The MDS itself is a screening tool that assists in identifying possible functional problems. Further, in-depth assessment of the possible problems via the RAPs is required to determine whether it is in fact a problem for the resident. This process is fairly thorough - as far as it goes. As I said, it is a functional assessment only, and it does not purport to cover all factors that must be assessed and care planned for a resident. The RAI Manual lists the following additional areas for assessment and care planning in nursing facilities (p. 4-34):
--Rehabilitation/Restorative Nursing
--Health Maintenance (monitoring of disease processes that are currently being treated)
--Discharge Potential
--Medications
While some aspects of these areas may be touched on via the MDS and RAPs, they are not addressed in a way that prompts assessment of the issues resulting in individualized care planning.
The other issue has to do with duplication of assessments that are integral to the MDS-RAPs process. The bottom-line question to ask is this: Since the RAI process includes within it some thorough assessment tools that are accepted by regulators and have been represent the standard of practice in nursing facilities for assessment of the issues they cover, why use some other form to duplicate the assessment? For example, why not use the RAP for falls even outside of the MDS process rather than bringing in another form to use each time a resident falls? In my opinion, there is no reason to do that. For areas not covered by the RAPs, a separate assessment protocol would be needed, but why try to reinvent a wheel developed by the same government that conducts surveys and complaint investigations and rules on the adequacy of our assessment processes?
Rena
Subj: thread Delores/Rena???
Date: 11/20/03 3:00:23 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
There was a recent thread on the listserve regarding all of the assessments that we do along with the MDS i.e. risk for pressure ulcer, side rail assessment, oral assessment, pain assessment, fall risk and on and on and on...
As usual, I never thought I would need the end result of all of this info and casually reviewed it then dumped it. Well, now of course we are reviewing the need for the assessments and trying to enter the assessments that we feel we need to keep into our software then train on their use.
My question is, what is actually required? We are not JCAHO certified.
The bottom line is if the MDS is a stand alone document, are the "assessment forms" really necessary?
Please email me privately @ [EMAIL PROTECTED] Thanks!
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Healthcare Consultant
