AUNTFESTUS

The best advice i can give is actually work the floor yourself to actually see what i going on and where the weakness lies. This will solve about 75% of your problems. Chances are the QA team are just as eager to get their job done as you are so these simple remedies often get overlooked.

In response to self medication administration, if you read CMS resident's rights, etc. self med administration is a choice that is to be offered to each resident. We used to do quarterly questionaires on our residents asking does resident request to take their own medications or are they appropriate and than depending on the response than a self med administration check list was done to see if resident would be safe to do this. We could look at cognitive deficits, visual deficits, etc. anything that may interfere with safe self med administration. If a resident's response was yes that is as well as other areas to assess. My old D.O.N. did away with these which I felt was a stupid mistake but who am I? lol...I am waiting for it to creep back up with state and by the sounds of this social worker it obviously was a policy at another facility or she has been to a recent 2.0/3.0 workshop. Let us know how your facility handles this.

THANKS RUAS, I agree with you completely and it is scary to think about. Obviously ADL's may be at odds given the acute process and possibly incontinence for a continent person. And the reason for dr. visits and orders? Our facility for our medicaid residents do not have a ADL flow chart to justify ADL's. We get this info from staff observation and the occassional nurses note regarding a area of a ADL. This part has me a little worried. For our skilled resident's though we have a check off that the nurses do. What are your thoughts on this?

May I PLEEEEZE have a copy as [email protected] thank you

May i have a copy as well? [email protected]

Ruas61, on a discharge return not anticipated and discharge return anticipated may I ask what you think is absolutely neccessary to code since we have the option of the dash or did not assess option? For me if I have 3-4 discharges in one day all unplanned why would i assess ADL's,skin,pain, etc...and I would love to know what state is expecting to see on these type of discharges/assessments.

TALINO, thank you for your quick responses regarding the 3.0. Considering what the 3.0 manuel says regarding discharge assessments (return anticipated) it allows for the dash on items that cannot be determined. Yes I would consider this for the resident interview but what about the importance of staff interview, ADL coding,pain assessment, orders and visits. I would love to hear your opinion on what items would be absolutely neccessary to code on this type of assessment. If the discharge assessment does not count for rug scores and the manuel is so vauge on what is absolutely neccessary I am afraid it leaves alot of room for error and scrutiny with state. Their opinion of what is important on a discharge assessment and mine may be two different things. And I do feel I could complete most all of the information but do I have to considering the amount of time it takes for a discharge return not anticipated. Especially if some of the questions on this type of assessment have no significant relevance. Thank you in advance for your reply.