cmsnurse49

I feel your pain. I have had similar experiences twice in my career. It is best to put it behind you and begin again. TRUST NO ONE! And there are many job opportunities for Nurses now. So dust yourself off - When one door closes another opens... Usually a much better one.

I work in Texas we just recently went the RUG 34 to replace our TILE payment system for Medicaid. But before I start on that let me comment to the ADMIN problem... I have been working in LTC for 31yrs, 15 of which I have been doing MDS's, TILEs ie. It has been my experience that if you make someone responsible for their actions they will usually come around. Have the ADMIN sign the MDS. Say that it is for accuracy. Any how.... all disciplines that have input in the assessment are to sign. Sounds like he has quite a bit of INPUT. Back to the above - I have taken a position with a company as a Case Mix Resource Nurse. We look at MDS and find the "best" RUG rate. At this moment there is no rule in how often, or close together you can complete an MDS - but I believe that will change.... Because the almighty state :bowingpurwill not abide with so much money going - not to LTC facilities...

Care tracker is a GREAT tool IF - used properly... It takes a lot of training and effort :deadhorseon the part of nursing admin to get the ACCURATE information from the staff. But the Care Tracker can be modified to be accessed by all - Dietary, Social Servc, Social Woker (mood and behavior), and best of all the Restorative CNAs - We all here in Texas (most) use this info as supportive documentation so if it is not accurate you as the accessor will have do your own documentation-a nurse note, typed note put in clinical records, or a summary type assessment done each time you do an MDS, this being the best in my opinion. Any way :anbd: the Care Tracker can be a great asset if the correct information is input!!!