rukiddingme

name:_____________________________________ ard:________ 7 back:________ 14 back:________ lastmds ard/type:__________________________ bims:________/________ mood:________/________ pain:____________________/__________________ (sect.i) active diagnosis list: ________________________________ uti past 30 days? y n since last assessment? y n date:________________ medicationsused/taken (in past 7 days) ___________________________________________ sect.j: (in past 7 days) sob w/ exertion sob @ rest sob whenlaying flat hospice/terminal fever vomiting j01800 falls (since admit or last assessment) no injury_________ minorinjury_________ major injury_________ dates:_____________________________________ sect.k: (in past 7 days) diet:_______________________________________ weight:_____________ height:____________ bmi:________________ supplements:________________________________ sect.m: (in past 7 days) askin report/treatment book for pressure ulcers, skin tears, incont. skin relatedproblems, surgical wounds, etc. sect.n (in last 7 days) # of days injectionsgiven:_____________ # of days insulingiven:______________ # of days phys. changedinsulin orders:___________ # of days these meds used in past 7 days: antipsychotic_____ antianxiety_____ diuretic_____ antidepressant_____ hypnotic_____ anticoagulant_____ antibiotic_____ sect.o (in last 14 days) while not a resident chemo radiation oxygen suction trach vent/respirator bipap/cpap ivmed transfusion dialysis hospice isolation(strict) sect.o (in last 14 days) while a resident chemo radiation oxygen suction trach vent/respirator bipap/cpap iv med transfusion dialysis hospice isolation(strict) flu shot:______________ pneumo:______________ physicianexam/visits (in the past 14 days) ___________________________________________ phys. orders (in the past 14 days) *not clarifications or readmit orders ___________________________________________ sect. p restraints used inthe past 7 days: y n used daily or notdaily? type:_____________________________________ othernotes, etc. can go on the back side

I agree with the previous post. MDS nurses often do other duties such as infection control, skins, etc. Be sure to ask plenty of questions if they allow you to 'shadow' her. Depending on what exactly she's doing for the MDS position, she may not be doing exactly what your job duties will entail.

Sounds like your Activity Director needs someone to come in and give him/her some fresh, new, innovative ideas for these people. We have a monthly 'auction' that the resident participate in, using 'fake' money and donated gifts that they can bid on. We have a garden club in the nicer weather months, a walking group that track how far they walk on a scheduled path in the facility. A monthly newsletter that residents are involved in writing articles for -- someone does a similar type of 'dear abby' column, others write stories about their lives when they were younger, etc. Resident assist in coloring placemats for all the residents to use on special occasions. For Valentines day we had a 'fake' Kissing booth that staff handed out 'hershey kisses' to the residents, and 'chocolate and 'simulated wine' tasting.

This type of scenario also happened to me in a prior position. They stated I needed to be in the on call rotation, and that it was part of my new job description. I refused, and they said that if I chose not to comply, I was no longer needed - and that my refusal was my choice, so I was resigning from my position. They can 'make' you work on call, if they so decide -- and if you won't, they will try to find someone who will instead. I assume in order to fulfill this duty, they should have to give you proper training to work the floor -- that is unfortunately difficult considering you already have a full time job doing MDS's. Wishing you luck. Tara

Our restorative nurse recently did an interactive inservice - using an empty private room, and did 'mock' transfers, etc -- and explained how to code for the specific procedure done. Seemed to make them understand it better.

From what I understand: In order to have electronic records ONLY, you're software must be set-up for electronic signatures, so each team member can 'electronically sign' for each MDS you complete. Your records must also be available to floor staff - to view care plans,etc. as needed, unless you would continue to print these out and keep in the chart or wherever. At my facility, we do not have electronic signature capability, so we print out everything. We have set-up our printer to print 2 pages on each side of the paper, so it has cut down on pages dramatically.

The MDS 3.0 Track Changes are the changes made to the manual after the manual was completed. You can find the full RAI manual - including the Track Changes on the CMS website, just search the CMS website for MDS 3.0 and you will find the online RAI manual. The person doing the sections of the MDS should sign for the dates they did the interviews, so, yes, they could be signing for different dates for different sections. The pain interview should also be conducted on the ARD or the day before the ARD - so the information gives a correct picture of the residents pain for the MDS.

The BIMs interview has to be done within the 7 day lookback period. The PHQ-9 should be done the day prior to the ARD, or on the ARD. (this info can be found in the MDS 3.0 Track Changes for the RAI manual) None of the interview items or information should be gathered after the ARD.

We have 90+ census, and we basically split these, so we both have long term and medicare residents. And we try to keep it as equal as possible, but we don't get crazy counting each one. We both attend morning meetings, have care plans one day per week. The coordinator does the medicare billing book, and I take care of the assessment calendar each month. We both help with transmissions & validations.

No current openings, sorry. But I'd be willing to let the other one go for someone easier to work with. My facility: current census, 95. PPS residents, 7. MDS staff: 2 fulltime. We do not work the floor, do not take call, do not get overtime. We work for hourly pay.

How can you be doing all that, and getting quality information for facility $reimbursement$ -- which should be the #1 purpose of your work.

Went for interview for the position. The Super/Principal asked me questions, the lady currently in the position was present and talked about her duties. When they got done, he started to give me the 'bones' of the position, and the benefits -- the position was going to be only 27.5 hrs per week, pay: $12-$14 per hour, no insurance. The current lady doing the job isn't even a nurse anymore. She used to be an LPN, but let her license lapse. So now they want an actual nurse, but only for part time hours. I told them I needed full-time work in this economy to even consider the position, so I was there for 45 minutes and it was basically a waste of all of our time. Wish I had known it was only part time hours before sending in my coverletter/resume.

We always take therapy info/participation into consideration - especially for ambulation.

My daughter (age 11) says, "Mom, you know the nurse also works in the office and helps with the library books". Which sounds pretty strange to me. Maybe because it's such a small school, she has to do these other things also. I left a voice mail for the Superintendent/Principal on Wed. but haven't yet heard back from him. I told him I was looking for a little clarification on the job position - such as how soon does he need the replacement to start, about the non-nurse duties, and regarding their health insurance. Still waiting for a call back.

I'll keep my fingers crossed for all of us dealing with the 3.0 every day. It would be wonderful to have CMS change the discharge assessment process and reduce the interview needs for Medicare residents - so they aren't answering the same questions @ the 5day, 14day and again @ 30day. They really do look at us like were crazy when we come back and ask the same thing again.