MA monthly Nursing Summaries

Specialties Geriatric

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Specializes in LTC MDS PPS MMQ.

I have had great success in getting monthly Nursing Summaries completed by the 25th of each month with EDUCATION. I have found that if the Nurses understand the importance and significance of accurately and timely completion of this document from a reimbursement perspective they are much more likely to comply.

When I first started the MMQ Nurse position (medicaid reimbursement for all those case-mix states) in this facility most nurses felt that this was just one more piece of paper. It has taken over 6 months of daily communication with all nurses (day-evening-night shifts) for all to feel like they are truly a part of the reimbursement process.

MOTTO: TAKE CREDIT FOR WHAT WE DO AND MAKE SURE WE GET PAID FOR IT...OUR RESIDENTS DESERVE IT!!!

There will always be days when things are extremely busy on any particular shift....falls, admissions, transfers to hospital, etc., and summaries will not be completed. In these instances, verbalizing the fact that a particular nurse was understandably unable to complete the summary goes a long way...but still needs to be completed by the deadline.

I schedule the monthly summaries for my building for completion between the 15th and the 25th. I also make all nurses aware that although they may have between 5-10 summaries to complete by the 25th, I have the entire buildings summaries to check for revisions between the 26th and the 5th of the following month. It is not just all about completing the summary but also making sure the information on the summary is accurate.

There are (and probably always will be) those nurses that flat out refuse to comply. I track compliance and review this each month with each nurse. By including the nurse responsible (before administration), he/she has the opportunity to improve compliance before actual written reports are included in evaluations.

All in all, completion rates (by the 25th of each month) have increased to about 99% and my job for semi-annual submission of MMQ (medicaid reimbursement) has been much easier.

I am getting ready to submit my MMQ turnaround (cycle B) for 2/1/10 turnaround by 2/15/10 and had all monthly summaries completed by 1/26/10.

Kudos to the staff at my facility.

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Thanks for your post. I've been doing MMQs for about six months. I work for a large company. Corporate really pushed to take credit for things that truthfully I felt they were pushing it. Needless to say the audit was horrible. I feel as though I was self-taught as my corporate boss was never around. She wouldn't even return my emails when I asked questions. The auditor was a wonderful support for me. I was pretty upset about the audit even though I did have my corporate boss there telling me how things should be coded.

I now know the auditors are great resources for MMQ nurses. I'm under the impression that smaller, private LTCs do not push so hard to take points that are borderline. While I believe in taking credit for what is done, I do not believe in going over the line like the larger chain LTCs often do.

Regarding nursing summaries, what date is used on them? Is it actually the date they complete the form or is it a work in progress and they sign/date on the last day of the month? For example if behaviors are assessed and they have 10 days by the 15th, but the nurse's last day to work in the month is the 27th for example and they didn't have 15 days on the nursing summary, however the ADL flowsheet shows that two days after the 27th behaviors were recorded is that acceptable? Can a nursing assessment be dated the 15th if some of the days you need for behaviors don't occur until after the 15th? Some of our nurses will write > 15 days on the 15th even if they only have 10 days at that point, but the resident is sure to have behaviors nearly everyday and they will have 15 days for the month. Someone told me they shouldn't date the nursing summary until they have a full 15 days for behaviors. Hope this makes sense

Thanks for your help!

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Specializes in LTC MDS PPS MMQ.

Lisa,

We are a rare breed - MMQ Nurses!!! Where in Mass are you located? I am a strong believer that you should always take credit only if all documentation supports that particular claim.

Regarding dates on the summaries... nurse should only include info on that summary as of the date she is signing it. Our summary has an area located at the very end that is titled "Addendum". In this area the nurse that completed the initial summary can document anything (and usually this involves behaviors) that occurred after the the date of the initial summary was completed through the end of the month. For example: summary completed on 4/15 indicated 10 days of verbally abusive behavior. The addendum would say - "Resident had 25 days of verbally abusive behavior (swearing at staff) during this month, verbal redirection with little effect. Nurse would then sign and date the addendum 4/30/10. The option of having the nurse complete the summary after having > 15 days of behaviors is an option but the problem often is that particular nurse being on duty during the last few days of the month. The addendum is a much better option.

Which auditor do you typically have?

Feel free to contact me at [email protected] if I can help with anything else.

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Specializes in Med surg, LTC, Administration.

Hi, hope you two are still online. Fellow MMQ nurse here. Would love to start a support group for MMQ nurses. Er...actually need one...:lol2:

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Specializes in LTC MDS PPS MMQ.

Chin up......sounds like a great idea....would love to be involved in starting something like a support group for MMQ Nurses in Mass.

Keep in touch

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Specializes in Geriatric & Wound Care.

I am a new MMQ nurse and stumbled upon this... If you all ever made a support group for MMQ nurses please let me know!!

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