mdecastronp

if you have a social service consultant, i recommend discussing your resident with hx of being a sex offender. i was consulted once on a case in which the ltc did not know the resident was a sex offender until his parole officer called. i consulted with our social worker and indeed there were regulations that we have to follow. if your facility is near a school, you may want to review it also with the parole officer even if he is w/c bound.

i requested information from this website http://milvalihealthcare.com/Guestbook.php... they have good tools and forms...

please email me or let me know your email... you just need to save it on 2003 excel to ensure that you have the format correct... as you add months and information into it, it will automatically calculate the number of infections and will do the sorting (as long as you pick what you want) and will also produce the graphs you need as it is entered.

I've seen these situations happen over and over again. I've worked mostly in the management, corporate level in my career. I've been asked by fellow Filipinos whether I still or even understand the language, in which, I always reply "yes". Following that question, I am frequently asked why not speak to fellow Filipinos in the native tongue? My answer is very simple: I want to set examples to other Filipinos. The workplace is not to show off whether I understand or speak or even to favor Filipinos. I have been branded as a snob for not gossiping or have leisure time or conversing with fellow Filipinos. The worst of all, I was told I do not respect my elders, which I respond when told, that I respect them as they are older but they should also respect me for which position I represent the company in which we work. The problem is, most Filipinos feel that since there is someone up ranking high in the management/corporate level, most countrymen assumes that they will be provided with a special treatment. It is sad to hear bad things about Filipino nurses. I find them as the most hardworking ethnic group. But, having been in so many management positions, the best group of nurses are those blended from different nations. I tend to limit the number of Filipino nurses I hire (not being prejudicial) because of what was said that started this thread.

grievance or complaint form - usually we think this form is only for residents, but this system is for everyone. this will start the ball rolling. you can also place a complaint with your HR department, so that information is on record. if you have a compliance department, i would suggest to start calling and you can either provide an anonymous report or not. every nursing home is required to have a compliance department. i would also suggest that you recommend having a psychologist see the resident to see what kind of fixation he/she has. if there are no prior records of what has been done with previous employees, it will be tough to prove your case later as your best defense is the record of what have happened in the past and chronology of the incidences. suggesting a meeting with the family, with resident present and getting the threat on the record will be helpful to you. consider this as a form of abuse (threatening verbal abuse) and remember, abuse goes both ways and must be investigated. it can also be from resident to staff. goodluck!

i would start a log of your whereabouts when you are out on the floor. avoid interactions with this resident without anyone present. request that your DON have a meeting with family to indicate what was said. BTW, you can also file a grievance/complaint. remember that process goes both ways, not just for residents and if there is one, management has to get back to you with a resolution. goodluck!

please google national patient safety and also enter Morse scale... you should be able to get the website that includes the protocols that goes with it and the assessment also includes intrinsic and extrinsic factors which is answers the information on the CAA part of the MDS. goodluck!

CA - Difference between North and South is 20% (that is due to cost of living)... just want to correct prior post - highest paid in CA - SF, although it can be insanely high in Sacramento area or Reno, only because of the shortage in that area. SF (not looking at Sacramento) is followed by San Jose, Monterey, and the rest of Northern Cal counties are almost the same. As far as Southern Cal - Orange County, LA, San Diego and the Valley areas are the same, followed by the Inland Empire Area (Riverside, San Bernardino, etc). BTW, NA makes 120k-150K, NPs makes 85K to 120K (depending on experience), expert witness $120- 150/hr for reviews and court appearances at $250/hr. DONs for LTC makes 80-150K depending on the size and number of beds, while CNOs starts at 120K. Nurse consultants starts at 100K with bonus packages depending on the company plus expenses and mileage. Highest paid are nurses in CA and Hawaii because of the high cost of living. (I work for a company that have hospitals and NH nationwide and have seen budgets for different states). Credentials: NP, LNC-CSp, MSN - I work as nurse consultant and have contracts in the entire state. If you want more information as to specifics on salary ranges, please send me a message.

that depends on which State you are in. In CA, F does not triggered a re-survey. only when you have a substandard care (G) triggers re-survey. if you would like to see the guidelines on re-survey, cms just release in october the new survey guidelines... i found it easy to look at the regulatory updates at milvalihealthcare.com if you want to download the guidelines.

What are things or processes or procedures, you would like to see offered, started to make your daily work easier as the MDS Coordinator?

Your software company is correct. If you look at Appendix H on the RAI Manual for NQ (nursing quarterly), Section F is not included. Only Section S and the RUG scoring (which is in Section Z) are "State" specific.

There is no board approval here in CA also, but inorder for the training to be called a certification training, the Board of Nursing has to approve the class as a certification class versus a regular CEU class. I attended the AANAC training and was not very pleased since the CMS training in Blatimore closed and the August training was not projected then. I thought it was a money making deal. The training cost, at least $3000 for 3 attendees, not including expenses. In the end, I had to review the 3.0 MDS on my own to provide classes on it. Not really impress with the trainers since I worked with some of them in the industry. One trainer, was the consultant for a Rehab company I work with. That Rehab company had so many violations and very minimal understanding of the reimbursement. Really, I dont know how they screen their educators! You would think, that Rehab company should be up and up with what's going on and up-to-date since their consultant is AANAC certified and I found that to be the opposite. They dont even know how to code short stay and was arguing about payment!

I am wondering why you asked? In CA, to get a course certified, it will have to be approved by the Board of Nursing. It is the same application as CEU provider except with a twist.

Your BIMS score was lower than 5 to trigger ADLs. Although you may need to care plan the ADL need, it does not trigger on the new MDS 3.0 unless your BIMS is at least 5. I quoted below Chap. 4 from RAI. Hope that helps. Goodluck! The new CAT logic does not trigger ADLs if the following were not met: 1. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for bed mobility was needed as indicated by: (G0110A1 >= 1 AND G0110A1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 2. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for transfer between surfaces (excluding to/from bath/toilets) was needed as indicated by: (G0110B1 >= 1 AND G0110B1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 3.Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for walking in his/her room was needed as indicated by: (G0110C1 >= 1 AND G0110C1 ( (C1000 >= 0 AND C1000 C0500 >= 5 AND C0500 4. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for walking in corridor was needed as indicated by: (G0110D1 >= 1 AND G0110D1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 5. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for locomotion on unit (including with wheel chair, if applicable) was needed as indicated by: (G0110E1 >= 1 AND G0110E1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 6. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for locomotion off unit (including with wheel chair, if applicable) was needed as indicated by: (G0110F1 >= 1 AND G0110F1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 7. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for dressing was needed as indicated by: (G0110G1 >= 1 AND G0110G1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 8. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for eating was needed as indicated by: (G0110H1 >= 1 AND G0110H1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 9. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for toilet use was needed as indicated by: (G0110I1 >= 1 AND G0110I1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 10. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary as indicated by: (G0110J1 >= 1 AND G0110J1 ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 11. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while ADL assistance for self-performance bathing (excluding washing of back and hair) has a value of 1 through 4 as indicated by: (G0120A>= 1 AND G0120A ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 12. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while balance during transition has a value of 1 or 2 for any item as indicated by: ( (G0300A = 1 OR G0300A = 2) OR (G0300B = 1 OR G0300B = 2) OR (G0300C = 1 OR G0300C = 2) OR (G0300D = 1 OR G0300D = 2) OR (G0300E = 1 OR G0300E = 2) ) AND ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 13. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while resident believes he/she is capable of increased independence as indicated by: G0900A = 1 AND ( (C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500 14. Cognitive skills for daily decision making has a value of 0 through 2 or BIMS summary score is 5 or greater, while direct care staff believe resident is capable of increased independence as indicated by: G0900B = 1 AND ((C1000 >= 0 AND C1000 (C0500 >= 5 AND C0500

i worked with several software and each one received several patches already. one software has not been able to resolve the issue of CAT logic up to this point and I was told it will take a while.