I would love to see the sheet that who moved my cheese designed. We use a nursing progress note to back up the mds that includes the 7 day look back period -- it has mds supportive questions with simple boxes to mark & a nursing summary note. We also have implemented something called the accunurse system where the cna's document the adl's -- this is supposed to back up the mds data ha! HA! I am actually working with a cross walk for accunurse and american health tech system --- the information the cna's recprd is not accurate most of the time. It takes one hour to correct the documentation for one resident & then inservice the cna. I als am the ADON, MDS Coordinator, IN-Service Coordinator, Care Plan Coordinator, Head Accunurse Coordinator. I educate the LPN working with me to use pack up nursing notes that we ourselves write because none of it matches. Not the notes the floor nurse document's, not the cna information recorded into accunurse, & that leaves us with all the mess to clarify and provide adequate documentation for mds support purposes. Now, that is definately a documentation issue to over come. I like to try to stay positive at all times because I am the leader however, it gets very frustrating trying to complete just one assesment. So, if anyone has advise or a shorter method please let me know.