RE: I'm Frustrated!

Wed, 19 Nov 2003 16:34:47 -0800

No, I don't go to care plan conferences unless the head nurse is out. I help the head nurses do the MDS's when they are due for their floor and also educate them on the MDS process and RAPS......but its like fighting an uphill battle. I am the only nurse in this facility of 218 Residents that is a RAC-C. When I first started there, I was just flabbergasted to learn that their ARD date is their DUE date!! Which means if the ARD is set for the 7th, the MDS's for the floor will come out say on the 1st, to be completed say by the 7th. On the 7th (which is always a Wednesday), the RAPS are due and care plan meeting is the following Wednesday. When I do MDS's on any given floor, I must set my own ARD because if I am doing the MDS on the 3rd, I need to count back the 7 days etc from the date I am doing it. On the front, I sign for the sections I did and the date I did the MDS, which always has to be earlier than the ARD! Screwed up eh? My reply if a surveyor ever questions me???? "Its company policy". It's all I can do.......believe me, I have tried to educate them!!


From: "Brenda Chance" <[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
Subject: RE: I'm Frustrated!
Date: Wed, 19 Nov 2003 17:21:40 -0500

Something doesn't add up here.  As the RN, you are the head of the team.
You are the one that is supposed to insure that everything is done by
the book.  Since when, do you have to have a PT's OK to do a significant
change.  That is ludicrous.  The folks at your facility need to read the
manual and live in the real MDS world.  They are not doing them by the
"book" and will ultimately reap the problems associated with this.  Why
are you not going to care planning conferences?  If you are doing the
MDS and so forth, you should be a major part of this team.  It seems to
me that they have the team approach backwards.  I am not trying to knock
any therapists out there, but few have read the MDS manual, much less
understand what a significant change is.

EDUCATION!!!!  I would talk with my DON and administrator and explain to
them my concerns.  If they don't want deficiencies, they will listen to
you.

Brenda W. Chance, RN, RAC-C
MDS Coordinator


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-----Original Message-----
From: Gail RN [mailto:[EMAIL PROTECTED]
Sent: Wednesday, November 19, 2003 5:13 PM
To: [EMAIL PROTECTED]
Subject: I'm Frustrated!



Hi Everyone,
I don't understand where non MDS people come from. I am referring to
other
disciplines (the team!) that have no clue about MDS's and yet in my
facility
are responsible for determining if someone is a change in status.
I am a RAC-C and although I would never profess to be an expert in doing

MDS's, when I came across a Resident that was coded 1-1 in transfers,
mobility and toileting last quarter and now is an extensive 2 person
assist,
to me that is a change in status. To them, since his only areas of
change
were in sec G, he is not a change of status. I pointed out to the TEAM
in
the RAI manual where it very clearly says 2 or more changes can be in
the
same domain,  but its always fighting a battle! When I "cleared" doing
this
change with the physical therapist she reluctantly said I could do it.
Then
I found out today that in patient care to which I am never invited, I
was
slammed for taking it upon myself to do this sig change because this
same
physical therapist had apparently forgotten that I had talked to her
about
it.
Ya know, I just needed to vent. Thanks for being a great support group!

Gail
~~~~~~~~~~~~And tomorrow's another day!~~~~~~~~~~~~~~~~~~

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     "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
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