ARD's, care plan dates & information

we're having some problems at my facility, and i am hoping to get some new ideas here.

the other members of the mds team are stating that they don't have enough time to get the information together, reviewed and turned into us before the care plans. before this new 3.0, we mds nurses did most of the gathering of info, thus we didn't have this problem.

example: our ard's are on friday & saturday the week before the care plan - our care plan meetings are on tues & wed after those ard's (in the afternoon, starting at 1:30pm)

is everyone else having similar problems?

how does everyone else have their ard's set, in comparison with the care plan meeting date?

[Talino]

IMO, that is too short a time for OBRA required assm'ts, unless you're only doing one or two or just PPS assm'ts.

• You have up to 14 days from ARD to complete the annuals and quarterlies. From ARD, complete the MDS in 1 week (or more days as needed). Set the care plan meeting a week after the MDS completion allowing disciplines another 7 days to formulate or update care plans prior to the meeting.
  
  
• If disciplines write progress notes, document as if you're responding to the MDS questionnaire.
  
  
• When handing out MDS weekly sched, include also a projected ARD of the next scheduled assm't. (An Excel template is great for this process).
  

Albeit, regardless enough time is afforded or organized the process is, only the disciplines compliance determine success.

[rukiddingme]

Thank you for the information.

[golflinda2214]

I agree that this is a short span in which to have all information gathered. CMS had a reason to give you 14 days to complete the MDS from the ARD, and another week to care plan. I believe you should use it to your advantage.

[rukiddingme]

Unfortunately, the only other discipline that does care plans is social service. We enter all data, and all CAA's are done by us MDS nurses. It seems as if this facility has always kept a short leash on the assessment process due to days where we MDS nurses have very few hours on the computer, and things will start piling up on us.

We average 12-14 MDS' per week probably - divided between two of us.

[susanthomas1954]

I want your job. 12-14 MDS's between my office mate and me would be a 40-60% reduction in our workload on any given week.sigh. Can't get Social services to do the CAT's. Dietary and Activities do theirs, and I am closing without Soc. Svc. doing their care plans on the computer. Some are done on paper, some are not. Soc. Svc. are my favorite people, but they can take their own darn F-tag!

We are given a monthly calendar with listed ARD due dates for the patient. The MDS coordinator issues this every month to all the disciplines who have to complete sections. She also gives the nurses on the floor a calendar so that they will know when to complete the monthly summaries. The calendar is usually put out by the third week of every month for the following month. If someone is added she lets us know.

[lisaRN37]

In our office, the Medicare, Managed care and Long term care all do their own MDS schedule and then I type up a care plan schedule. Except for Medicare 5 days, we give our departments 7-10 days to gather and input their information and they put copies in the charts for us to reference when we do our part of the assessment

I require my disciplines to have their section of the MDS done within 3 days of the ARD, then I allow another 4 days for the CAAs to be completed. What I find is the longer you give them, the longer they take. With the regulation of completion due within 14 days of the ARD, by giving them such a short time period, it alows me some "wiggle room" in case they are late. If I waited the 14 days then they would still be late and we would be out of compliance.

[rukiddingme]

I require my disciplines to have their section of the MDS done within 3 days of the ARD, then I allow another 4 days for the CAAs to be completed. What I find is the longer you give them, the longer they take. With the regulation of completion due within 14 days of the ARD, by giving them such a short time period, it alows me some "wiggle room" in case they are late. If I waited the 14 days then they would still be late and we would be out of compliance.

I'm glad to finally see that we're not the only ones that have short time periods on the times when information from other disciplines have to be turned in. As I've mentioned in earlier posts, we MDS nurses do all the CAA's and care plans ourselves, and thus need extra time to review, input and complete CAA's and care plans that will coinside with the information from the other disciplines. (along with getting other duties done)

[mdsnewbee]

What are the montly summaries that your floor nurses do? My nurses do nothing for the MDS. I had a chart the other day that hasn't been documented on since Aug.

[rukiddingme]

check med-pass.com to see sample monthly summaries - you can order theirs, or take ideas from them and come up with your own form.

I did the same with short deadlines for the shorter sections. Soc Services, dietary, and activities start their interviews during the AR period. Our ARD is Wednesday, family conference is the day before. We try to address the family concerns, and care planning issues on Tues, and Wed, then have MDS due Thurs, and CAAs on Friday. I wrap up and verify all other sections by close of business on Friday, and if necessary, use Monday to finish my sections.

Sections may be done anytime in the AR period, with signing done after the AR date. I also have a note sheet for the family conference which all participants sign at mtg, then we mail a copy (a week or so later) to the family with resolution of problems addressed at the mtg. This helps to keep families updated if they don't come to conference, or if they want a record of what was discussed. After the family leaves, we go over current care plan with the CNA, CP team, and identify changes and new problems to address. The team member responsible (or me if that person is slow or computer ignorant) then is resposible to make the changes in the computer for printing the following week.

Edited Jan 6, 2011 by NurseMomDori
wrong thread

We copied the actual pages from the MDS for each department and they use it as part of their admission assessment . It is kept in the resident's chart and we put that info into our computer by the 10th day so that gives us time to get everything done by day 14 . It has worked out well for our facility . Good luck !