1st with an order to keep denture off for 2 days.
on april 3, the opthalmologist saw resident for his glaucoma follow-up and change his eye meds.
these would equal to 2 md visits and 2 md orders.
since your ard begins on 4/20, you would have missed these events based on the 14 day lookback for p7 & p8.
however, if you move the assm't earlier and set the ard on or before 4/14, you will capture the visits/orders and raise the quarterly rug score to ca.
have a cheat sheet similar to this and memorize what conditions yield a higher rug.
be present during the daily 24 hr. report and check if a resident has an acute change in clinical condition or may have required more staff assistance in adls during the week. when is his next assm't due?
most important, choose ards wisely. be flexible. schedule it later or earlier depending on what conditions or better adl sum you can capture that will produce a higher rug. just remember you have to complete the assessment (r2b) within 14 days of the ard, and, that r2b is within 92 days of the last assm't's r2b.[/quote]
Treat every payor source as if it were medicare or medicaid. This will save you a lot of pain in the long run when you find out that the resident was actually medicare and NOT private insurance.
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