Late days and BIMS, MDS Nurse in a tough spot.

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Specializes in Clinical Documentation Specialist, LTC.

I know BIMS have to be dated within the look back period, but what if, when the MDS nurse starts a new job at a new facility, the MDS are two months behind? Would you put dashes in section C to indicate cognitive function was not assessed? I was somewhat hinted at to back date BIMS, but I don't feel comfortable doing that since I didn't interview the residents until I started and actually DID the MDS. Corporate MDS nurse is not happy with me since the BIMS are not dated within the look back period.

The thing is, there was another MDS nurse there but the only MDS that were kept up to date were the eight Part A assessments.

Administrator and DON thought they were being kept up to date. They're not happy at all. Would be a bummer if I am terminated because of late BIMS when I wasn't even there to interview the residents.

ETA: MDS nurses do the BIMS at this facility.

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Did the facility social worker complete the BIMS on time? I know with our facility, it falls on the SW to do the BIMS.

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Specializes in Clinical Documentation Specialist, LTC.

Oddly enough it's been put on the MDS nurse to do the BIMS. First place I've worked where that's the case. She's been there almost 30 years so gets away with dictating what she will and will not do. She will not even do admissions or any sort of marketing.

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Specializes in ER CCU MICU SICU LTC/SNF.

Politely show the DON and Adm the attestation clause of Section Z400 -- "I certify that the accompanying information reflects resident assessment information..." that you cannot possibly sign and enter the dates they were due because it precedes your hire date.

The facility may choose to pursue the matter unethically and have the DON or the other MDS person create and complete the overdue MDSs and enter their signature and the actual due dates at their discretion. Obviously 'cannot be the newly hired MDS person.

The newly hired MDS person should only offer to complete ALL the overdue MDS using the current date and submit them as late assessments. A warning is sustainable than perjury.

You cannot get dinged for dash-filled BIMs on a few isolated cases with the reason documented, only when it becomes a pattern.

Assure the facility and the corp MDS that these events will not be repeated henceforth on your watch.

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Specializes in Clinical Documentation Specialist, LTC.

Thank you Talino. I'm so glad you chimed in. I won't back date for anybody. After the events of today, hopefully we have a better understanding of each other at my job. Just going to do my best and get the heck out of dodge when another opportunity comes along.

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Specializes in Clinical Documentation Specialist, LTC.

Well...I'm done. They can have it. I see why I'm the fourth MDS nurse in less than two years they have lost. As soon as something else comes along, I'm out of here. They will not do anything about slackers. Just want to punish those who actually work.

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Hi there,

I'm kind of shooting in the dark here, but wondering what advice you may have to a new nurse, since May 2012, who has just been promoted to MDS Coordinator for a 120 bed LT care/rehab facility, 80/40 split. I knew the previous MDS Coordinator who really liked her job. Currently, I'm concerned since there were 2 other nurses in the office, but for now, one of them is out on leave. Am concerned about going into new position with just one other body in the office. Suggestions? I'm completely new to MDS work. Thanks!!!

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Specializes in Clinical Documentation Specialist, LTC.

Just a quick update. I have left the MDS job in the OP because the MDS Coordinator made it impossible for me to enjoy anything about the job. I am starting a job at a family clinic on Monday and couldn't be happier. If I *ever* go back to MDS it will be where teamwork is practiced. In my 15 years as a MDS nurse I have never experienced anything like I did in that LTC home. It was a terrible experience. I am so glad to be out of there and so grateful to God for opening another door for me right away. He is so good to me.

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Specializes in retired LTC.

I must say I admire all you MDS nurses (et al) out there. A long-time way back as UM, I did some MDS 2.0 stuff, but it's like you guys are speaking a different language now. (I can see my old MDS 2.0 Briggs manual on my bookcase as I type.)

I've THOUGHT about moving to MDS, but no thanks as it is now. My LTC experience is there, but not for all the MDS detailed stuff y'all have.

I do enjoy reading your section, but I admit that much of the abbreviations are foreign to me. Hats off to you!

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Specializes in Clinical Documentation Specialist, LTC.

amoLucia, MDS 2.0 was nothing compared to 3.0. It seemed like 2.0 was so much easier. I really enjoyed doing MDS before 3.0 was implemented, and didn't mind it so much when 3.0 came on the scene until I was hired at the facility I just left. Teamwork makes a lot of difference in one's success as a MDS nurse, since all disciplines *must* work together for it all to flow the way it should. With no teamwork among all disciplines, there is sure to be failure.

I have heard a lot of MDS Coordinators are jumping ship because of the stress and constant changes. The case mix auditor came before I left, and she told us that every home she goes to for MDS audits has had high turnover of MDS nurses. She said herself if she had to go back to doing MDS she would find other work. That's saying something coming from a case mix auditor LOL!!

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Specializes in retired LTC.

To LTCNS - that's what I'm saying! :wacky: I haven't a clue what you all talk about, like even what is BIMS ?!? And all your little timed schedules.... No thank you! And to know that a facility's reimbursement hinges on MDS!

I'll just work on helping with careplans. But I will acknowledge that it is difficult to chart meaningfully for skilled/rehab care when you work 11-7. I try.

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Specializes in Clinical Documentation Specialist, LTC.

BIMS=Brief Interview of Mental Status, aka a royal pain in the backside :D

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