How do you get your MDS done?

Published

Here's what we are currently doing...

Every Thursday, I put out a list of the MDS that are due in the next seven days...I list the resident name, the type of assessment, the date that I want the completed sections of the MDS back to me, and the care plan date. Each department completes their section and I enter all of the information into the computer. I then submit the MDS and put it out to be signed.

We've been informed that we need to figure out a way to make them more multi-disciplinary. The social service director wants to have a meeting every week and do the whole thing together. I'm not really sure how I feel about that...it seems like it is going to take a lot of time and is going to be really tedious. I don't really know if I like our current system either, but I'm just not sure where to go from here.

Any suggestions?

Talino

1,010 Posts

Specializes in ER CCU MICU SICU LTC/SNF.
each department completes their section and i enter all of the information into the computer. i then submit the mds and put it out to be signed.

let me point out first that your practice of disciplines signing the mds only after the entire mds is completed and submitted may not comply with the regulation. an earlier date entered instead of today's constitutes backdating.

"manually completed forms are signed and dated by each individual assessor the day they complete their portion(s) of the mds record. when mds forms are completed directly on the facility's computer (e.g., no paper form has been manually completed), then each individual assessor signs and dates a computer generated hard copy, after they review it for accuracy of the portion(s) they completed. backdating completion dates is not acceptable."

interpretive guidelines 483.20(i) p 125

i recommend you print out a blank aa9, leave it in the chart, and have disciplines sign it on the day they actually complete their section/s in the mds. after it's completed, entered into the computer, and submitted, simply attached the already signed aa9 to the printed mds.

going back to your main concern...

your scheduling seems fine.

disciplines assigned to complete a portion of the mds are considered the experts. otherwise, reassign the section to someone who is. the discipline will initiate an interim care plan after completing the mds. the care plans are then presented to the team in one formal meeting during the following week. herein, the disciplines are enjoined to add, delete, or dispute goals and interventions. when everyone concurs, the care plan is finalized. all disciplines participating sign the resident's care plan to indicate a multidisciplinary approach. a p&p stating so would support a facility's practice.

... a suggestion, it is.

Specializes in LTC, Hospice, Case Management. Has 37 years experience.

I personally think it would be a pain in the "arse" to have everyone in a room trying t complete an MDS. Jeez, talk about ineffecient use of time! Plus why do they have a say (or even care) in how many meds, injections, dr. orders, etc the resident has.

When I start an MDS, I want quiet, so I can read and think. A group would not work for me.

UdonNomi

63 Posts

Specializes in LTC/MDS/PPS. Has 25 years experience.
I personally think it would be a pain in the "arse" to have everyone in a room trying t complete an MDS. Jeez, talk about ineffecient use of time! Plus why do they have a say (or even care) in how many meds, injections, dr. orders, etc the resident has.

When I start an MDS, I want quiet, so I can read and think. A group would not work for me.

Yep, sounds like everyone getting together for an arguement session. Much like Talino stated, we generate a blank (or current) computer copy and forward it to each dicipline for assessment/review. This has worked wonderfully in our facility and has cut completion time by days in some cases.

disney158

33 Posts

Specializes in Hosp, SNF.
:down: Have to say it and can only say it this way, that person is NUTS !!! For multiple reasons, some of the MDS questions are "expert opinions" not a data item like a height or weight and the arguments can go on forever !, for the sheer sake of time alone, you will never get any other work accomplished, and speaking fiscailly, why the hell would I want a team of professionals wasting time completing a document not designed to be completed in this fashion, let the interdisciplinary process occur after the data collection process has finished, in other words, make the care plans interdisciplinary not the data collection, I can't imagine you facility administrator would even go with this idea !!!:no:

Rexie68

296 Posts

Specializes in Vascular Access Nurse. Has 21 years experience.

Ah, don't you love it when some idealistic soul comes up with such a wonderful idea! (such as the new unit supervisor who wants to go thru each care plan as a group intervention by intervention.....oh shoot me now!) I think the way you do it now sounds fine. And we have each team member put their initials and date on the "working hard copy" and then their entire signature on the computer generated copy that's printed out after being entered. That's not back-dating, that's signing the computer copy for the date you completed your section of the MDS. The computer copy goes in the chart...we keep our hard copies just in case there's any questions later on. :no:

tinytoo

4 Posts

All our disciplines meet at 8:00am every morning. I sit at the computer and SS gives me the answers to her section and I enter it. Activities and dietary do the same. I does not take much time at all. If a RAP has to be done, we also do this together at this 8:00 meeting. We alot ourselves 1 hour. If a care plan needs to be done, we start on it if there is time, otherwise that discipline does it on their computer sometime that day or I do it. This actually works well having all the disciplines together every morning. Our DON pops in most mornings and at time our Administrator comes.

Rexie68

296 Posts

Specializes in Vascular Access Nurse. Has 21 years experience.
all our disciplines meet at 8:00am every morning. i sit at the computer and ss gives me the answers to her section and i enter it. activities and dietary do the same. i does not take much time at all. if a rap has to be done, we also do this together at this 8:00 meeting. we alot ourselves 1 hour. if a care plan needs to be done, we start on it if there is time, otherwise that discipline does it on their computer sometime that day or i do it. this actually works well having all the disciplines together every morning. our don pops in most mornings and at time our administrator comes.

tinytoo, that sounds wonderful....but impractical in many facilities, and would eat up a lot of time for all disciplines. i know i'd get antsy waiting for others to do their sections while i could be working on other things! we have 139 residents, anywhere from 20-30 of which at a time are skilled. now that security blue is requiring the same mds schedule that medicare does, are workload is even higher. we don't have an hour every morning to meet....plus, our dietician is only at the facility 3 days a week. anyway, point being, i'm glad it works for you, but still think that the way the op is doing it is perfectly valid.

dbsue1954

39 Posts

I ISSUE A CALENDAR FOR THE ENTIRE MONTH. I HAVE 58-60 RESIDENTS. CALENDAR IS ISSUED TO ALL DISCIPLINES INVOLVED. IF THERE ARE ANY CHANGES, I LET EVERYONE KNOW IN MORNING MEETING. WE HAVE CARE PLAN AND ALL OTHER MEETINGS ON THURSDAYS AND AT THE END OF THE MEETINGS WE ALL GO OVER THE CALENDAR FOR THE NEXT WEEK. I ALSO ISSUE MEMOS ON AN AS NEEDED BASIS IF ANY CHANGES OCCUR (SIG CHANGES, DISCHARGES/READMISSIONS, ETC) THIS SEEMS TO WORK WELL FOR US. I ALWAYS HAVE A CURRENT CALENDAR POSTED IN MY OFFICE SO ANYONE CAN DOUBLE CHECK AT ANY TIME. THIS IS HELPFUL, TOO BECAUSE THE ENTIRE CARE PLAN SCHEDULE FOR THAT MONTH IS ADDED ONTO THE MONTHLY CALENDAR SO EVERY ONE IS PREPARED (USUALLY) :nuke:

rukiddingme

209 Posts

Specializes in Long term care. Has 14 years experience.

this is a pretty good thread. i'd also like the details on how others get the full process completed.

i, too, have a similar system going at my facility. i give out a schedule with dates that each patients mds info is due to be turned-in. (but often, it's not turned in on time)

each mds team member(5 total, including me) submits their info to me on paper, i enter it into the computer, print it out, and then have them sign it.

i've been trying to come up with a way to stream-line the whole process, and haven't figured out how.

now, to let it be known, i've only been doing this for 5 months, and don't know much about the rules/regs pertaining to them. my training was very limited, and i've not been offered to attend any class.

i asked my administrator for a larger office - so i'd have room for a table & chairs, and could get the other mds team members into my office, as needed, when i have mds' things to talk about with them.

right now, i hand the mds' off to them in our morning meeting, and may not see them for days.

one of the mds team member has mentioned all of us getting together to do/review the mds' - but i believe she means after it's been completed & printed out - to sign them, fill out raps, and review/update care plans.

i'm dreading the state survey which will be around november, from what the administrator says.

tara

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