jpav33

Healthsouth

It's a free standing for profit rehabilitation hospital.

Thanks.

I have been an RN for over 13 years and applied to work at a rehab hospital. I asked what the nurse to pt ratio is on days and was told on the avg 7-8 pts, could be as high as 10-11. Is that normal for this type of hospital? Is that safe and do-able? I havent been offered it yet but want to know if I do.

I do for most part, there are times though the visit is cut short and I want to be able to remember if I document some at home and figured a cheat sheet for those things would be of great help. Working on making my own.

Ive searched all over for a cheat sheet or checklist to go from patients home to my home to use on laptop to complete documentation at home. New home care admission nurse. Cant find any please help!

First HAPPY THANKSGIVING TO EVERYONE! I just started doing the MDS/PPS for medicare residents at our facility which just became medicare certified and still am not sure on 1 thing (1 of alot!) but my DON said since we are all new to this, Billing, PPS assessments and everything we would start with just one Med A at a time for awahile. Well within 1 week I now have 3. I do their MDS/PPS schedules, care plans and work the floor at times do all the assessments and charting among everthing else that gets thrown at me. 2 of our MED A are being skilled for behavior and med changes that were current residents but had been sent to a Psych Hospital for issues and returned on MED A, since they are not getting any rehabs, they are fairly independant but need almost constant monitoring I am wandering when I/ or I tell the Dr I feel they have stabalized and no longer require daily skilled services do I just stop doing the PPS's and they go back and continue their OBRA schedule? I know when they are in a rehab group and that is dc'd but still continue to need skilled services I need to do a OMRA, BUT what do I do when they were never in a rehab group to start with to end me doing their PPS, you see when they are off of medicare A the other MDS nurses take them back over, right now if they are my residents I do their their OBRA and Medicare PPS..Also what type and when is a notice suppose to be given the the resident or family letting them know they can no longer be skilled? Am I suppose to be giving anything to billing while I have the medicare A residents. No oone has ever told me and since we are all new to this It seems very disorganized to me. Billing doesn't seem to have much of clue either..Thanks ahead of time for the help. I am in Colorado

I am a brand new medicare and medicare MDS nurse, I will be doing all the assessments (among) a thousand other things for the MED A residents. We have another nurse who does the MDS for the other residents. We are a brand new medicare certified facility, my question is we have a resident who had been here and already had their OBRA adm mds done, about 3 weeks ago but had gone to the hospital for about a week and now is back and he is going to go on MED A, I know I just need to do a 5 day for now, there is no sig change and I don't anticipate him being skilled for too long, right now it is for behavior observation and medication changes(was in med surg then to psych) so I figure once he is stable he won't have the need for skilled. When I make that determination does the Dr. have to say he is no longer skilled or do I? AND since he isn't getting any therapies do I just no longer do the PSS/MDS and just continue with his OBRA schedule that the other nurse will do? Thanks

I work in LTC and we have just received out Medicare certification, so my question is if one of our current residents go to the hosp, and come back and meedt the qualifications for Med A, would they just stay on their MDS schedule but would I start the PPS with a 5 day? I figured it wouldn't be the re- admission since they were not a Med A to begin with, also if they come back and are a sig change could I do a sig change and combine it with the 5 day? I am the new medicare nurse and medicare MDS so this is all new to all of us. I figure the majority of our med A will already be current residents that go the hos[ for the 3 day stay. Does the discharging Dr have to write the skilled med A order or if they are sent back without that and I know they can be skilled on Med A can their PCP Dr that covers our residents write that after they return? Any help is appreciated, Thanks

If a resident had a 3 day qualifying stay at an acute hosp but then sent over to the psych floor, has a dx of dementia with behaviors and was getting IV sedatives before going to psych and comes back to the LTC, can they be skilled for psych since they would need daily monitoring with medications, behaviors, ect??? If so would they be dc'd from skilled once they stabalize? One more, wouldn't the discharging DR from the hosp have to write an order to admit on medicare A skilled services and specify the reason skilled? Thanks ahead of time for the help!

could you please e mail the PPS worksheet too..I am just starting and tried to make one and come up with 4 sheets...thanks

Can you please e-mail me the worksheet!!!!! new to the Medicae PPS MDS's!! THANKS

:confused:If you have a resident that is on Medicare with a RUGS SE2 has a stage 3 ulcer, O2 and a few other things that qualify him for that Rug group and 35 days after admission he is put on Hospice with a prognosis of 6 months does he still qualify for Med A services?? When would skilled services end?? Do I need to so an OMRA?? And if initial services do end, would he qualify for skilled medicare and when?? Thanks ahead for everyone who helped!

Thanks to everyone! I haven't really started yet I am still doing wound care at this time. I did get my MDS certification but we are still waiting for our medicare approval. I am still reading and attending a few seminars here and there. I haven't been able yet to train with our current MDS nurse, I still am just hoping everything will be fine and trying to figure out a worksheet for me to gather information for the MDS. I would like to thank everyone who has replied to my requests. Reading all this stuff for the MDS is great but actually being able to apply it is totally different. I know it will all be fine once I can get hands on experience and will become second nature just like everything else I have done in my career. Any ideas or help is always appreciated.

Hi, Does anyone have ideas or forms you already use to do the collection part (pre MDS) that you use for collecting the information you need to do your MDS? I am just starting and any forms anyone uses would be of great help.. If I can download them or e-mail them to me. THANKS ahead of time!:wink2: