AAARRRRGGGGHHHHH!!! More new CMS guidelines!

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Specializes in Gerontology, Med surg, Home Health.

I just spent the entire day at an inservice about the new CMS guidelines for incontinence and catheters. YIKES!!! Our old bladder assessment was one page long with some pretty basic questions. The new one, devised by corporate to incorporate ALL the details of the regs, is 2 pages long...about 47 questions. Can you imagine having 4 admissions and having to take at least 30 minutes on one assessment?!? The questions are patently absurd: "How many times a day do you void?" DUH..gee I don't know..depends on how many cups of coffee I've had. "Can you hold your urine for 2 hours?" TWO HOURS??? are they joking? Seems to be another case of the regulatory agencies looking for a way to give us citations.

And, oh yeah, you can't claim someone is too cognitively impaired to be "retrained". If they answer to their name, and can name 2 objects on a table, the surveyors will think them cognitively intact enough to participate in some sort of retraining or bladder program. Sure, we'll "train" the CNA's to get the person to the toilet. I can guarantee that the residents on the dementia floor in my building would rather be left alone in a brief than to be dragged to the toilet every few hours. :uhoh3: :banghead:

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Specializes in MDS coordinator, hospice, ortho/ neuro.
I just spent the entire day at an inservice about the new CMS guidelines for incontinence and catheters. YIKES

I'm going to one of those seminars later this month, and what I've already heard makes me just want to go play in traffic. :eek: Some of it ( like the determining the type of incontinence ) sounds like its outside the scope of nursing practice....and I'm not going to do prostate exams. Our medical director probably won't co-operate either.

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I am extremely worried. F315 becomes effective June 27th. I believe that date is correct. Corporate is in the midst of making policies to match the 38 page incontinece guidelines. OMG bladder assessments, diaries, prompted voiding schedules, etc... If we all thought the skin care guidelines were detailed this one make it look good. We already tried to get the incontinence program up and running w/o success. We had a lot of push back from staff. The bladder diaries were always partially filled out or the info was obviously made up. The monitoring alone is a full time job. Now there is no choice we all have to just do it and hope for the best.

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Specializes in med-surg, home health, hospice, LTC.

Since I have not been to an inservice about this, can anyone tell me where to find the new regs on the net? How can they expect to hold us to those standards if you can't even find them, I looked on the net for a good hour yesterday without success.

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I just spent the entire day at an inservice about the new CMS guidelines for incontinence and catheters.

AHHHHHHHh man What stare are you guys in??????? We have a new DON and I am the Restorative nurse and she wants me to do full bowel and bladder program and I'm already getting overwhelmed. The program she gave me that she wants is a 1" thick notebook full. (the programs we have now I designed and developed from other corporate programs and from plante moran and we have NEVER been cited on it) They want you pushing so many papers anymore you don't have time for the residents.

Rosie-

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Specializes in Gerontology, Med surg, Home Health.

the state of Massachusetts

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I just spent the entire day at an inservice about the new CMS guidelines for incontinence and catheters.

AHHHHHHHh man What stare are you guys in??????? We have a new DON and I am the Restorative nurse and she wants me to do full bowel and bladder program and I'm already getting overwhelmed. The program she gave me that she wants is a 1" thick notebook full. (the programs we have now I designed and developed from other corporate programs and from plante moran and we have NEVER been cited on it) They want you pushing so many papers anymore you don't have time for the residents.

Rosie-

I'm from Illinois. Trust me it takes more than one nurse to get this going. We are struggling. Staff has been resistant. Life is not fun right now!

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Specializes in Gerontology, Med surg, Home Health.

Yesterday the new regs went into effect....guess when we got the "final" papers from corporate....Late Friday night....lol....

My corporation likes to call people who head committees "champions"...since I was informed that I will be in charge of the bladder business, I have dubbed myself the Maven of Micturation!....now, where did I leave my crown..........

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Yesterday the new regs went into effect....guess when we got the "final" papers from corporate....Late Friday night....lol....

My corporation likes to call people who head committees "champions"...since I was informed that I will be in charge of the bladder business, I have dubbed myself the Maven of Micturation!....now, where did I leave my crown..........

I love it. LOL. I need to share the " Maven on Micturation" with our Restorative nurse. At least you have the policies. We are still waiting. We were told to continue with what we are doing until they are finalized. God help us all. BTW I loved the ALERT from CMS(or was it LSN) that stated that the incontinece guidelines would be much harder to implement then the skin guidelines.

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We haven't even heard a peep out of our company regarding the new guidelines - hence, no policy and procedure from the corporate weenies on implementation! I found all the info - thanks to my fellow posters here - (thanks guys) and gave them to our DNS and she forwarded them to the corporate weenies - still no action and we are in our survey window. I think i will go play in traffic!!

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I got the copy of the regs yesterday. They are marked advanced copy but are already in effect. What the heck sense does this make. Oh well we are talking government here so I guess I answered my own question.

We are a non-profit county home so we have to muddle through the best we can. I'm still trying to make sense of them. Restorative nurses beware cause we are getting slammed here.

Rosie

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Specializes in Gerontology, Med surg, Home Health.

wait...there are more:

the Boss of Bladder

the Diva of Dribble

the Tzarina of Tinkle

the Princess of Pee

the Lieutenant of Leaking

the King of Kegels

I am NOT sleeping well these days...why take Ambien when you can lie awake and come up with so many names for the same cumbersome, thankless job?!? :uhoh3: :uhoh3:

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