reylem

i do emphatize with you. it's unfair for these surveyors to site you on the basis of just a small percentage of inaccurate coding. they should have a standard criteria for inaccurate MDS coding citation. why don't you file an appeal? because of the nationwide shortage of nurses, RNAC and assessment nurses are called to assume other responsibilites. most of us are losing our vision, developing CTS, stress related conditions just keeping us with paperwork we believe that quality of life of the patients we serve is much more important than this.

Hello fellow MDS Coordinators. Welcome to the MDS/PPS world. I have been an MDS Coordinator from 1996. Our MDSC at that time resigned and I was 'promoted.' Well, I started by reading the RAI manual. Also made an MDS roster which list the residents and the due dates for a one year period. Required nurses to write quarterly and annual summaries as well as do pain,SR, B&B, Braden scale and mini mental as per facility policy as back up documentation for my coding. Yes, you have to surf the web, attend seminars and call your State RAI too if things are not that clear to you. Make a monthly MDS schedule so your team members can keep track of the due MDS and the Care Planning dates. Try to make a separate list for your medicare patients and keep track of the RUGS categories for each ARD- 5day,14 day,30day etc.. Have a daily medicare meeting and know when the anticipate last covered day is and discharge plan. Stress the importance of daily medicare charting and documentation on how resident is functioning with ADLS. Inservice your staff with current trends, documentation, PPS. Instruct team to fill out a significant change in status notification when they recognize a significant change in the resient and set a date to meet. Schedule your readmits for a meeting to discuss readmission status. Learn as much as you can the all the features of your software. AANAC, CareComputer.com, LTCCasemix.com, SNFinfo.com, Careplans.com are helpful websites. Good luck! Melinda

I can understand your frustration Carol. We can set the ARD earlier than scheduled. If Feb. 1 is your scheduled ARD, you can set the ARD maybe 2 days earlier like Jan.30 so that the extra 2 days can be devoted to checking completion and working on the triggered RAPS. R2b is the basis for completion and this date can be within 7 days from ARD. VB2 & 4 should be within 7 days from R2b. Talk it out with the MDS Coordinator without being too critical. We all are subject to stress and a smile, kind word will really help everybody going. By the way, I have been an MDS Coordinator from 1996. I am open for criticisms only if they are done nicely. I always encourage the team to speak out and we discuss whatever is bugging anyone in a professional manner. With MDS/PPS, everyday is a learning is process.

Nurse aides plays a vital role in the nursing home. Care of the elderly is hard work and I do admire our nurse aides that are dedicated to this service. It is when I see CNAs that are not sensitive to the needs of the residents, that spends time running their mouth and taking long break hours, ignoring residents calls, that I stop and say "No, this should not happen to our elderly." I give credit where credit is due but when I see neglect, attitude in a staff member, I act on it and work for improvement.

We should not allow this to happen because if we continue to tolerate being taking advantage of by employers, it will continue to happen. An RN should always be present in the facility 24 hours. If this is not happening in your facility, you can very well call the State about this. Yes you need the experience but no you should not subject yourself to a situation wherein you are liable to lose your license at the early stage of your career.

I would like to get feedback from the group on the topic that in some nursing homes, nurse aides rule. I have worked in facilities where charge nurses are afraid of the nurse aides. They complain that have noticed nurse aides sleeping on the job, running their mouth throughout the shift, taking lunch and break hours longer than required, yelling at the residents, ignoring residents' calls and what have you. But they are afraid to write them out for fear of retaliation. I am always the first one to bring this out to the administration. May I know if any of you out there experience the same.