June 2008 - Texas Department of Aging and Disability Services
Contents
1. he MDS Mentor is March June Sep tember and De cember each year If you have an arti cle an idea for an article or would like to give us feed back please see page 4 for our con tact information x TEXAS TIP AA8b 6 Other State Required As sessment is not a valid reason for any MDS assessment done in Texas INSIDE THIS ISSUE Clinical Update Item H3a i More about l Incontinence More about 2 Incontinence Coding Hla 2 amp HIb Automation News Broadband 3 Update New AT amp T 3 Global Client Contact Us 4 Websites published in The MDS Mentor Cheryl Shiller BSN RN RAC CT MDS Clinical Coordinator VOLUME ISSUE 2 TEXAS Department of Aging and Disability Services JUNE 2008 Item Ha Any Scheduled Toileting Plan One of the most frequently miscoded items on the Minimum Data Set MDS 2 0 is H3a Any Scheduled Toileting Plan This item asks you to indicate whether the resident is on a plan for bowel and or bladder elimina tion whereby staff members at scheduled times each day either take the resident to the bath room give the resident a urinal or remind the resident to go to the toilet during the 4 day look back period This item includes bowel habit training and or prompted voiding Three key concepts to consider when coding item H3a are Scheduled Toileting and Plan Program Let s review Scheduled mean2. QM QI reports port Office the link is on page 4 of this publication k Click on MDCN AT amp T Client Software Information fh Click on AT amp T Global Client Version 7 2 1 to start the download Note Download AT amp T Global Client only from the QTSO web site Versions on the AT amp T public web site are not approved for use with the MDS assessments are c eee eee ee mee a a aS SS E E E M ee M EES EE Cheryl Shiffer BSN RN RAC CT Cecile Hay LMSW i MDS Clinical Coordinator MDS Automation Coordinator i 1307 Roszell Street Room 1910 P O Box 149030 San Antonio TX 78217 Austin TX 78714 9030 l Mail Code 279 4 Mail Code E 345 Phone 210 619 8010 AN o Phone 512 438 2396 I Fax 210 619 8159 Shared Fax Call First _ E Fax 512 438 4286 Shared Fax Call First E Mail cheryl shiffer dads state tx us Fy Ng E Mail cecile hay dads state tx us I l J Useful Web Links CMS MDS Training Web Site MDS computer based training CBT http www mdstraining org upfront u l as CMS MDS Web Site MDS 2 0 Highlights MDS RAI Manual with updates and a link to MDS 3 0 http www cms hhs gov NursingdomeQualitylnits 20 NHOIMDS20 as DADS MDS Web Site Texas MDS Policy page http www dads state tx us providers MDS index cfm Nursing Home Compare CMS site that compares Nursing Homes in a given area http www medicare gov NHCompare Include DataSection Questions SearchCrite
3. e response to code level of bladder continence and one response to code level of bowel conti nence for the resident over the last 14 days Code for the resident s actual bladder and bowel continence pattern i e the frequency with which the resi dent is wet and dry during the 4 Day assessment period Do not record the level of control that the resident might have achieved under optimal circumstances For bladder incontinence the difference between a code of 3 Frequently Incontinent and 4 Incontinent is determined by the presence 3 or absence 4 of any bladder control To ensure accurate coding in Hla H Ib assessors must use multiple sources of information to accurately code e g resident interview and observation review of the clinical record including flow sheets and discussions with direct care staff across all shifts Source RAI User s Manual pages 3 120 amp 3 121 PAGE 2 wo Consider continence patterns over the last 14 day period 24 hours a day including weekends CS l l i 4 7 ee eee l VOLUME I ISSUE 2 PAGE 3 Automation News by Cecile Hay MDS Automation Coordinator We pledge y 2 MDS AND A CHANGE OF OWNERSHIP We all know how frustrating it is to go through a change of ownership CHOVWV and lose ac cess to previously submitted MDS assessments It becomes impossib
4. f help For these two items determination of whether or not to code incontinence is not a matter of volume but a matter of skin wetness and irritation and the associated risk for skin breakdown Ensure you validate conti nence patterns with people who know the resident well Of course the best source would be the resident However if the resident is not a reliable source Continued on page 2 VOLUME II ISSUE 2 More About Incontinence Hla and HID Continued from page of information ask involved and knowledgeable family members of the newly admitted resident family ee ee EE Coding Hla and HIb Coding continence is different from coding other activities of daily living ADL as the time period for review ing reminders etc occur less than once a week members who Celebrate participate in care of the resi successful MDS coding dent or direct care staff Remember amp Consider continence patterns over the last 14 day period 24 hours a day including weekends If changes in staff assignments or staff turnover is frequent consider initi ating and maintaining a bladder and bowel elimination flow sheet to gather accurate information on which to base your coding and care planning decisions For the source of the informa tion in this article and for more details see pages 3 119 and 3 120 of the Long Term Care Facility Resi dent Assessment Instrument RAI User
5. le to submit a Significant Correction assessment modify or inactivate an assessment or submit a dis charge when you are cleaning up your Missing Assessment Report The Centers for Medicare and Medicaid Services CMS re quires facilities to retain the ability to correct previously submitted data If your facility is going though a CHOW work with your infor mation technology IT department to backup your MDS data so you can import the data if your MDS software changes If either software is not amenable to this solution you may wish to use one of the following options Retain a computer with the old MDS software and assess ments installed to allow up dates to data from the previ ous ownership time period Install the MDS RAVEN soft ware which is free software from CMS and available on the QIES Technical Support Office web site the link is on page 4 of this publication Click on RAVEN Import the old as sessment data into RAVEN so you may make your update wW and submit the assessment It s time for lots of summer fun baking in the Texas sun Vacations broadband Update CMS determined MDS assess swimming and fire E eee i works too he internet connection CMS recog submitting via their ISP a don t forget the ments and reports can be securely transmitted over broadband lines through an IP Sec connection into CMS Medicare Data Communica tion Network MDCN Providers are
6. required to obtain connection to MDCN via an Internet Service Provider ISP The ISP connection may be made through dial up modem cable mo dem or through your corporate nizes there is an issue with the MDCN connection when the Pro vider uses Network Address Translation NAT CMS is evaluat ing solutions to this problem The MDCN direct dial up non ISP connection termination date has been extended until CMS resolves the NAT issue It is highly recommended the Provider look for their own alternatives and begin If you have not done so please install connect and submit assessments and retrieve reports due using AT amp T Client Software The C3 software and the loading instruc tions are available at www gtso com Click on MDCN AT amp T Client Soft ware to obtain the download For assistance with your download contact the MDCN at 800 905 2069 we e oe mem a a New AI amp T Global Ghent Version Available The AT amp T Global Client version 7 2 1 was approved for use with MDS It is reported to be more user friendly than the prior version Please uninstall the version you are currently using before in stalling the version 7 2 1 Contact your IT staff if you need assistance Use the following steps to download version 7 2 1 kh Go to the QIES Technical Sup W CASPER Login ID and Password Remember to use your MDS login ID and password to run your CASPER Quality Management Quality Indicator
7. ria asp QIES TECHNICAL SUPPORT OFFICE QTSO MDS 2 0 3 0 RAVEN and AT amp T Client Soft ware information Validation Report Messages Guides Training and DAVE DAVE 2 Tip sheets Help is hteps www gtso com Justa Click Quality Matters MDS Web Site News and clinical assistance for MDS coordinators including The MDS Mentor Away http qmweb dads state tx us MDSweb Quality Reporting System QRS DADS information site on Texas nursing homes http facilityquality dads state tx us NEW Sign up for E mail Updates Go to http www dads state tx us Click on Sign up for E mail Updates in the upper right corner Enter your e mail address and select Nursing Facility Resources This will ensure you will get communications as well as The MDS Mentor NEW TILES to RUGS http www dads state tx us providers TILEStoRUGS index html
8. s Manual dated December 2002 the CMS MDS web site link is available on page 4 of this publica tion Once on the site scroll down the page and then click on the RAI User s Manual to un zip the manual Once un zipped click on chapter 3 and navigate to the pages provided above covers 4 days The following is a review for coding Hla Bowel Continence and H Ib Bladder Continence A five point coding scale is used to describe continence patterns Notice that in each category different fre quencies of incontinent episodes are specified for bladder and bowel The reason for these differences is that there are more episodes of urination per day and week whereas bowel movements typically occur less often 0 Continent Complete control including control achieved by care that involves prompted voiding habit train Usually Continent Bladder incontinent episodes occur once a week or less Bowel incontinent episodes 2 Occasionally Incontinent Bladder incontinent episodes occur two or more times a week but not daily mee ee ee ee a Bowel incontinent episodes occur once a week 3 Frequently Incontinent Bladder incontinent episodes tend to occur daily but some control is present e g on day shift Bowel incontinent episodes occur two to three times per week 4 Incontinent Has inadequate control Bladder incontinent episodes occur multiple times daily Bowel inconti nent is all or almost all of the time Choose on
9. s performing the activity according to a spe cific routine time that has clearly been communicated to the resi dent as appropriate and to Completion of the MDS is required by CMS a federally funded agency caregivers Toileting means voiding in a bathroom commode or other appropriate receptacle e g uri nal bedpan Changing wet briefs or garments is NOT included in the definition for Item H3a Plan Program means a spe cific approach that is organized planned documented monitored and evaluated All three 3 key components must be present in order to code Item H3a The Centers for Medicare and Medicaid Services CMS developed a Tip Sheet for Item H3a and some of the tips were included in this article However more information is available on the Toileting Plan Tip Sheet and is available on the CMS MDS web site the link is available on page 4 of this publication Once at the CMS MDS website scroll down the page and click on the Toileting Plan Tip Sheet More About Incontinence Hla and Hib MDS items Hla and HIb describe the resident s bowel and bladder continence pattern even with scheduled toileting plans continence training programs or appliances during the 14 day look back period Coding of the items does not refer to the resident s ability to toilet themselves A resident can receive extensive assistance in toileting and yet be continent most likely as a result of staf
Download Pdf Manuals
Related Search