Need some help/advice reguarding nursing home regulation

[RN Rosie]

i desperately need some advice. my don has lpns doing assessments and then she co-signs it. now she is basically giving my job; i'm restorative nurse; to an aide that is finished with school for lpn but has flunked the test twice now. and they are paying for her to take the test again for her to take over my job. she said "oh well of course you will have to co-sign all of her assessments. now i found a "bulletin" from the state that says that co-signing any documentation is no longer acceptable. now mind you this was dated 2004. my question is number one can she do this, and 2 what can i do about it. thanks in advance for the help

rn rosie

[blueeyes827]

The requirements for completion of the MDS are completely separate from state nurse practice acts. The MDS regulations do not specify who can or should fill out the MDS and RAPs, except for the discussion of health professionals in the RAI User's Manual. The regulation does require that an RN coordinator verify that the assessment is complete at R2a and VB1 and VB3 (depending on the type of assessment). When the RN coordinator signs at those locations, he or she is not attesting to the accuracy of the information on the MDS. (If he or she fills out portions of the MDS, then he or she must attest to the accuracy of those items at AA9.)

The federal regulations do not address scope of practice for classifications of nurses. The states do that. You will need to find out the scope of practice in your state.

How many beds is your facility? It sounds like she is doing some cost cutting measures. A nurse should still be overseeing the rehab and she is able to make the appropriate documentation.

It sounds like your job description is changing and you will need to make sure it does not say that you are responsible for the accuracy because that would be not true.

Good luck,

Susan

[fultzymom]

In our facility (Ohio) we had a LPN doing MDS assessments et the RN who also worked MDS co-signed. No problems ever arose. I guess the big question would be if you trust the nurse et know that their assessment skills are good. Have you talked to her about your hesitations to do this?

[CHATSDALE]

i have seen a lpn [more experienced that you describe] doing all treatments..rn made rounds with her on a specific day of the week and signed assessments

as to your problem i would start looking for another job, if that is feasible, be careful with your license

[RN Rosie]

I'm sorry I wasn't trying to offend and I will in no way ever say that LPN, aides or whoevever. This is more about Them giving my job to someone else who is not as qualified and then push me to work the floor because I filed workman's comp on them. But in the state of Ohio RN's just cosigning an assessments is not acceptable.