evalesco

i don't have a problem with the 3.0 if we can completely cut out the discharge assessment. this is going to sound very bad, but......when i see a resident had died in the facility, i feel relief knowing i don't have to do a d/c assessment! here was a cute christmas poem sent to me............... twas the night before christmas - another year had flown by mds 3.0 landed with new regs from on high. the interviews conducted again and again and our heads are still spinning - when will it sink in? is it blue - is it red, a sock or a shoe? did she miss it by one year? or could it be two? and me with my coding - the rates to uphold were they omras or short stays or trackers to load? do i schedule an extra assessment today? or wait til tomorrow - what rug rate will pay? and on to the software my fingers did fly i know i can learn this - at least i will try. the adl index is lower - oh no! there are holes in poc adl’s as big as my toe! but wait - is that resident smiling at me? she really likes sharing her dreams i can see. i think this might be worth it to see that sweet smile and i think i'll stick with it - at least for a while!!! don't know if anyone already posted it. i have been too busy to look due to trying to complete discharge assessments.

Can you get your validation report? We are having trouble retrieving ours.

I watched that AANAC video, but I was so "lucky" to be in Vegas to hear the Gold Standard Nurses speak. It was a joke then, and it's a joke now. Their video is even more a joke. They really don't know what they are doing. They have been out of patient care for so long, that they are clueless to what an MDS coordinator does. They kept saying that this was going to take less time. Everyone in the audience knew better. One nurse got up and said "this is like a vacuum, and SUCKS" people started clapping.

We are on Matrix. It's okay. We liked pointclickcare at my company, but it was too expensive.

If they were admitted 9/9, just do the 30 day 10/1. From what I understood today, you will be paid that rate for the remaining 8 days the 14 day would pay for.

Well our plan is..... Social Services B, C D, E, and Q. Activities F Restorative G, H, P Dietary K MDS I,J,L, N, O Wounds M Therapy (part of O) Everyone is responsible for their own raps and care plans. This is the goal, now what is going to happen is another story. Currently MDS does all the raps, completes most of the sections and the only people who ever really get their work done is Activities and Dietary. Some of our homes have 250 residents with 50-60 medicare, and 3 MDS coordinators. MDS can no longer be responsible for filling everything out. With 2 weeks to transmit the Administrators are really going to have to push everyone to do their work, or they default, and I am sure they won't like that.

I am preparing to have no life come October!!

Spotlight Skilled Nursing Facilities PPS The CMS website has some downloads for the transition from rugs III to rugs IV. We are redoing all our assessments on October 1st, 2nd, and 3rd. Yes it sounds crazy, but our company is not going to accept any default rates. We are making our schedules now to pass out to the staff.

CMS was still revising the 3.0 RAI manual mid August at the Las Vegas conference. That is the reason your corporation seems slow to train everyone. I really do feel that my company and I are in this all together. I was at the AANAC conference in Las Vegas in May, they didn't even have the rugs IV, and were not even sure if it was going to be ready until December 2010. It is a mess I agree.

I believe CMS has some tools also MDS 3.0 Training Materials Nursing Home Quality Initiatives scrool down to the downloads and the second link is tools.

The AANAC 3.0 course is a great start, after October 1st we will all be new. The 3.0 is going to be bringing some big changes and I believe the first month will be trial and error. So go for it, I do think it looks good on a resume that someone took the course on their own. Good Luck

:yeah::yeah::yeah: i laughed out loud!! so funny and true!

The rap just indicates risk factors for dehydration, delirium, falls etc. But if you have a resident who is actuall showing s/s of dehydration that would be in your nrsg. notes, right? And your care plan should outline what your interventions would be for fall prevention, dehydration, etc. I'm thinking if I hit that someone was dehydrated I would have labs nrsg. notes, MD intervention, etc. all which would be in the chart. To make the rap simple I would write........... Resident was at risk for dehydration due to UTI and use of lasix BID, labs indicate a BUN of 65, MD was notified and orders are in the POS dated 10-19-06. Proceed to care plan. Simple and it just tells you to find the information in the POS. Your care plan has the problem....at risk for dehydration r/t.............. then your goal---------------will be hydrated by evidence of blah, blah, blah,........ and then all your interventions........... provide H2O, labs, MD etc etc. Does that make sense????? Maybe your state is different? But I was told by NASPAC and a state surveyor that the rap should be short and simple.

Delirium usually triggers due to decline in mood, and on new admits they usually will have a decline in mood, I just write ... Rap triggered due to decline in mood, no need to care plan, no s/s of delirium are present, refer to Mood rap and care plan. That's the case for me anyways.

PPS is the payment system for medicare residents. Prospective Payment System. You are paid a per diem daily rate per the MDS codes. Each state varies. http://www.cms.hhs.gov/SNFPPS/ I have always worked where they have two MDS nurses, one who does long term and one who does medicare.

I can't believe the MDS nurse is pulled to the floor where you work, I guess your company don't care too much about the money the MDS brings in. Anyways, you only need to indicate why the rap triggered, you don't need to put a big long summary. For example a dehydration rap that triggered due to a patient taking lasix, only needs to say.... Rap triggered due to use of 40mg lasix po BID, proceed to care plan. That came directly from the NASPAC training I went to. Diane Brown (editor of the MDS briggs 2.0 manual) told me that herself. I used to write a paragraph or 2 in my rap summarys. But she explained that everything you put in the rap will be in the care plan and why write it twice. Hope this helps.

In Illinois it varies but on an average from what I have seen... RN-$26-$35.00 an hour LPN-$22-27.00 an hour I am sure it varies on experience and different certificates you might have, NASPAC, etc.

I agree with the above^^^^ Go to day 8, see if therapy can project a high or medium and go for the RMX or RML score which will pay higher then the original 5 day you did which was probably an SE2 or SE3.

No, but if you ever come to Chicago I have a job for you!!!!

I believe it is standard contact precautions. At least where I go to it is.

I think that it depends on your state. My company is always sending me to seminars for updates etc. I am in Illinois, what triggers the new rug codes are the ADL's AND skilled services combined, IV meds, IV fluids, suctioning, and I belive trach care, depending on the ADL score 16+ will put you in the X catagory and below that will put in the L catagory.If you have no skilled services in the 14 day lookback and just therapy your score will remain the same as it always did. Although in Illinois the usual rehab scores kinda went down in payment. Try to look online for a seminar or do you have a sister facility or hospital in your company that you can go to for training. Good Luck:)

i'll be looking out!!!!:chuckle :chuckle :chuckle

Hello! I live in Frankfort, currently working in the city:) alot of people from all over Illinois on here!

Of course LPN's are nurses, depending on where you work, LPN vs. RN duties are different, I think that RN's do deserve higher pay, due to education, responsibilities etc. I have been a LPN for 7 years now, I really have no intention on ever going back to school. I work as a consultant and make probably more $$ than most RN's. But I am being paid for my experience, I am a paper push nurse, I just like it better. No one ever asks my title, sometimes people will openly discuss in front of me how LPN"s are not as smart etc. Then I am always proud to say that I am a LPN, then let them feel stupid. It is a very general statement to say all LPN's or all RN's, I think every career has their lazy people, including nursing, wheter it be a RN, LPN, or CNA.