crazyforthis

Interesting... 95% of the people I know that have contracted covid and/or had exposure are in the hospital I work in. The only one I know that wasn't from an employee at the hospital I work in died from covid. The odds seem to say otherwise in my world at least. I don't understand their thinking on this one

I did not say the covid vaccine was mandatory. Here it is optional. It is encouraged but optional.

I've been an RN mostly in hospital settings for over 30 years now. I've seen way too much. I now work in care mgmt for our trauma team. My exposure to covid patients is more limited but my bedside nursing friends are exhausted from all the covid patients. Even if I were in my 20's I would never say or think I'd rather catch it than take the vaccine. We are already seeing the short term affects of covid... sure lots have no symptoms but no one is guaranteed that outcome, the heart and lung damage alone is pretty severe. My 20 something coworkers, most of them, are anxious to hurry up and get it. I'm getting it but did put a lot of effort into reading about it and listening to talks for ID docs and pulmonary docs and cards docs here at my hospital. Yep you better believe I am taking it. Like most places Flu vaccines are mandatory here. The covid vaccine which we start getting on Friday this week, 12/18/20, is not mandatory. I've heard rumors about a stimulus but I don't need that to be willing to take it. I don't look at it as a bribe either though. That $1500 bucks is a drop in the bucket compared to the costs everyone incurs from 1 hospitalized or even symptomatic at home. I also don't think the $1500 is actually a bribe. A dear friend, a doctor, got covid a few weeks back, she's in her mid 30's, a runner, super healthy has a 1 year old... she got it and brought it home to her hubby and child... my doc friend got it bad, she was so so sick. She is still trying to get back her energy and stamina and still has some symptoms lingering. It's been almost 2 months. No thank you. I don't want to risk it. You just never know if you will be a lucky host of the virus or prone on a vent 2 days later. Plus I want to contribute to slowing the virus down in every way I can. I want to protect others and especially my family where I can. It is though a personal choice...

My question is about tube feeding. We have a patient that was admitted with a new peg site (among other things) and tube feeding regime. He was getting bolused TF's and was expected to continue the practice once discharged home. On day 16 of his stay in our SNF Nursing began to teach the patient how to care for peg site and give own tube feeds. On day 24 the patient was giving his own tube feeds at each scheduled bolus time. The formula was brought to his room by nursing from our on unit 'kitchen' each time he needed it. While doing his 30 day PPS I noticed that some nursing staff was coding in the eating section as 0/0 and some were coding it as 4/2. Upon speaking with the nursing staff they all agreed that they were bringing the TF to room for patient to give his own bolus feeds. He had no other nutritional intake. Nursing also agreed they were all assessing PEG site for s/sx of infection, leaking, displacement and asking patient how he felt he was tolerating the TF's. But none were actually setting up and giving the TF. In this case, what would be the proper coding for the eating section? Thank you

I thought it was 48 hours also... but can't swear to it, especially with how fast things seem to change lately!

Hi fposey, I am sorry you are having such a difficult time finding a job. Years ago when I graduated as an ADN things were the opposite. I have been very blessed in my career and still have only my associates degree. I work in MDS now, and am writing to you to offer an idea. I never thought I would ever work in a SNF but after moving several states away and applying for several positions at the local major medical center I chose the SNF I am at because of the position. Since I started there 1.5 years ago I have seen countless new grads in your same position. At my SNF we interview new grads from out of state a lot, both Associate degreed and Bachelor degreed. I am finding that a new grad is still a new grad. At a SNF there tends to be a little more turnover I think, and is a good place to learn some basic skills. We still have our pick of best and hire a lot of RN's because our facility only had a couple when the new director took over just before I was hired. It was staffed by almost all LVN's and C.N.A.'s. Once we hire an RN (new grad) we ask but dont require a one year commitment from them. The director then helps with getting them into other positions within the acute care hospital system we are associated with. It works out great for both parties that way. Just a thought. If you haven't made the rounds of all the SNF's it might be a good idea. Good luck, I hope it works out soon for you

Hello Everyone! I just wanted to say thank you all for all the help when I posted here. Also for all the information gained while just browsing others posts. I was brand new to MDS in 2011 and New to LTC then also. I took over the role of MDS coordinator for the retiring MDS Coordinator. I started my training in April 2011 and took it over completely on my own at our facility in mid July 2011. I have been to this board many many times since then gaining knowledge, along with a class and some training from the previous MDS Nurse. In 2011 we had our CMS survey in June and had an issue come up with MDS that required I audit records for the next 9 months, other than that no MDS issues. I was also still considered in training. Last week, June 2012, we had our CMS survey. My boss felt like the surveyors were really digging deep into our MDS. When all was done and said the entire facility did great with only very minors dings. For the MDS dept (me) the only thing that came up was that I had clicked on a box in error, meant to click on bipap/cpap but had checked off vents instead. I was able to do a modification on this the same day it was found. I know I have a ton to learn yet with MDS, I know I have worked extremely hard this past year learning understanding etc all I can about MDS. I still could not have done as well with this forum and my State MDS Automator. I offer up a huge thank you to all here who have helped me many time. Thank you! Carol (crazyforthis)

Susan, Are you saying that regardless of pay source or no paysource go ahead and do the OBRA assessments by day 8 also. Just in case....

Thank you!

Thanks Talino, Just to clarify... yes I did the OBRA, and there is nothing more I can or should do, correct? Our billing department seems to think I can somehow fix this and I just want to make sure That i am doing my part correctly. I did read pages 653-54. What i understand is that for billing purposes the OBRA assessment I did is what they need to use to get what payment they can. Is that right?

I was just notified today that a prior patient had Medicare part A while here from 2/21 to 3/3. How do I change the assessment or do I Modify it to reflect her Medicare? We had no insurance info on her at all when she was here. This was sent long ago and accepted by CMS so I am not sure how to handle this one! Thank you!

My Boss is willing to let me take the CPRA course, in this case it is offered thru HCPro Inc. I took the MDS Boot Camp they offer online last year and I would say it was pretty good, but would have been a better option if I had worked more in MDS before I took it. They also offer 2 or 3 day live seminars if you prefer that. The book they give you is great and it goes thru each aspect of the RAI manual and breaks everything down to help you understand it better. They also have 2 hours of open call time included in which you call and speak with the experts to ask your questions. I am wondering if there is any differance in the MDS certification offered by other companies. Meaning is the certification called something different through other programs?

@mdsnurse12, which part of texas? I am curious as to the diff in pay in different regions in TX also. I am in Central TX, about half way between Austin and Waco.

Completed a weekly patient conf a while ago, in this one, for the first since I have been here, the activities coordinator actually had to say out loud what kind of activity the patients were participating in and how often... it was a low census week for us but we just got 6 more admits, usually we do run around 40 residents most of which are shorter term patients averging 2 to 6 weeks...here is the breakdown; 4 people are non-responsive and 6 had not been assessed yet, 2 were hospice and I dont know if they even get invited into the activities program (will check into this, this week), 2 watched movies in the activities room, 7 participated in the Valentines Day party and 5 of those attended beauty shop day also, 13 watch TV in their room, and have company a lot but refused the activity program. Several of us concerned staff here have suggested many different activities but they are all shot down for various reasons. Currently there are 2 scheduled activities listed on the activity calender, at 0800 there is one to one time (usually initial assessments are done during this time) and the other is at 1:30 which is usually schedled as pt choice or movie and popcorn. The Valentine s day party was thrown together last minute when someone asked the director what was being done for/with the patients for Valentines day... when he checked nothing was scheduled so the AC got cupcakes and some decor form what I heard and that afternoon had a party. I feel sad for the patients. especially the ones here for several weeks or months that get so bored. I am thinking of starting an informal audit r/t to it all.

cynthiamc, not comfortable talking about it here. I will say that you would need to be prepared to account for every minute of your times on the phone. every minute, it's all about stats. you can pm me if you would like to