I need help!

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I am a RN in a facility where in March we will become Medicare certified. My DON is having me take the online classes to get certified in MDS. We have a 10 year experienced MDS nurse but she wants me to be the charge nurse, medication, & wound care nurse (which I am experienced in all of these) and to do the MDS/PPS on our Medicare residents which she tells me should be no more than 5-7 residents. I am not understanding the whole medicare PPS part. For instance when they say you need to do the 5 day Medicare assessment I know you would mark that on the MDS, but does that mean I have to do the whole MDS for the 5 day, 14 day and so on. I know I can code both the 5 day and a admission assessment. All of this is confusing to me and our MDS nurse has never worked on the Medicare side of the MDS. I would love to have someone give me step by step instructions but am not sure where I can go. I am a hands on type of person and reading a book isn't doing it for me. Any idea out there. I am trying to find someone in the town I live that might be able to let me get some training one to one with them but that would mean another facility in town would have to allow that. Any information would be greatly appreciated. I feel so much resposibility to do well since my DON hand picked for this because of my assessment skills & I rarely call off, I am worried I bit of more than I can chew, because I am a perfectionist & put so much on myself. Right now I am the current wound care nurse with another WCN and my job is pretty great now but I could,nt say no to my DON (even though I tried for a couple weeks!!):uhoh3:

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I wish I could help you, but I don't have enough experience with the MDS to tell you what you need to know. Maybe this will ease your mind. We are a 70 bed facility, we have a RN MDS coordinator and an LPN MDS coordinator. The LPN does everything the RN does, but she can not sign the MDS. Our LPN has been in this position for 8 yrs and had to train 2 RN's to do the position. I know it is not an easy job, but our small facility sometimes has up to 18 medicare residents. I think you will be fine after you start doing the job. I hear that it takes a long time to learn, but as soon as you think you know what you are doing something changes. Just keep in mind it is a job that keeps you at your desk in front of a computer for the majority of the day. I am the QA/Infection control nurse, I spend a lot of time doing paperwork, sometimes I miss the floor. So maybe you should think about is this going to be something you like doing. I hate to say no to my DON as well, but I have learned that if I am not happy making her happy doesn't help me in the long run.

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Specializes in Gerontology, Med surg, Home Health.

You seem to have a lot to deal with besides being a new PPS MDS nurse. There is a really good CMS website on how to do MDSs and the regs for the PPS. The hardest part of the PPS system is learning what day to choose for your ARD to maximize your income. I'm assuming you have rehab at your facility. It's crucial for you and the rehab manager to work together to pick the ARD. Good luck and let us know how you do.

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Specializes in ER CCU MICU SICU LTC/SNF.

Basic Medicare PPS assessment is explained in the RAI Chapter 2 pp 2-27 to 2-40

PPS RUGs are explained in Chapter 6

Medicare Guidelines (who's covered and who gets cut off) ... http://www.cms.hhs.gov/manuals/Downloads/bp102c08.pdf

Plus tons more... http://www.cms.hhs.gov/Manuals/IOM/list.asp

In order for Medicare to pay, an MDS assm't MUST be completed following specified timeframes ONLY. DO NOT be late. Be patient, be very attentive. Significant revenues are at stake. Joining a free discussion group dealing with all stuff related to MDS and PPS (Medicare) is a MUST. You can post ANY scenario you get stuck with and get a prompt resolution.

Good news, it can be learned!

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CMS has a free online training program at http://www.cmstraining.org/. There is a section there on how to work with PPS. Also go to http://www.providers.ipro.org/index/nhqi-conferences-mds and listen to the mp3s from Andrea Platt's MDS boot camp.

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Specializes in SNF/ MDS/ Clinical Reimbursemen.
I am a RN in a facility where in March we will become Medicare certified. ...... I am worried I bit of more than I can chew, because I am a perfectionist & put so much on myself. Right now I am the current wound care nurse with another WCN and my job is pretty great now but I could,nt say no to my DON (even though I tried for a couple weeks!!):uhoh3:

It is now March 14th and I am wondering how you are making out? Have you got your first Medicare patient yet? Do you have any questions? Let us know how you are doing?

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Hang in there...it can be learned. We have 152 swing beds with 51 specific for rehab. I have 101 beds mostly long term and another LPN has the other 51

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Thanks to everyone! I haven't really started yet I am still doing wound care at this time. I did get my MDS certification but we are still waiting for our medicare approval. I am still reading and attending a few seminars here and there. I haven't been able yet to train with our current MDS nurse, I still am just hoping everything will be fine and trying to figure out a worksheet for me to gather information for the MDS. I would like to thank everyone who has replied to my requests. Reading all this stuff for the MDS is great but actually being able to apply it is totally different. I know it will all be fine once I can get hands on experience and will become second nature just like everything else I have done in my career. Any ideas or help is always appreciated.:rolleyes:

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