lisaRN37

I have both a mail out letter and an in house letter for those patients that do not have family to invite. If you'll give me your email I will send them to you

Are you doing a Sig Change every time a MCD patient has a 3 day hospital stay and comes back Medicare? If you are, why? You only do a sig change if the decline is permanent. If your doing it because they are now receiving therapy your making a lot of unnecessary work for yourself.

You can't have an observation period for someone who was in the hospital and 3.0 no longer allows 14day look back to the hospital. The patient is being admitted to hospice which means a Sig Change is required, over-riding the Annual. The final validation will come back as assessment being done late but that is only because the CMS program has not been fixed to recognize discharge summaries. We've had this happen several times at my facility and this is what we did.

Run, run while you can unless you like to be tortured on a regular basis trying to figure out the new regs, filling out full assessments on people who have been d/c'd two days after admission or being yelled at by patients for asking them the same stupid questions over and over. :sofahider

I count everything that is not a standing house order at admission. Might be wrong but no one has told me it is yet :flwrhrts:

We have ADL sheets for the CNAs to fill out that match the MDS exactly. Our nurses use them to chart and we gather our information to fill out section G from them

I have one that works pretty well for us. I also have a Med A schedule form if you'd like that as well.

Does it happen all of the time or just occasionally? If it's only once in a while then I would stay. They do the same thing to me but I like starting IVs because it keeps my skills up.

In our office, the Medicare, Managed care and Long term care all do their own MDS schedule and then I type up a care plan schedule. Except for Medicare 5 days, we give our departments 7-10 days to gather and input their information and they put copies in the charts for us to reference when we do our part of the assessment

Oh, I'm gonna have to STRONGLY disagree with that statement. In MDS, you not only have to know the patients, you have to know the federal and state regulations, you have to know guidlines for how to answer questions, timelines for when assessments are due, etc. While I agree being a floor nurse is stressful, having done it before going into MDS, I've learned to never think one job is easier than the other.

MDS is stressful, probably more so than floor nursing because you are responsible for making sure your assessments are in on time and transmitted on time, otherwise your facility does not get paid, especially with PPS. Now with the change to 3.0 the stress levels are higher, so I think you should either stick to floor nursing or go for your back up plan.

Any validation reports you've received are no good because there is a glitch in CMS processing program. You can keep transmitting to register your work but don't submit for a validation report on Casper until the CMS site says it's up and running.

Once a person has been skilled the entire 100 days for a feeding tube they cannot be skilled again unless the feeding tube has been removed and stayed out for more than 6 months, (not sure if that's the right time frame). It doesn't matter if there is a 60 day break, a 3 day hospital stay or a new illness.