lisalake

Thank you. I just sent you an IM!

Does anyone have a triple check tool you can share? Thanks!

I can't stand PCC! It's worse now than it ever was!

Very well said. I, for one, have never been "down" on RN's; they have been mentors for years....you cannot work in any industry for 30 + years and not become proficient in your skills. By virtue of outdated state and federal regulation, and the stiffing NCSBN, who barely even consider us nurses; concerning our scope of practice, we have been increasingly relegated to the role of glorified nurses aides. It's a shame that an industry such as ours so easily throws experienced and qualified nurses under the bus! Thanks for your comments!

Done!

Great post! I have already sent my comments to CMS (more than once). After attending the CMS Train-the Trainer conference in Baltimore, I am more convinced that this tool is a real mess if I ever saw one. While CMS and all their "experts" have lauded the fact over & over that 3.0 will solve the SDTI issue, and "back-staging", we still WILL NOT be coding by clinical guidelines! It's an outrage! Can't this not be interpreted as going against our Practice Act?? Willfully and knowingly mis-categorizing/coding a a potentially serious medical condition for payment?? What are these people thinking? They had more than enough time (and then an extra year) to map the tool correctly. That's what you get when trying to combine a tool that is clinically relevant with a payment tool. And what about the PHQ-9 interview? What if a cognitively intact patient refuses to answer? (as many would, including me) How can you do a staff assessment on these items... for the most part, they ARE NOT observational items, and who are we to code answers here for someone who chooses not to participate? Ex: I come into your facility for a ten day stay after a knee replacement, I'm cognitively intact with no history of depression, and I refuse to answer. Are you then instructed to tell me you'll be conducting this assessment FOR ME?? NO! How does this comport with my rights, and the so-called Culture change" movement? How is it valid to conduct the same assessments over and over for all populations; LTC, short term, MR, and children?? And how valid are the studies, if you keep changing the item-sets? CMS has only succeeded in creating a more burdensome tool, for the already troubled LTC community, and for LESS reimbursement. After years for work, and countless taxpayer dollars??? Unbelievable.....

LPN MDS Coordinator in CT. with hourly rate 32.75.

LPN MDS Coordinator for five years and counting....with never an MDS tag at survey....RN unit managers sign at R2B. This is a stupid regulation since MDS has been automated/computerized....the software tells you if the "assessment"/DATA COLLECTION TOOL is compete. Any monkey can check to see if all the boxes are checked and completed! If you've worked in LTC for any amount of time, you'd know that LPN's do assessments all the time...we are certianly capable, and furthermore, it's expected of us, no matter what the rule says....all facilities get around this by having the RN sign off. I even know an LPN who functions as the ADON.

I find it hard to believe that no one ever questions why the R2B signature is even relevant. "Coordinating" anything does not require an RN license "Completion" of the document is determined by the software; do you need an RN to see if all the items are complete???? VB2 and VB4 are to be signed by an RN, as it is a well known fact that we LPNs are surely not capable of participating in assessment, critical thinking, or any kind of postive outcome for our residents. Sometimes, I wonder why they even pay me!!

so right! we should be care-planning for the resident, not the staff, the qi’s or the surveyors….but this is what’s happening everywhere, and debbie is right….coordinators are expected to, and instructed to care plan anything and everything whether a problem or a potential problem, or not a problem! it has become a tedious, all day long, never-ending job, and in many cases, without team participation. whenever the resident farts, the first question to the mds coordinator….”did you put a care plan in for that???? did the resident smoke 20 years ago? better care plan that! did the resident complain about a staff member?? better care plan that they are uncooperative and non-compliant!! were they sad and crying 15 minutes ago??? better call psych...and don't forget the care plan! we care plan the disease, the fall, the behavior, the mood, the med, the splint, the meal…and on and on, without really identifying if it is an actual problem for the resident…all to cover our butts….and please the surveyors’.:angryfire

seems the word is out?..... there is speculation circulating around the scheduled date of the october 1, 2009 mds 3.0 launch. and, if you visit the cms 3.0 website, you will note that the published time line document has been removed. this occured on or about january 16th. it is further speculated that an announcement will (might?) be made during the january 29th snf open door forum. snf open door

The obvious answer to that is no, considering they have no nursing education. Having said that, if our educators feel it is appropriate and safe to create a certification program enabling CNA's to perform the licensed duty of passing medications; why can they not create a curriculum whereby LPN's can become certified in assessment, delegation, and critical thinking; as these are the tasks most of our State Practice Boards say we are not qualified to perform. Why do hospitals pay upwards of 10,000 dollars to hire a foreign RN, when they can spend this money on certification and mentor programs to bring back the experienced LPN, and the "team nursing" concept back to acute care?

Yes, seems like this is the plan to replace LICENSED Nurses with UNlicensed personnel; they are much cheaper labor, allowed in many states to perform more tasks than LPN's, have less education, and are conveniently not governed by the nursing boards. It's a much cheaper way to care for sick Americans, who are paying through the nose for health care, and better helps the hospitals meet their bottom line! Too bad for all the experienced LPN's who are losing their jobs due to the limitations placed on them by the nursing profession.

ct nurses for reform http://www.ctnursereform.org about usconnecticut nurses for reform would like to bring the ongoing debate regarding our country's nursing shortage and under utilization of licensed practical nurses to the general public. as health care advocates, we believe the public has a right to quality of care in our hospitals and nursing homes, and that means being cared for by licensed staff. we want the public to be aware of how our legislators are addressing the nursing shortage, and how qualified licensed nurses, directly related to the restrictions imposed on us by our state scope of practices, are being replaced in the health care setting with unlicensed personnel. as the cost of health care for americans continues to sky-rocket, our country's hospitals and nursing homes are cutting costs by hiring more and more unlicensed personnel. our goals are logical and straight-forward. to address our country's nursing shortage through legislation enabling the thousands of licensed practical nurses meet proposed new requirements to sit for boards and transition to registered nurse, and for our educators to create the criteria and certification to allow licensed nurses to practice at our full scope of practice. the time has come for our legislators and educators to address the considerable resources of the already educated, experienced, and available, licensed practical nurse........... learn more @ http://www.ctnursereform.org lpn's, please help us collect data by completing our survey @ http://www.ctnursereform.org and get your colleagues to also participate! sign our petition, and forward it to all your colleagues, families and friends! @ http://www.petitiononline.com/lps2t/petition.html "for we who nurse, our nursing is something which, unless we are making progress every year, every month, every week, we are going back. no system shall endure which does not march." florence nightingale lisa morell, lpn, rai-c [email protected]

do you believe a solution to nursing shortage can be increasing our scope of practice? lpn's, please visit our site and take our survey! we would appreciate hearing form you. [color=#3b3d90]http://www.ctnursereform.org on-line petition [color=#3b3d90]http://www.petitiononline.com/nslsfr/petition.html lisa

Most facilities require q-shift charting on Medicare residents, although the I believe the regs are daily...this usually ensures adequate documentation is recorded for the skilled service being provided. Many times this is repetitive, but if there is a review, it is necessary. Besides, most Med A residents are not skilled for just one shift; your doing physical assessments, monitoring for pain, behaviors, doing treatments...etc...take credit for what you do and document; it's important; for the resident and facility reimburstment.

LPN in Connecticut LTC: 28 yr. - MDS Coordinator just under two years Salary: 27.58 Hr.