Today is Oct 1st. All set?

sls73 · Oct 4, 2010

Anyone else having problems with your software programs? Assessments wont close up for locking so we can submit and a bunch of inconsistencies in the data entry, which have nothing to do with the operator as they are doing what the instructions say. It's all in the programming. I put in 3 tickets alone today for support and know of at least one for tomorrow. Still waiting on 2 of the 3 to be even acknowledged. :uhoh3:

rukiddingme · Oct 5, 2010

Yes to the software problems. This just adds to the extra stress of the new 3.0. (besides waiting on staff to turn in their sections so assessments can be started)

katoline · Oct 6, 2010

i don't believe mds nurses should take clinical call at all. we are really mcr reimbursement specialists planning care on the side. i haven't worked the hall in 10 yrs except in a couple of emergencies and it's not pretty. i'm sorry others do and i should be grateful. still doesn't make it easy when you are expected to work miracles without overtime yet.

we are having software and printing issues. program shuts down during assessment and loses all you put in. glitches as to date of entry (original I'm guessing) will only allow 10/01/2010 or later. so according to our program life started when it was implimented. of course nothing pulls over, so has to be reentered, preferences, activities, diagnoses. better have a copy of your old assessments handy.

NurseMomDori · Oct 6, 2010

To mdsnut:

Enter exactly eight dashes. That is the magic number. I just figured that out after trying 100 different answers before mine would accept without error messages. Also remember you must be the final person to enter info and sign off.

NurseMomDori · Oct 6, 2010

To katoline:

I wish no clinical call! Our DON quit--walked out in the middle of her shift, and I am working the floor this whole week!! My COO submits the MDS, but I get it ready and audit. Our software for 2.0 used to do that too, so I type my IPNs in microsoft word, then cut and paste into the IPN section. I can leave a word document open forever and can use the same info. I use "he" and "she" for most of my generic info... He is incontinent of urine and continent of bowel when on a toileting plan......and then copy the paragraph. It saves many hours of frustration when the computer swallows my info and IPNs. I also save often and use a worksheet which I write all of my info in one place. Good luck all.

katoline · Oct 7, 2010

Dori, excuse my ignorance, but what is a COO and ipn? All i can think of is cheif operating officer and ipn sounds like a computer server number. lol

a resident's family member gave a lovely comment today about how caring and helpful everyone is and that she couldn't ask for better care for her husband. she did mention though that it's obvious the company doesn't put any money back into its' facilities. sad. i have seen some training videos with lovely facilities. where are they? that's where i want to go. florida? california? why do some, maybe all exects try to pinch every penney out of each employee until there is nothing left, then just hire someone else? our population is aging fast and who is going to take care of us babyboomers? i'm moving in with my daughter, that's what my mothe in law did.

years back you either rotated shifts regularly (everyone - that was way back) had a regular shift M-F with baylor weekend nurses who got more pay for giving up every weekend, less call outs, or some kind of flex system with people on call who got premium pay. people call out because they are burned out. people resign for the same reasons, a desire for something better that doesn't materialize. grief over how many bandaids, straws or cups is not the way to go. treat people with respect and you will get respect and loyalty in return. priorities seem to be a little mixed up.

sorry, my soap box.

Ruas61, BSN, RN · Oct 8, 2010

What a massive wasge of paper.

NurseMomDori · Oct 9, 2010

Katoline:

Chief Operating Officer (former HIMS manager who now is in charge. We have a CEO who is mostly absent.) is the one who submits my MDS, and the IPNs are the interdisciplinary progress notes we write to summarize each MDS. I cover pain, med changes, new problems, bowel and bladder, G items=mobility, skin, etc. Each of our care plan team members write one covering their sections. It ties all of our assessments together. Also our state office says we can reference the IPN instead of writing a RAP documentation note for each triggered RAP or CAA now.

Dori

katoline · Oct 9, 2010

Dori, where do you write your ipns? at another place i worked we did raps in a summary form that covered all issues. the state really liked them, gave you a good picture of the resident. i was told recently that we couldn't document anything in the chart that supported our mds, that it was like a conflict of interest. i remember doing that in the past, especially on the adls, before all the payment stuff. often times the flow sheets didn't give a true picture. do you do this on the CAAs somewhere? or attach it?

NurseMomDori · Oct 10, 2010

Katoline:

Our software is Keane care, and we have a section for IPNs in addition to the Assessment and Care plan sections. We each type our IPN (activity, nursing, SS, and dietary) and then print them out and put them in the chart with the paper copy of the MDS. My section covers pain, new medications and medical issues, mobility, G items, bowel and bladder, skin, infections, falls, rehab, etc. I summarize the quarter, or shorter for medicare 5, 14, 30 days. Our surveyors seem to like the summary, except when I neglect to mention a fall, or accidentally write that someone is independent instead of supervised!

I just discussed with our state rep about referencing the IPN instead of writing a RAP documentation note explaining each RAP. She stated it would be fine...and it would eliminate the duplication. So now, on the CAA summary, I will write "see IPN dated 10/9/10 DW (my initials)" instead of "CAA documentation note." All of my team are happy with this as we now are writing the IPN (which takes about 45 minutes each) and doing RAP or CAA documentation notes too. I have been the MDS coordinator for just over a year and found in our last survey that this seems to answer a lot of the questions before the surveyors have to ask for additional info. I hope this helps you. Also, I have changed my original worksheet as I have done more MDSes. Is there a way to post it in a message if I am not a GOLD member in allnurses? I suppose I should just officially join, but I just don't seem to get around to it!

aiker31 · Oct 10, 2010

The transitioning process is pretty ugly no matter how prepared our company is. We had atleast 3 workshop and conferences re: the mds 3.0, about 5 webinars and consultants in and out of our bldg, added man power, name it and still we've got some setbacks. - Oct 1, we are ready to encode MDS with ARD of 10/1/10 to MDI but we've got some problem getting RUGS plus alot of missing sections after print out. In short, we're set to fail encoding on the new MDI system for MDS 3.0. And thank GOD last thu. our company decided to use Jraven while MDI is doing theyre hot fix. We don't want to be late encoding especially its around 45 medicare due...

Anyway, I did a few CAA and I found it time consuming. I spent 2 hours doing 6 CAA for one assessment. Is there anyone here can give me a tip on how to complete it faster? Any trick? template? Can we actually do IPN in replacement of CAA? atleast here in CA?

Thanks

rukiddingme · Oct 11, 2010

So far, I've only done 2 entries, 2 PPS assessments, 1 discharge assessment using 3.0. I have at least 7 assessments from last week that will need done when I go in tomorrow. When I left on Thursday evening, I was still in need of sections from another staff member to complete some of these assessments.

Not looking forward to doing a comprehensive. Our software has had problems, and I'm sure the CAA's will give us headaches also. The information on our 2.0 software isn't transitioning to the 3.0, so have to re-enter almost everything.