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Who's in the driver's seat? Therapy or MDS

Posted

Specializes in MDS. Has 25 years experience.

I've always been told that MDS is "in charge" if you will, as far as leading, setting ARD's, especially the 5 day, etc...99% of the time we use the 8th day. I set a 5 day up and I got a semi nasty email telling me to hold off, that the therapy manager would tell me when the 5 day would be. My problem is, if I don't set it up soon enough I'm risking default. How early do you all set up your 5 day assessments? I never had this issue until a new therapy manager started.

Yes the MDSC is suppose to be the one in charge of setting the ARD. Where I work we work together to make sure the date is the best one, to meet the minutes of therapy etc, for the best RUG. You as the MDSC can always set the ARD & it can be changed to fit better. I set all of mine, due to the timeline .

If the patient is not getting any therapy, only skilled nursing, The earliest I would do a 5th day PPS assessment is on the 7th day just to capture 7 days of any nursing service...example, respiratory treatments. If the patient is on rehab they generally do it on the 7th or 8th day to capture at least 5 days of treatment if the orders for therapy are for 5x/week.

The therapy manager didn't have to be semi nasty about it though! :)

I work with Therapy to set some of the ARDs but I do let them know about things I would capture on the MDS like IV fluids. There have been times that I have set the ARDs as early as day 1 or 2 and I let therapy know especially if it is a higher functioning resident that may not be complaint with therapy or doesn't need much therapy... A good thing to look at is the ADL score.