In the years that I have been teaching, auditing and completing the MDSs, I have interpreted the ARD as the set date that all departments base their data on (ie 7 days, 14 days, 30 days prior etc.), and do not allow staff to initiate on or before that date. I have however found that based on practices of some facilities always completing on that day...scheduling conferences on that day....telling staff to sign things on that day....etc. I have had to do a great deal of teaching and reminders and reteaching to ensure that everyone is on the same wave length. When I transferred facilities most recently, I didn't wait to determine how they all interpreted it, I just initiated a memo right off the bat covering the definition of ARD, interpretation of certain MDS responses based on past clarification to ensure all were interpreting codes consistently and clarifying expectations regarding the window during which MDS data and RAPs are to be completed so that the staff knew when I planned to or HAD to close and lock. It saved me a lot of work and frustration.
Also, in the event that someone (staff) is not in the building to complete the MDS or RAP during the designated time period, they are reminded that they may only complete in advance if they have someone that is available double check the data to determine if it is still accurate at 12 midnight on the ARD. It rarely happens. Usually they have someone else review and complete during the appropriate time frame. I have tried to set up a set routine for ARDs (nonmedicare) so that the staff can get in a routine of completion. That has promoted prompt completion as well. Ie All of my OBRA ARD's are Sundays. Therefore staff can initiate immediately Monday am if they have the opportunity. It aids in tracking, monitoring, initiating tracking forms, etc. I can come in the end of the week and pick up a few pieces, but usually unless it was an especially trying week, everything is completed. I complete the "nursing" sections of the MDS and monitor the remainder, therefore all assessments and tracking forms for nursing are set up with the ARD as the last day of data collection. Has worked fine in the 2 buildings that I am currently coordinating. Everyone has there own way of doing things. There are in most cases no right or wrong way. It's what works best for them and their team! As long as the regulations are followed, there are many ways to get to that point. -----Original Message----- From: Michelle Witges [mailto:[EMAIL PROTECTED] Sent: Thursday, November 20, 2003 9:31 AM To: [EMAIL PROTECTED] Subject: Re: I'm Frustrated! Way back when the MDS first came out, it was taught that the ARD was the date that it needed to be completed by. You could chose a date prior to the ARD and then count backward from the date you chose. That was when the MDS was first required to be completed. I cannot remember when that changed. I have been doing the MDS since it's inception and the rules are always changing and the players are not usually notified of the changes. That's our government in action! Michelle ----- Original Message ----- From: "bill" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, November 19, 2003 5:35 PM Subject: RE: I'm Frustrated! > Im very suprised that survey has not picked up this practice, > how can u sign and date an assessment with a date BEFORE, the > ARD? that doesnt make sense... > > > > > > > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of > Gail RN > Sent: Wednesday, November 19, 2003 6:28 PM > To: [EMAIL PROTECTED] > Subject: RE: I'm Frustrated! > > > 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 > > > > > >CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, > >is for the sole use of the intended recipient(s) and may contain > >confidential > >and privileged information. Any unauthorized review, use, disclosure or > >distribution is prohibited. If you are not the intended recipient, > >please > >contact the sender by reply e-mail and destroy all copies of the > >original > >message. > > > >-----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!~~~~~~~~~~~~~~~~~~ > > > >_________________________________________________________________ > >Share holiday photos without swamping your Inbox. Get MSN Extra Storage > > > >now! http://join.msn.com/?PAGE=features/es > > > >/---------------------------------------------------------- > >The Case Mix Discussion Group is a free service of the > > American Association of Nurse Assessment Coordinators > > "Committed to the Assessment Professional" > >Be sure to visit the AANAC website. Accurate answers to your > > questions posted to NAC News and FAQs. > > For more info visit us at http://www.aanac.org > >-----------------------------------------------------------/ > >/---------------------------------------------------------- > >The Case Mix Discussion Group is a free service of the > > American Association of Nurse Assessment Coordinators > > "Committed to the Assessment Professional" > >Be sure to visit the AANAC website. Accurate answers to your > > questions posted to NAC News and FAQs. > > For more info visit us at http://www.aanac.org > >-----------------------------------------------------------/ > > _________________________________________________________________ > Gift-shop online from the comfort of home at MSN Shopping! No crowds, free > parking. http://shopping.msn.com > > /---------------------------------------------------------- > The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" > Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org > -----------------------------------------------------------/ > > > /---------------------------------------------------------- > The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" > Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org > -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
