mdsmadness

Yes, I agree with Tara........find out the history of the previous MDS person. I found out too late that the last MDS was single with no kids and would work all day until 11-12 at night and still left because she could not keep up. I am working 10 -12 hr days, take work home with me and I am behind. I have asked for help for months but am getting nowhere with that. The administrator and DON know nothing about my job other than it brings in the revenue. I say that is pretty big and they should be more supportive. So with all this said, if you get in the right place with the right people it can be very satisfying. If not it is totally frustrating. Good luck to you!!

Questions you should ask........will you have support? Is there anyone else in the building that knows how to do assessments if you get in a bind or (God forbid) you want to take a day off or maybe even a vacation??? Is your administrator supportive or is it the......."It's your job you need to do it attitude?" Is the DON a good DON and make nursing do what they need to do? What is their CMI? What did they get on their last EDS audit? Yes, sorry to say it probably means that you are salary so expect to work twice as much and earn anywhere from $7 -$10 hours less that what they tell you you will make if you base the hours you work against your actual salary, oh if I had to do it all over again!!!

Unless he has had significant changes in his Cognition or 2 steps doen in ADL's, a new GT or a drastic decline and no therapy? Not sure how he still qualifies for skilled?

and what is time off??????????

Great Job Cotjockey! I took the class in CA, July 15-18. They said you had 60 days to take the test............just need to find the time! They said at the end it prints off a certificate or lets you know if you passed or not? I do not have a printer at home so I am thinking I will take it at work.........that is another issue, at home or work...........TIME! lol Glad for you that you got it done and over with, now you can add RAC-CT to the end of your credentials!!!

I am in an 88 bed facility and I am the only MDS so I do not have that issue (wish I did). I did talk to someone a couple weeks ago at the RAC class and they divide it that one does the PPS assessments and the another does remaining assessments. Definately the experienced one in your case could do the PPS part. Food for thought.

Ok, thanks! Just wanted to know if that was an option, because this week I had someone code 0/2 and 1/3 on ADL's ! And SO many holes!!! OMG!! I have inserviced until I am blue in the face and they just want to get out of there! They don't get it. I went to a mock survey today for a sister facility and they have the same issues about improper coding and the "copy cat" thing going on but no holes...and I am asking, how do you get everyone to document?? She says she drives a hard line (and she is not a mean person), but starts at the initial inservice and states that "You will document every shift before you leave!" I am to the point of being a hard nose and doing that and adding, "If you don't you will get wrote up". It is not the avenue that I wanted to take but I am thinking this may be what it takes....because in the end, it all falls back on me." I really do not think our corp office will pay for Care Tracker but I know the ED has worked in a facility where they had it and he is open to it, BUT.........it really isn't up to him. Just so tired of , know what I mean! lol Just trying to f ind out what other facilities do.

Just curious about, what if someone codes a resident totally wrong? Because you and I both know that you can have someone that you know is totally dependent and then someone comes along and codes minimal assist or something silly...is it locked in stone with the Care Tracker, or what do you do?

I am interested in any information that anyone can give me on the Care Tracker system, has it helped your facility as far as correct ADL coding? And do you know if it will have to be updated/changed with 3.0? Thanks to all, I love reading these threads! So informative!

I do not think that I would like so many fingers in the pot either......but then MDS Nurses tend to be a little anal about their job, I know I am and admit it! lol Not all DON's know about MDS, maybe a little discussion with her about the importance of that R2B date would be helpful?

I answer to the Administrator and he does my evaluations. The Administrator knows if the money goes up or down and that is about it.

Basically I capture everything I can ...as long as I have documentation to back it up.....some key things that will raise your CMI are ALWAYS, ALWAYS get your signed IV records from the hospital for new residents. Make sure that you pay attention to that 14 day look back period on your Special Care section P1, these along with correctly documented ADL's and therapy can really raise the CMI. I always let our therapy department set the date for the first assessment, if they want it to start on day 1-7 or 2-8 and then I set the second according to any special services that the resident recieved in the last 14 days. If I have to overlap assessments to capture IV's or something, I do it. If I have someone that is in assessment or coming up for assessment and therapy is going to pick them up, I will move the assessment accordingly to be able to capture the most therapy minutes I can. Not only with MCR, but part B also. Just a practice that I have with all residents, capture everything you can but have the documentation to back it up. Train staff to code ADL's correctly, (which is a BIG challenge and cannot say that I have that mastered yet) but definatley work on it daily because the ADL's scores can make a huge difference. Anyone that is not in therapy and would benefit from a maintenance program, get them on 2 or more, 15 minutes a day. Make sure that you have all that would benefit from a toileting program on one and Care Plan it, evaluate/assess it and document it....same with turning and repositioning. All these things benefit the resident as well as your case mix. Hope this helps! Good Luck!

And so I cannot sign the R2b??? And that means what? I should not get paid as much even though I raised the CMI? And getting my facility $50 more a day per MCR resident this quarter. :typing Maybe I am out of the norm but...........maybe my facility understands the importance of the whole process? As all facilities should appreciate their MDS nurses, whether LPN or RN..........we all work just as hard.

I am kind of late to reply but I just saw your post tonight and feel compelled to reply!! Way to much work! Our facility is about the same size, the admission director or someone from the IDT does the evaluations at the hospital. I put in the DX but, she does the face sheet info, I do not do anything with insurance, the BOM and Medical Director take care of the certs. The ADON (at this time) does the intitial care plans(that is probably going to change because she does not even look at my raps to do them) The care plan, IDT rounds involve myself, , the DON, the SSD, Activites, Dietary, Restorative and Therapy..would be nice to have the floor nurse and the CNA involved too, but rarely happens. I make up the MDS schedule, Care Plan schedule, IDT rounds schedule and track all assessments...and I feel overwhelmed at times so I cannot even imagine what you are feeling. I know others at the same corp, in different facilities do the certs.....and they are overwhelmed. The DON where I work tries to put more on me, but I pretty much have set my limits as to what I can do and do it effectively. And not to brag at all, because I am so not. I make more than you per hour, what sucks is that I am salary, so all those extra hours I put in, well they are gone by the wayside. But I am left alone because I am the only one in the facilty that knows my job...........no 3 deep here , that would be a joke!

Hi Tammy, I believe you are talking about a PPS Wheel or PPS spinner. Here is a link, you can find them at Briggs Corporation or www.briggscorp.com Here is a direct link to what I think you are looking for http://shop.briggscorp.com/e2wItemMainBriggs.aspx?functionId=09000008&parentID=019087065b Hope it helps!