----- Original Message -----
Sent: Friday, November 14, 2003 9:05
PM
Subject: Re: late MDS's
Kathy,
In order to get done there is a lot of take home work and many late days.
My schedule sort of looks like this:
Monday 8/8:30 to 4pm - It is the day I attend one meeting
(PPS) and no lunch. I leave "early this day. Update any VA and case
managed cases. It is on this day due to I am essentially "locked " in my
office.
Tuesday - 8/8:30 am to 5/6pm - (PPS - detailed meeting) Lock day and
transmission. Reconciliation with the business office. Update Hotline
(Our company hotline) for the week.
Wednesday - 8/8:30 am to 5/6 pm - Catch up and look at any QA
issues, Focus Meeting, Another in depth PPS Meeting. Getting Care Plan
schedule to team. Complete MMDS (Maryland short MDS for Medicaid
billing).
Thursday - 8/8:30 am to 6 or so.... Catch up. Complete and lock
MDS's.
Friday - 8/8:30 to 4/6 or so.....Catch up more. Transmit
again. Reconcile with business office. Leave early if putting 1/2
day on Saturday or Sunday. Gather needed materials for work at home for
the weekend.
Saturday / Sunday - get in when I can (every 3rd or 4th weekend depending
on church, foster care parent responsibilities, and kids' schedules
and activities) and leave as soon as possible (4 to 5 hours in the
building). I get many things accomplished on the weekend.
The weekend staff do not want "Administration" breathing down their back
so they leave you alone and you can get work done. They are really good
on the weekend and will bring the charts to me if need be. They will
request that I call and let them know what I need and they will have it
ready. Some of the nurses see me in the building quite a bit and will
ask if there is anything that they can do to get me in and out of the
building.
In the past year we have lost a great deal of staff. That is a good
thing. We have managed to replace them with real good staff. The
documentation has improved tremendously and it shows by our increased RUGS
Levels. Some will ask what needs to be charted and they follow up to be
sure the other staff are charting as well. Are we perfect? Far
from it, but it has improved 100% over the past year. At this time, I
even have the Senior GNA Team Leaders volunteering to do teaching and training
of ADL Coding. They are monitoring the GNA records for completeness as
well. Is it perfect? No, but the number of holes in the records are
decreasing rapidly.
The new staff are even open to change and improvements. They are
involved in the teaching and training and are receptive. We are rolling
out many programs for pain management, wound management, infection control and
for ADL coding.
Mind you that the drive to work is a minimum of 40/45 minutes. Most
days the drive is one hour to one hour and 15 minutes. I will call the
hotline and case managers via cell phone to do updates if I am not able to do
so while I am in the building. I have great Unit Managers that will
follow up on concerns and questions rather quickly. One will give me
notes as well as tell me the follow up in person.
Again, I need to reiterate that I do all the MDS's for the facility, both
LTC and Medicare. We are 129 beds with an average daily capacity at
97.8%. Our current Medicare is 35. Case managed is One, VA is
2. As of this month I no longer do the Medicaid billing. The unit
managers have been trained are now doing the billing. I adjusted the
assessment schedule for them so all the Medicaid assessments are completed by
the 25th of the month. That gives them 5 to 6 days to get the billing
done. That also allows me the opportunity to "crank out" MDS Assessments
at the end of the month.
We are not perfect in any fashion (we still see ourselves as disorganized
at times). We are striving to do the best for the resident and we are
moving forward with this goal in mind. We have a team that is team
driven and team solving. There is no one leader, but a team. I am
very proud of our team. We have a long road in front of us but I think
we are on the right track.
Glenn
Gorleski (Barnes) RAC-C
Case Manager, MDS Coordinator
Quality Assurance
Nurse
