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Specialty Areas: MDS 3.0 and new Charting Guidelines
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07/19/10 08:33 AM | Edit ReplyReply   |    MDS 3.0 and new Charting Guidelines
boogity
69 Posts
Cincinnati Area
Registered Dietitian

Does anyone know of any inservices related to the new charting guidelines and how it affects long term care dietitians and/or inservices on the changes to the MDS 3.0? Thanks

09/10/10 07:27 PM | Edit ReplyReply   |    RE: MDS 3.0 and new Charting Guidelines
showzy
10 Posts

Registered Dietitian

CMS has some good resources on the new MDS 3.0. I googled MDS 3.0 section K. There's not much of a difference with the coding, but the timelines of when they have to be completed and how to input is different.

09/12/10 09:17 AM | Edit ReplyReply   |    RE: MDS 3.0 and new Charting Guidelines
RD2000CAT
130 Posts
West Chester OH
Registered Dietitian

The ADA had a webinar presented by Plante Moran in August I think you can probably get a taped version on line. Becky Dorner has a webinar for sale as well. Be careful it may look like little changes on the outside but they are making major changes throughout that might impact you. Part of the interview process in Section E(?) asks how important having snacks are among about 20 different things, then when you have the information what do you do with it. If you dig deeper, the RAPS are gone but the CAAs will trigger for BMIs, even though no research has ever shown that BMI applies to the geriatric population that this MDS serves. You also have to be careful on how to document wt losses. I am still working on the plan on how to document physician ordered wt losses, mine will not do it he only does it when is upset about an obese resident, but what do you expect when he ramps up the diuretic or they have an amputation, or taken off of their appetite stimulants. You can only count the IV fluids when there is an acitve dx of dehydration, even though we have for years have tried not to have that happen. Good news is that no one will have a QIS survey for at least 18 months while this new system collects data, even though I prefer that type of survey. Stuff I learned from the MDS nurse...to get good rates on the skilled residents they will have to have double asssessments when it starts in October or you get the default rate which I think is about $100 a day, which apparently is something that isn't well known. It can be a real eye opener, the webinars that I have attended want EVERYONE to be able to do the interviews that they require and they state they have done studies that 90% of all nursing home patients will be able to answer, I question their data gathering techniques. Good Luck.

09/13/10 10:28 AM | Edit ReplyReply   |    RE: MDS 3.0 and new Charting Guidelines
sophie45
84 Posts
Kansas City MO
Registered Dietitian

Wow---what good and detailed information! I will look into these resources and try to possibly restructure my assessments and care plans to conform to the new MDS.

I know the RAPS are gone, so what do I put in its place?

I'd like to put the Nutrition Care Process in, and have explained that to one LTC facility that I go to.

The facility has me filling out one page of Section K on their basic diet and weight information. Took about five minutes. I did a corporate telephone conference w/power point and there seemed to be a lot of changes-but they glossed over everything. The corporate RD said it's up to the facility to give the RD the Section K part. I heard RD's are supposed to be more involved by filling out the Section K part because it entails information the RD needs to do and verify accuracy.

Thanks

09/16/10 04:34 PM | Edit ReplyReply   |    RE: MDS 3.0 and new Charting Guidelines
RD2000CAT
130 Posts
West Chester OH
Registered Dietitian


    Posted by sophie45:
    Wow---what good and detailed information! I will look into these resources and try to possibly restructure my assessments and care plans to conform to the new MDS.

    I know the RAPS are gone, so what do I put in its place?

    I'd like to put the Nutrition Care Process in, and have explained that to one LTC facility that I go to.

    The facility has me filling out one page of Section K on their basic diet and weight information. Took about five minutes. I did a corporate telephone conference w/power point and there seemed to be a lot of changes-but they glossed over everything. The corporate RD said it's up to the facility to give the RD the Section K part. I heard RD's are supposed to be more involved by filling out the Section K part because it entails information the RD needs to do and verify accuracy.

    Thanks


The RD or DTR should be responsible for filling out section K, not nursing in the facility as well as the CAA (aka RAP I feel that they just changed the name and added some more triggers). The MDS is what that surveryors will look at and you should know what is there and your documentation should back up that data, thus why they do the QIS surveys. Here is a free from CMS YouTube video that will help explain it, it is about an hour long. http://www.youtube.com/watch?v=wyU7OEpONMc

Hopefully it will help you some more.

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