gonenutz

We get a call the night before asking for a list of MI residents, traumatic brain injuries, stage 3 or 4 wound ( none thank godness) and a resident roster. No list of which MDS though. that would be nice.

I am not own to take constructive critisms to heart, I take it as a learning experience. Like I said it must vary from state to state. And I am supervised by my nurse consultant. As for nursing assessments and care plans LPN do thm in my state. they assess the patients and obtain orders and call the doctors. we are only are required to have 8 hours of RN coverage each day. Do you guys have RN every shift?

Ours have to come out on any complanits or reportables. The have a complaint survory for each region that takes care of the complaints. we get a lot of digruntled employee complaints.

I am jealous of all. Any compliant or reportable to the state where i am from the state has to come in and do a facility visit. thus the complaint/reportable is deamed substanciated or not and we have to proceed from there. It doesn't matter what you send them, they will be in your facility within thiry days. Good info to know is that from you MDS casper reports you can check to see if state has pulled your qi/qm reports and have an idea of when they are coming.

I agree it depends on the state and the size of the facility. I am a LPN and worked as an Acting DON for almost three years. I feel that it is base on the state laws and ultimately the LPN's expierence. Some states allow you to apply for waivers where you can have the DON be an LPN.

In Indiana it is usually once a year but they have a 15 month window from your last audit to come in. If for some reason your CMI increases drastically or the notice anything odd in the patterns of your MDS submissions they can come in at anytime. Word is out though that Meyers and Stauffers is going to take over EDS' contract in the future. It is at least nice of them, they call the day before they come into the facility.

In Indiana EDS is a contract company that comes in and audits the mds' in the payable sections. we have supporting documentation guidelines we have to follow to goalong with the payable items. In a nut shell they come in every year to audit theMDS to see if everything is coded correctly if not the record is unsupported and you lose that RUG classification that the record was in. This ultimately affects your CMI. this is a quick run through if you got all day i can explain further. the get really nit picky at times. such as the restorative programs not having the same title as in section p. errors on adl grids, resident numbers and dates being left off. 2/1 as opposed to 2/2/09.

I am from Indiana and I have a couple of builings in their window for their audits. Does anyone have any tips on what EDS' targets are this month? They tend to get on their tangents. I had one building that they couldn't find any issues so they tried to throw out all the restorative because the builing kept the mds and care plans in a seperate binder and EDS was trying to say that this was not part of the clinical record. Of course this didn't fly and the building received a 98% on their audit but they called me in because they were beside themselves. It just took a phone call to the groups supervisor and the issue was resolved.

I am also in Indiana and have spoke with the state mds coordinator and a few of my other consultant contacts and the impression that I have got is there is a few things that CMS wants to tweak before they train the trainer. Most of the coordinators can start looking at training mid May and it sounds as if the the implementation date will be 10/1/09.

Scrubs all the way! What happens if you get pulled to the floor to work? I don't know about anyone else but I know I don't want to be doing patient care in business or even business casual wear, especially a dress. As for whites that is fine but in my experience most of my residents enjoy the colorful scrubs stating the whites make them feel institutionalized.

I can't code if the documentation isn't there and in this last wuarter my CMI has dropped signifignantly. the DON and administrator has chalked it up to we have lost a few of our long termers with higher rugs and no we have a lot of walky talkies. True but not that extent. Even with the residents with lower adl scores if you have the proper documentation a decent rug cna be obtained if you set the ard at the right times, but that is a whole nother set of issues. I think my DON and administrator should have to try and do a mock MDS just to see what I have to work with.

I was taught to code independent ambulatory residents on or off the unit as 0/1 because they are ambulating indepedently but if you or your staff observe them while ambulating at least once during that shift you can code as supervision. Just be sure and watch how you code the locomotion in resident room if no one is actually seeing that resident ambulate in the room. Hope this helps. Remember staff support only has to occur once during the assessment window.

We keep our care plans in a binder along with the quarterly assessments and MDS. Each resident has their own binder. It works out well everything r/t the MDS is in the binder and are kept at the nurses station in a cabinet designed just for these binders. It also keeps the residents charts from being over loaded.

I am currently in my survey and would greatly appreciate if you could send me a copy of your form also, i know it is not going to help now but will with plan of correction.:bowingpur

In my experiences and references from the RAI, you can do a quarterly assessment at any time during your 92 day cycle to capture what ever it may be that is going to increase your rug score and it does reset the 92 cycle from that r2b date. This also pertains to annuals, they can be done early also. Just remember the MDS must reflect the current residents condition and becareful that what ever you are using to increase the rug does not trigger a Sig Change if it does you need to do the sig change assessment instead of a quarterly.