TIP OF THE WEEK
Considerations for coding J2-pain symptoms (7-day look back)
On the MDS 2.0, section J2 is the area where frequency and intensity of pain signs and symptoms are coded. Sometimes, nursing home MDS professionals misinterpret the directions provided in the MDS RAI manual, leading to an inaccurate reflection of pain management in the MDS system.
KEY CONSIDERATIONS
Below are a few key points from the MDS RAI manual and the NHQI Quality Measures Resource Manual to take into consideration:
- MDS 2.0 only captures pain symptoms.1
- There is no place to code interventions for pain on the current MDS. It does not capture pain management/pain intervention data.2
- The assessment covers a 7-day period and should reflect the highest level of pain reported by any staff member, not just the assessment of the professional completing the MDS. If through assessment or clinical record review you note that the resident has received pain medications or other pain relief measures, investigate the pain need and capture the pain event on the MDS. However, if the resident does not experience ANY breakthrough pain in the 7-day assessment window, the assessor would indeed code “0,” no pain.1
J2 PROCESS3
- Speak to the resident.
- Observe the resident (guarding, protecting an area of the body, or particular behaviors noted).
- Consult with direct care staff over all shifts.
- Review the resident’s record.
J2 DOCUMENTATION
Facilities should have a consistent, uniform and standardized process to measure and assess pain. Use your best clinical judgment when coding. If you have difficulty determining the exact frequency or intensity of pain, code for the more severe level of pain.3
RESOURCE SPOTLIGHT
The clinical resource manual for the Pain Quality Measure on CD-ROM, containing screening tools, assessment checklists, and other pain resources. All documents are in PDF format.
To order, click here and select “Nursing Home” in the drop-down box. Then add the “Pain Resource Manual CD-ROM” to your cart. Finally, proceed to checkout. All resources in the Ohio KePRO Shopping Bag are free of charge to Ohio healthcare providers. Please allow 10 business days to process your request.
IN THE NEWS
June 12, 2007 -- Washington Post -- Twenty years after Congress vowed to improve the way we care for the old and the infirm, nursing homes still inspire dread. But some mavericks are working to deinstitutionalize them and make them more like home.
"We want to change the culture of aging," said Bonnie Kantor, executive director of the nonprofit Pioneer Network, a Rochester, N.Y.-based umbrella group leading the effort, "and we're beginning with nursing homes." Read more >>
ATTENTION TRAINING MAY HELP OLDER ADULTS IMPROVE CONCENTRATION
June 14, 2007 -- Newswire -- Can a fitness program for your brain improve thinking and concentration the way lifting weights can increase muscle strength? Early results from a Wake Forest University Baptist Medical Center study suggest that attention training can change brain activity so older adults can block out distractions and improve concentration. Read more >>
CONCERN MOUNTS OVER CAREGIVER SHORTAGE
June 14, 2007 -- Seattle Post Intelligencer -- There will be an enormous increase in America's elderly population in the next few decades, while the traditional labor pool for caregivers -- women from their mid-20s to mid-50s -- will scarcely grow at all, compounding problems for a work force already beset by low wages and high turnover. Read more >>
NURSING HOME CARE IMPROVES UNDER WATCH OF OMBUDSMEN
June 19, 2007 -- Cleveland Plain Dealer -- Removing restraints. That is the biggest improvement nursing homes have made in the 30 years the Long Term Care Ombudsman program has monitored resident care, says Debby Allen, the program's director. "They used to be used on 60 percent of patients, and now it is down to 10 percent and many homes don't use them at all," she said. Read more >>
OHIO KEPRO EVENTS
THE GOOD APPLES: TIPS FOR ATTRACTING AND RETAINING THE RIGHT EMPLOYEES
In this half-day workshop, we will delve into key strategies for improving workforce retention in the nursing home, including:
- The impact of turnover and absenteeism on an organization and what you can do about it.
- Strategies to improve the hiring and orientation process.
- Motivating employees and improving staff satisfaction.
- Setting goals and measure improvement in workforce retention.
Who should attend: Directors of Operations, Directors of Nursing, Nursing Home Administrators, Staff Development, and Human Resources.
7/11 – Cincinnati | 7/26 – Oberlin | |
7/12 – Springfield | 7/31 – Lyndhurst | |
7/17 – Cambridge | 8/7 – Boardman | |
7/19 – Sylvania | 8/15 – Columbus | |
7/24 – Wooster | 8/21 – Wellston |
Save these dates and register today!
INDUSTRY EVENTS
Healthcare Personnel -- What Immunizations are Advised? (NCIRD Net Conference)
July 12, 2007, from 12:00 p.m. to 1:00 p.m.
Navigating the MDS Through the Ohio Medicaid Reimbursement System
Ohio Department of Job and Family Services
August 23, 2007
Call Cheryl Robertson at (614) 466-9088 for more information.
Medicare Learning Network:
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Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
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