fulzgold

fulzgold

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All Content by fulzgold

  1. Independent contractor vs. agency nurse in a hospital

    fulzgold replied to btoddrn's topic in Nurse Entrepreneurs, Innovators

    My specialty is clinical reimbursement, MDS, for long term care. I have been working as an interim, using recruiters as my marketers basically. I invoice the company directly. My contracts start out...

  2. Brutal Clinical Reimbursement Regionals

    fulzgold posted a topic in MDS Coordinator Information

    I have a Regional consultant that is absolutely brutal. Every time she comes to my building, she spends the entire time drilling me, insulting me and embarrassing me. She tries to get me to spar with...

  3. New DON

    fulzgold posted a topic in LTC: Directors, Assistant

    I'm a new DON in a small facility, less than 25 res.. 14 yrs of SNF experience:ADON,MDS Coordinator, staff nurse... I was not inserviced of course, given a list of tasks to sign and tossed the...

  4. Family diagnosticians: just Google it!

    fulzgold posted a topic in LTC: Directors, Assistant

    Ok,this is makeing me crazy. What do you do when family members google a med and insist this med is the cause of some S/E. Yes, by God, they've Googled the med, read the S/E, assessed the patient and...

  5. on call rotation

    fulzgold posted a topic in LTC: Directors, Assistant

    My admin wants me to try an on call rotation for the staff nurses to keep the floor covered. I have worked in several types of nursing settings that used this solution, but that was years ago. Do you...

  6. Administrators

    fulzgold replied to c.oconnor's topic in LTC: Directors, Assistant

    A prior admin I had, told my scheduler to cut staff back to one cna and one nurse on night shift without any knowledge of resident care needs. Over 60% of the residents were a 2 person assist, 4...

  7. Considering LTC in the future

    fulzgold replied to iwillact's topic in LTC: Directors, Assistant

    No, there isn't such a place, there are numerous DNS out there who all had the same ignorant (not an insult,) thoughts going into it. You'll soon discover that doctors and nurses are not consulted...

  8. New DON

    fulzgold replied to fulzgold's topic in LTC: Directors, Assistant

    This is a terrible job. You all have my admiration. I have met with so much resistance from "the powers that be". I'm fairly certain I was set up to fail. Back in April, after review of a referral, I...

  9. DNS/DON question

    fulzgold replied to pixie120's topic in LTC: Directors, Assistant

    I got lucky at my facility. The Rehab was an SLP with a head for business. I showed him the case mix index and explained how the nursing care, and therapy tx effects RUGS. I gave him the list of rugs...

  10. New DON

    fulzgold replied to fulzgold's topic in LTC: Directors, Assistant

    Wow, good ideas. Thank you so much. The prior DON had an assistant who did everything for the staff nurses for so long that they have forgotten their job tasks. They truley think it's not their job to...

  11. Unbelievable

    fulzgold replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    Jeesh! Our admin does stupid stuff like that too. One time she drove 2 hrs away to a womans apartment to assess her for placement. When she came back she was actually considering this patient. The...

  12. Who is your software vendor for 3.0?

    fulzgold replied to Ruas61's topic in MDS Coordinator Information

    Our is Twonumbnutsinacan. Still having all kinds of glitches. It won't validate because no matter what assessment you code for it throws old answers from prior 2.0 admits in there and fatal errors it....

  13. MDS 3.0 RUGIII to RUGIV Medicare PPS Transition

    fulzgold replied to Talino's topic in MDS Coordinator Information

    In August, I moved all the routine OBRA assessments due in october, up to September and spread them out through the month. That was rough, but that way we have plenty of time to focus on the PPS. We...

  14. ADON'S what are your duties and what and how many hours do you work?

    fulzgold replied to Bubbles82's topic in LTC: Directors, Assistant

    Too many,, and too

  15. CNA Mutiny

    fulzgold posted a topic in LTC: Directors, Assistant

    Anyone ever have a mutiny at their facility? One shift of CNAs against another? What did you do to stop

  16. Discharging a resident who does not want to leave?

    fulzgold posted a topic in LTC: Directors, Assistant

    Ever had to or tried to discharge a patient who does not want to leave? Been lucky so far, but we have had a few who were either not sick enough to qualify with their payor source and did things like...

  17. Describe good and bad CNA's you have seen

    fulzgold replied to gardie's topic in LTC: Directors, Assistant

    [ You can't teach common sense . No, you can't. Common sense isn't all that common. It is actually a gift. I've heard these questions from staff: "Since the resident fell at the hospital and not here,...

  18. Monthly Summaries

    fulzgold replied to Bubbles82's topic in LTC: Directors, Assistant

    We dont do those any more. We instituted a "weekly assessment". It covers everything that the MDS covers and encourages the nurses to provide a routine full assessment of residents who normally would...

  19. Clinical difference of opinion on cognitive status with SS

    fulzgold posted a topic in MDS Coordinator Information

    I may be a little to picky about accuracy in coding but, I scheduled a Sig Chng on a res with End Stage Alzheimers who went hospice. She can no longer speak anything but gibberish, screams, hits,...

  20. Rn's are better than lpn's???

    fulzgold replied to lisa41rn's topic in LTC: Directors, Assistant

    I wouldn't say "better" than. I have experienced the same ungracious comments from insecure LPNs. It's not in my character to pay them back with comments in kind. Remember, the difference between LPN...

  21. MDS 3.0

    fulzgold replied to Strawberry63's topic in MDS Coordinator Information

    Not really, boobs don't have the education required to understand the questions. Any of them who want to argue, just tell them the difference is 2 more years of college and 8 more

  22. Admission orders the day before?

    fulzgold replied to cockynurse80's topic in LTC: Directors, Assistant

    Has anyone ever had the hospital fill out your paperwork for an admission? I have often considered requiring this. We normally get orders faxed early on so we can get a head start on the paperwork and...

  23. Pushing The Limit For $

    fulzgold replied to disney158's topic in MDS Coordinator Information

    Right.

  24. Pushing The Limit For $

    fulzgold replied to disney158's topic in MDS Coordinator Information

    There are many situations where there may be more than 3 quarterlies re: adding the OMRA and OSRA when needed. Since they have no specific OMRA/OSRA assessment, one would use a quarterly. Now when 3.0...

  25. Pushing The Limit For $

    fulzgold replied to disney158's topic in MDS Coordinator Information

    My consultant says the quarterlies can not be any further apart than 92 days but can be closer together. So if you have a res due for a Q in a month and notice right now they had a PICC line put in...