MDS 3.0 Discharges

[texasheat]

It seems you can plan all you want, but you will never be prepared enough. How are you all doing your discharges? It's crazy!! I had "3" residents sent to Hospital and Admitted over the weekend. So how do I assign everyone their sections?? How do they assess?? They were admitted friday nite and saturday nite. I can see us doing the whole 'planned' discharge. Can anyone help, please?!?

[Talino]

a group of us went to the 3.0 training and were informed that we should forget using grace days under 3.0. we understand the start of therapy but our new rehab director is using a grace for every new admission to cover sundays when ther is no therapy. i have always been told graces are for the patient not the convience of the therapist. iam so confused anyone have an answer?

mds 2.0's grace day definition has this excerpt...

if a facility chooses to routinely use grace days, it may be subject to review through the survey process, by the fiscal intermediary, or by the data assessment and verification (dave) contractor.

that is now expunged in the mds 3.0, instead...

there may be situations when an assessment might be delayed (e.g., illness of rn assessor, a high volume of assessments due at approximately the same time) or additional days are needed to more fully capture therapy or other treatments.

since you can not project therapies (as in section t of the 2.0), use of grace days is the smartest option to capture the highest rug score possible. better yet, relieves you from doing another assessment - the sot.

[dbsue1954]

use accucare too...and it is very slow. A new update from web this week should speed it up a little...the discharge assessments i have done have been alot of not assessed/no info due to emergency discharges. i am very upset about the amount of paper i am going thru.we had to buy new file cabinets to hold the mds's that need to be accessible . I have changed a couple investments in my 401k to paper manufacturers. hope it pays off.I am also very confused with validation reports. where /what is the adjusted "hybrid" rug score anyway. ????Spoke with my state person who oversees this this today. he said he could not tell me because he is still trying to figure it out!!! so i will continue to stumble blindly along and hope for the best. what a mess!!! as i am geting more familiar with the software i have to say the 3.0 does seem to flow a little better..still can not see much difference in raps and caas...oh well... i do have a question...for my part b residents who participate in skilled therapy...can i just do a start of/and end of therapy? how many pages does it have? if a resident is recieving part b therapy and has a quarterly in the middle of their 6 weeks of skilled therapy...should i put the therapy minutes there....or should i just do an start/end of therapy?? i am confused by this...please help!!!!thanks

[Talino]

i do have a question...for my part b residents who participate in skilled therapy...can i just do a start of/and end of therapy? how many pages does it have? if a resident is recieving part b therapy and has a quarterly in the middle of their 6 weeks of skilled therapy...should i put the therapy minutes there....or should i just do an start/end of therapy?? i am confused by this...please help!!!!thanks

Part B residents do not require a PPS/MDS assm't, including SOT/EOT. For Part A residents, the SOT/EOT can be combined w/ an OBRA assm't (quarterly, annual) as long as the ARD satisfies both requirements.

Medically indicated therapies that meet the guidelines in the RAI, pp O17- O18 can be captured in the MDS regardless of payor.