MDS 3.0 coding question

[glm777, BSN, RN]

Can someone help me out here? The Psychosocial CAA triggers whenever the resident states in section F0500f (daily activity preferences) that it is "not very important" to do their favorite activities. This is the resident's answer - not staff. How can I care plan this? If it's not important to the resident to do his favorite activites - why do WE have to MAKE it a problem?

I HATE this new MDS!!!!!!!!!!!!!!!!!!!!!!!11:eek:

[Talino]

A trigger doesn't necessarily mean a problem. It simply alerts the staff to look into a triggered item whether it presents as an indication of a problem.

Rather than stopping at the resident's answer "not very important" to doing favorite activities, try probing - "Can you tell me why it's not very important to you?" The response may likely yield a reason for you to proceed w/ a care plan or a good explanation why you're not.

see also pp 4-26 to 4-27 for the CAT logic

[GRACERN47]

I don't know anyone that doesn't hate 3.0. I pray everyday that someone with really good insight will realize how ridiculous this extra paperwork is. The word nurse has been taken out of nursing and replaced with data entry. I have been doing MDS since day one as well as PPS. Does anyone really think any of these 50 pages will be read by anyone including state surveyors! If it's the patient's choice just document that! Good luck!

[rukiddingme]

I have the same outlook - if the resident doesn't consider what he/she said in the interviews as a 'problem', don't care plan it. This is the resident's voice afterall, which is what the government wants to hear. We have our interviewer giving us a synopsis of all the interviews, which is helpful with the care plan process, and deciding what to & not to care plan.

[mdecastronp]

You don't need to care plan all triggered problem in the MDS. Section F looks for activities that resident prefers. It only becomes a problem if the facility cannot provide the activity that resident prefers and/or the resident still prefers the activity and there are physical, psychosocial, etc. barriers. If you have any other MDS questions, I found this website helpful where you can post questions: Guestbook and a response to your question will be posted.

[LPN3RAC-CTMDSC]

Mds 3.0 is really not that bad! It's the change that is throwing everyone for a loop. After all, didn't we all get into nursing to help people? Mds 3.0 allows you to identify potential problems that might have escaped us with 2.0. If you took the time in the upcoming months before october to prepare your idt team, you should be easing along quite well. Keep plugging away, it will get easier & you will appreciate it more.

[susanthomas1954]

This is interesting. When I was teaching my team about the 3.0, I was it's biggest cheerleader. I had housekeeping, laundry, and maintenance invested in the importance of hearing the resident's voice. All the clinical IDT members are really invested in the interview process. HOWEVER, in the privaccy of my office, I truly am sick of the data entry and software problems and not seeing anything meaningful yet from the care planning process. It takes far too much time for the small amount of benefit that may come. I was really sold on the idea, but it is working out poorly so far.

[rukiddingme]

I have to agree with susanthomas -- on this MDS 3.0 we're triggering more problems, and although I would love to find solutions to them, there just isn't enough time or manpower.

For example: the dental problems that our residents have and are being triggered. We don't have a dentist/hygenist that come into our facility to give care, and very few dentists accept public aid patients without payment upfront. It's a bad deal.