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CAT & CAA's...help!!!

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Does anyone have any good info on the CAT & CAA for 3.0? Our corp office wants us to use the forms in RAI to do the CAA's with....talk about labor intensive!!! Are most of you doing short summaries with references to data location in the chart? Have I understood the schedule correctly...the MDS and the CAA's are all due by the ARD date?? :devil:Our careplan software does not intergrate properly with the MDS software and this has turned into a nightmare! There are only 2 of us in the MDS office and we have 162 beds. We had around 12 admits and d/c at change over plus all the new one's since. I feel like we are drowning...plus our MDS software is not fully functional yet!!!:eek: Any info would help!:lol2:

rukiddingme

Specializes in Long term care. Has 14 years experience.

Yes, we do short summaries - and reference to chart information, the interviews, and any statements by staff that are related.

Magaly63

Specializes in medsurg, everything in LTC.

Also having trouble with CAAS.....software remains problematic.... is anyone aware of "sample" CAAs that can be used for reference?

The CAAs from our software do not pull any information and navigating them takes forever.

Thanks

1lanarn

Specializes in mnagement, LTC, geriatrics.

I am also having a lot of trouble getting the hang of the CAAs and CATs. Not sure what is the best way to complete them. We have been printing off the worksheets and using those but it seems a big waste of trees and time. Not sure what our government was thinking, (or not). Nothing is qicker or easier and the discharge assessments are the most problematic.

rukiddingme

Specializes in Long term care. Has 14 years experience.

Many of the CAA's on our software program are 3 pages long - talk about wasted paper. Just add all those to the comprehensive assessment, and the care plans and you have alot of paper from just one assessment.

susanthomas1954

Specializes in Assessment coordinator. Has 35 years experience.

The paper is very problematic, IMHO. We are not printing anything except the actual plan of care. We have paper charts, no EMR's yet, and the thought of cramming another 60 pages for a full assessment and CAA's into it, is just not feasible. What is everyone else with paper records doing. It looks like a lot of people are printing these, but I can't bring myself to do it.

NurseMomDori

Has 3 years experience.

We are printing the MDS 4 pages to a sheet. You get 4 small pages but you can still read the print and it saves a ton of paper! Our state (Montana) survey office said it is okay for us to place "See IPN dated 10/05/10, DW (initials)" in the CAA documentation location and do a summary of the CAAs. I do that anyway, so it eliminates duplication. Noone looks at the CAAs anyway except on a state survey. As long as you cover all of the info in your IPN you are providing the necessary documentation. Using the CAA roms means you have to print them out and keep them with the MDS if you use paper charting. What a waste of time and PAPER! Just cover it in the IPN.

meghan61

Specializes in LTC QI MDS. Has 28 years experience.

The AANAC website has the CAAs in Word or PDF format. It looks like a checklist for the triggers.

golflinda2214

Specializes in gerontology. Has 40 years experience.

Your timing is not correct. The MDS is due for total completion 14 days after the ARD, as are the CAA's, but can be done earlier. Only on a new admit must the MDS and CAA's be completed by the 14th day of the admission to the facility. (Admission date +13 days.) SCSA must be completed by date of determination (ARD)+14 days. Go to the chart on page 2-15 of the RAI manual. Yes, I am doing the check marks and writing where my "evidence"is and the date of the "evidence", so if it was a nurse's nate that said the res. was SOB,then I simply put the date of that note. A short summary is all I am writing at the end of each CAA, and sometimes I refer to other CAA's that also have the documentation they are looking for. I am starting to gain confidence in the process, but I still don't LIKE it. Too much wasted time for me!

mdecastronp

Specializes in LTC, Magt, family practice, legal nsg.

Does anyone have any good info on the CAT & CAA for 3.0? Our corp office wants us to use the forms in RAI to do the CAA's with....talk about labor intensive!!! Are most of you doing short summaries with references to data location in the chart? Have I understood the schedule correctly...the MDS and the CAA's are all due by the ARD date?? :devil:Our careplan software does not intergrate properly with the MDS software and this has turned into a nightmare! There are only 2 of us in the MDS office and we have 162 beds. We had around 12 admits and d/c at change over plus all the new one's since. I feel like we are drowning...plus our MDS software is not fully functional yet!!!:eek: Any info would help!:lol2:

That's too bad that your corporate office makes you do the 4-6 pages of CAAs. CMS does not endorse the CAAs but merely uses it as a recommended format, if your company is not using evidence based assessment. There are a lot of talks on when to use or not use the CAAs. I have been in CMS training and they specifically do not mandate the use of the CAAs as long as "this is specified in your policy" and that "your assessments are evidence, expert tested assessments". This is also indicated on Chapter 4 of RAI manaual. Request your company to send you the policy on CAA documentation, if it is not specified, I would not worry about it. Indicate the location of your information on Section V and do a narrative. However, I will caution you on not using the CAAs forms, if your company has not adapted the use of evidence based assessment and practice.

CAAs requires clinical cirtical thinking analysis to draw the conclusion from it aside from having to check the forms. I have updated all our company policies, including the RAI and CAAs to eliminate the use of the CAAs forms but updated all our company assessments to evidence based practice and clinically tested forms. Having to do this eliminated having all my MDS coordinators in answering the CAAs forms. My policies have been tested on surveys prior to MDS 3.0 implementation and my bldgs had the most of 5 total deficiencies no more than "D" with either 1 or 2 nursing service deficiencies! I feel your pain... Goodluck!

Edited by mdecastronp
mispell

NurseMommyRN

Specializes in MDS Coordinator. Has 9 years experience.

Good luck to you. I"m a brand new MDS coordinator, too. I stepped down from a Unit Manager position and am loving it. However, the CAAs are driving me crazy. I only had 9 days of training before the experienced MDS coordinator left, so I'm kind of floating on my own. Nobody seems to know how to do the CAAs in my building. Some people are just pulling triggers from the CAA worksheet and restating the Care Plan in the CAA summary. It seems very redundant.

I would love to find a way to quickly do a CAA summary. Right now, I would rather do 20 short assessments versus one large one.

katoline

Specializes in long term care - MDS. Has 22 years experience.

I wish I had time to do these like they are supposed to be done. As it is AM mtg., clinical rounds, and corporate mtgs/teleconfernces and inservices leave me three hours a day if i am lucky. unless of course i stay late and come in early which i do, but have other responsibilities as well. with people coming and going, coming and going, not being able to open assessments without completing the prior one, i feel like a hamster on a wheel.:uhoh3:

LPN3RAC-CTMDSC

Specializes in IMCU, TELE, ONC, REHAB, LTC, SNF, ETC.... Has 16 years experience.

Your mds is due 14 days after the ard, unless it is an admission assessment (due 14 days after admission), or a significant change assessment (due 14 days after determination that a sig change is necessary). Remember, the caa's are just a pathway to the care plan. It supposed to get you thinking so that your care plans can be more effective for the resident. If you are spending hours doing caa's and filling up pages of caa notes, you are missing the point. If you don't have mds software, you need to seriously talk to your executive committee. Remember, all facilities must have ehr enabled by 2012. Well, they'll probably change that a little, but you should be aiming for it.

katoline

Specializes in long term care - MDS. Has 22 years experience.

I basically do the CAAs the same as we did the RAPs. No, I don't write down each and every document and date i got the info from. If it's ADLs, i'll write ADL flow sheet, or therapy eval and notes etc. We already have the ARD and the time frame. If the info came from the admission hospital records, i put that, or H&P if the attending has been in and written that note.

I guess it depends on your software. We have a button on the bottom to pull up triggers. I look at that section of the MDS and coordinate it in my summary note. I basically take into consideration the reason the resident was in the hospital (i do PPS), what the resident's previous and current capabilities are and just use common sense. All these complicated examples of what SHOULD be done are idealistic. None of us has the luxury of spending that much time on an assessment, let alone be able to hold on to a chart for any length of time before someone else needs it. If someone has advanced dementia, a toileting program isn't going to work. Their incontinence can be included under skin breakdown. A bed/chair bound tube fed resident that is missing teeth doesn't need dental intervention unless they have pain or sores. Likewise if the same resident does not communicate and you can't get an accurate vision assessment, then vision is adequate for level of care. Someone else i might write is able to grasp and use utensils etc. I guess i put more emphasis on my note and i make them as short and to the point as i can.

katoline

Specializes in long term care - MDS. Has 22 years experience.

NurseMommyRN, bless you for hanging in there with 9 days of training and "loving it"!!!:heartbeat

DixieRedHead, ASN, RN

Specializes in ED/ICU/TELEMETRY/LTC. Has 20 years experience.

Nine days of training?

I got three. I am brand new at this and the CAAS are killing me.

If any of you could provide me with a sample, just one same for something general like say, Increased Risks of falls and the approaches. All I ever seem to write is "see nurses notes (or ADL sheet or whatever) and "will proceed to careplan."

I would really be grated for just one correct example and I believe I could go on from there.

Thank you.

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

Over 80 clients each! Whew; that's just wrong :banghead:

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

My goodness, I sure bumped that one. It just astounds me when I hear that people are breaking their backs like that. We are suppose to be thinking and benefiting the resident, not going crazy and blindly running to finish something we don't understand. Good luck to all...