skilled charting

[nrsbetrn]

For Medicare Skilled residents charting does your facility chart every shift or daily charting? The requirements say the resident must need a "daily" nurisng assessment or therapy 5xweek. So are we required to chart every shift?

[CapeCodMermaid, RN]

If I tacked that note on...I'd get grieved by the union

[Rascal1]

If I tacked that note on...I'd get grieved by the union

A little humor goes along way ...:chuckle

[CapeCodMermaid, RN]

Ah, if only that were true....they don't seem to have a sense of humor.

[achot chavi]

If I tacked that note on...I'd get grieved by the union

Yeah, but whats true is true...

[Rascal1]

Ah, if only that were true....they don't seem to have a sense of humor.

This post is surely off the topic,but....here I go...First off, the suggestion to add such a note was not made here to be taken seriously. Of course it is ridiculous and it was a bait of sorts. I see remarkable success with regards to intelligent and pertinent skilled charting when the individuals that perform in this fashion are given positive feedback and acclaim. It's also beneficial to include skilled Med.A charting in the orientation process of new hires. This will be an important aspect of their job respondsibilities and therefore will be part of their future performance review and ultimately be reflected in their merit increase. And of course, it would'nt hurt to use a proactive ongoing positive approach involving other arenas of staff relations. We should allow room for sensitivity,validation and humor in our relationships. Thanks...

[travel50]

We chart 2 shifts every day on our skilled residents. We also use different sheets for their charting. ¾ of the front side of the page is a check list. The bottom ¼ and the back of the page are for narrative notes. I now have RNs around the clock, so my nurses have more time to do their charting.

[travel50]

We chart on 2 shifts for our skilled residents, and we have different nurses' notes for them. ¾ of the front side of the paper is a check list. The bottom ¼ and the back is for narrative notes. We now have RNs around the clock, which gives my nurses more time for their charting.

[achot chavi]

Yesterday at a staff meeting we broke down what has to be charted and assigned it by the day- it has worked before, if everyone is committed it will work!

[KullyLPN]

At my facility they have a paper which our Resident Assessment Coordinator completes that tells us the residents name and what details we have to discuss. An example would be John Doe post hospital for ____ skilled PT 3x's day ect.. It is nice because it targets the pertinent information you need to address in your nursing note. It is posted at the nurses station so it is visible to the staff. Our facility requires a nurses note q shift. The Resident Assessment Coordinator let's us know the duration the notes are required.

[poohmdsnurse]

It probably wouldn't work here.. some of our nurses I tell you I think they were born in a barn.. they would need that explained to them...

[ctm985]

I am an LPN who has questions regarding the substance of medicare charting. Isn't it required to chart by diagnoses? If they are there for a respiratory issue, then you document respiratory findings, etc. I have always had to chart on surgical incisions, assist with ADL, lung sounds, etc. until my current facility.

I tried to mention this and was told that generic flowsheets generated by our MDS program would cover all required doc, but the flowsheets do not address any individual problems. Any advice?

[Rascal1]

I am an LPN who has questions regarding the substance of medicare charting. Isn't it required to chart by diagnoses? If they are there for a respiratory issue, then you document respiratory findings, etc. I have always had to chart on surgical incisions, assist with ADL, lung sounds, etc. until my current facility.

I tried to mention this and was told that generic flowsheets generated by our MDS program would cover all required doc, but the flowsheets do not address any individual problems. Any advice?

What is a generic flowsheet ? Yes, you need to document specifically with regard to the medical reason(s) the pt. is on medicare or run the risk of denial of payment by medicare.