Latest Comments by NurseMommyRN

NurseMommyRN 998 Views

Joined: Nov 7, '10; Posts: 10 (50% Liked) ; Likes: 16

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    How do you all handle recon notes in your facility? Do you find yourself often having to code something completely different than all of the CNA documentation and how comfortable are you with the recon note if you are the only evidence in the medical record to justify coding, for example, an extensive assist when all of the CNAs are coding supervision & limited?

    We look at the resident's and review all documentation, including therapy notes. If we see somebody is an extensive assist, but the CNAs continue to document them incorrectly, despite being educated & inserviced several times, do we continue to recon the information with subsequent assessments?

    We have to recon on almost every assessment, but it does feel uncomfortable be the only documentation in the entire medical record to support our own MDS coding. We were basically told that since the ADL scores are low, and the CNAs "don't know crap", we need to disregard their charting and just recon what we say it is. Is this common in every facility?

    Any input would be appreciated.

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    In my facility, we do all the sections, except: therapy enters their own portion of section O, dietary does section K, social services does E & Q. The unit managers enter section M. We are also in charge of seeing the residents to do the interviews.
    I can get through the small assessments pretty quickly, but can only get about 3 big assessments done in a day.

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    We pull our ADLs from the computer. I get some funny coding if I were to follow the rules exactly as they are laid out. For example, there has been a number of times I"m getting a 0/2 for bed mobility and transfers?

  • 1
    ecdc94 likes this.

    Good luck to you. I"m a brand new MDS coordinator, too. I stepped down from a Unit Manager position and am loving it. However, the CAAs are driving me crazy. I only had 9 days of training before the experienced MDS coordinator left, so I'm kind of floating on my own. Nobody seems to know how to do the CAAs in my building. Some people are just pulling triggers from the CAA worksheet and restating the Care Plan in the CAA summary. It seems very redundant.
    I would love to find a way to quickly do a CAA summary. Right now, I would rather do 20 short assessments versus one large one.

  • 0

    Quote from itsmejuli
    I wouldn't work in a place that didn't count narcs. My license is at stake.

    Today I counted every single pill on 74 sheets of narcs in my med cart. That's right 74 sheets of them. Jeez.
    I'm agree with you completely! It sounds like there needs to be some inservicing on the importance of counting both the narcs AND the narc sheets.

    I could be wrong, but I can't imagine that the rules are more laid back for assisted living because drug diversion is covered by the DEA. They don't mess around and if they come into your facility, EVERYbody is a suspect. I know os some of my co-workers who were around during a DEA investigation and they've said it is not fun.

  • 3
    GM2RN, Meriwhen, and Fiona59 like this.

    I have 4 children, although I'm not a single mother. I have just accepted a new job as an MDS coordinator. I work 9-5, M-F with no weekends. The pay is also good. When I first graduated nursing school, I had to work at the bottom of the barrel, but after several years experience, I've finally found a job with these hours. I agree with the other people here---you are going to have a very tough time finding the type of job you have outlined here. You need some experience under your belt, and even then, it is tough.

  • 1
    systoly likes this.

    Thanks, everybody. The principal is one of the biggest problems I have at the school. He claims he has no medical background when it is convenient for him to do so, then tries to step in and "plays doctor" to alienate the parents every chance he gets.
    The school refused to let my home health nurse use the school nurse's office to change my daughter because they said there was no room in her office. Crazy!
    I have filed a complaint with the state. I'm not sure anything will come of it, but they at least need to get into these classrooms and train people in the definition of dignity.

  • 10

    I can't believe the NM didn't do any disciplinary action for this PCT. Her behavior is putting people's lives in jeopardy.

    SourApril, having a "bad day" does not excuse making up vital signs and not turning patients. This isn't about humiliating somebody, it's about making sure these patients are being cared for. I know I wouldn't want one of my family members in that person's care.

  • 0

    Quote from bluemorningglory
    ETA: In my OP I said that I had been out since my talk about attendance. That should read that I had not been out. Not once. I am afraid of getting fired. I just wanted them to know that I had been diagnosed with this. I don't want to hear anyone b*tch because I showed up sick. What I find odd is this...they hire a boatload of per diems...why don't they utilize them in cases like these?
    Having been a unit manager for the past year and a half, I can tell you this.......The per diems never seemed to be available when I actually needed them. It was as if they just wanted to pick a day or two here and there when they wanted to work, but never came in when we had callouts.

    Please don't take this the wrong way, but were your prior absences for illness? The reason I ask is because the company I worked for had a "no fault" attendance policy based on a point system. What would happen is people would call out just for a personal day when they weren't really sick. Then when they actually became sick and accumulated the points for a write-up, they would get upset and think the company was being completely irrational when they received the attendance write-up. Staffing issues were the worst part of my job.

    That being said, nobody wants to go to work sick. I can't imagine having to pull a night shift with a bad case of bronchitis. I hope you feel better.

  • 1
    systoly likes this.

    Hello. I'm an RN, but also mother to a severely disabled girl who has a lot of health needs. I recently found out that for the past 5 years, but daughter's incontinent briefs have just been changed openly in the special ed classroom. The reason I was not aware of it sooner is because they used to be in a different classroom that had a privacy area with a curtain, but when they moved, nobody saw fit to have another area made.
    When I questioned the teacher about it her response was "oh, I wondered about that when I first started here, but since there were no mainstream kids in the classroom, I didn't think it was a big deal". I was outraged, but the school seems to think I'm making much ado about nothing. Because of some of my daughter's medical conditions, she has had pubic hair since around 5 yrs old. She is also the only female in the classroom, parents are allowed in the classroom, as well as the male principal enters the classroom.
    They finally put up a privacy curtain, but I'm just so shocked that it went on for so long and nobody thought anything of it.



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