dbsue1954

apparently palvix is not warfarin based and Xeralto is???

Found the answer...yes code it checked with rai coordinator at state and mds consultant....heparing/warfarin based CODE! could not get ahold of anyone earlier.calls returned after i posted!

We have a new admission post hip fracture admitted on the anticoagulation drug Xarelto.I am not sure if this is coded as an anticoagulant .Plavix is a non codeable anticoagulant and i am not sure about this one....my instincts tell me yes it codable on mds but i want to be sure......Can anyone help??? thanks:)

Robin technologies has a tool available on line....put admission date and it shows the entire 100 day stay with grace days designated.It has made my life a lot easier!

I agree with the previous comment. Actually i dreaded when 3.0 happened but after becoming familiar with it , it seems to flow better than 2.0 did. While it appears to be longer, there are so many skip patterns built in it it does not work out to be any longer. Good luck

Thank you very much. for the record I agree with my therapy department. This is very helpful!!!

can someone please tell me how I can skill a resident who is on comfort care?I have tried to look it up in Medicare guidelines but all I am finding is in reference to Hospice Care?! have had 2 residents recently who were skilled but condition decline necessitated d/c from thrapy. Family chose not to go Hospice but preferred comfort care. These residents were exhibiting no pain . My therapy department is a little apprehensive to continue seeing a resident who has received a comfort care order (no progression) I would appreciate any info/guidelines you can help me with. thanks

We have each discipline completing their own sections of the MDS and formulating and updating their own care plans. We have not seemed to have any problems with it. My team is really good about communicating any significant changes they discover while doing thei sections on 3.0. We then discuss at team meetings whether they qualify for a significant changes. works well here!

I have found that it is becoming a little easier as i work with it..other than software issues, it has gone pretty smoothly. the d/c assessments are a waste of time. I use ALOT of not assessed/dash fills when doing them and so far have seen no negative outcomes. These assessments are not reimbursible so i feel if i do not have everything asked for, it is no great loss. the one problem we have encountered in our facility is the question which asks "have you thought about harming yourself/thoughts you would be better off dead" WHY DIDN"T THEY SEPARATE THESE TWO QUESTIONS????? Many of my residents answer yes theyf eel they would be better off dead ("I am ready to go"....I have had a good life.....I am tired>>>want to be with spouse, etc,etc,) but deny any thoughts of hastening their demise. however, if either section is answered "YES" you must answer a 1 which leads to the notification section. This has involved formulating a new policy/procedure, etc. related to suicide watches, etc. i just feel that who ever authored this question should have separated it into 2 parts.actually depite my prior opinion, it does seem to go faster and flows a little better, the change in font and only one column to a page results in needless tree death i think (we are still printing paper assessments for file) and we have had to purchase file cabinets instead of binders to hold these tons of paper assessments.

we use accucare....very slow. When u call tech support.they tell you there are "18" calls ahead of you....have had a couple issues with missing info on the print out. have had 2 updates so far and another expected soon.

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

Well...it has been interesting..my advice is buy stock in the paper manufacturing companies......hard to believe that a 14 day pps assessment takes 38 pages. For those of us who are not computerized I forsee storage of said documents a real challenge...also what is up with the double rug scores. I atttended a MYers and stauffers seminar and i do not remember them telling me i would get 2 scores..had a resident today with an RUB and an ES1. my software vendor's tech support totally jammed...4 hours twice today and the second time never did receive an answer. This is a nightmare!!!!! and of course this afternoon newsflash.....unable to validate any 3.0 info. continue to submit... but who knows when we will be able to recieve validation. good grief....could there have been any better planning of this whole process. Of course my 3.0 bible that i got in june... so many updates briggs just sent me a brand new book. WHO IS RESPONSIBLE FOR THIS ENTIRE MESS??!!

patient is a pleasant lady who has diagnosis of alzheimer's. has had a major decline past few weeks. up until 6 a few weeks ago, was maintaining colostomy (old one) with nursing oversight/minimal assist. suddenly, she has begun removing colostomy bag and placing it in her pocket, or wherever. she refuses to wear disposable briefs at this time (removes them). the colostomy she currently uses is the type with the foundation wafer and "tupperwear bag" that snaps on. her skin is too fragile for the one peice adhesive bags. anyone had this problem? any suggestions? she is ambulatory and still is continent of urine most of time. thanks in advance for any ideas.

here in indiana it is annual but they told me they have the option to come anytime. they are not strictly bound to annual.

just remember it is not the number of orders...number of days!!!this concept escaped me for a short while while learning this stuff!!!!!!!!