trixiedg

You are right on target! Unfortunately I am one of those who takes it home. I think there could be 16 hours in my work day and it would not be enough. My office is at the other end of the building so I have to pass just about everybody to get there and there is always half a dozen people calling my name wanting something. Most of the time when I leave my office to get a chart to do a progress note, I am gone for more than an hour and by then it's time to do something else. I am the social worker and the activity director so I have twice the paperwork and responsibility. I am also in the process of taking a MEPAP home study course. Thank God for my assistant. There is no way I could do it without her. My administrator keeps telling me not to take work home because she does not want me to get burned out but I guess I just have not figured out how to get it all done a work week. Maybe I will sooner or later. I love my resdents and I love my job. Doing activities is what I have wanted to do for years. There is nothing better than seeing the smiles on my residents faces because they are happy and enjoying themselves and each other. I am about to go on a much needed vacation in a week and I plan to do alot of unwinding, hopefully while fishing and hiking in the mountains. Well, I'm glad I got all of that off of my mind. Sometimes it helps just to put it in words.

I would also like to calendar swap with you guys. My email is xtreme4jc1@yahoo.com

The activity log you are using sounds much better than mine. It would be great if you could e-mail me a copy. My e-mail address is xtreme4jc1@yahoo.com. Thanks for sharing.

My assistant is also a CNA. She goes everywhere I go when we are on a bus ride and is alot of help. When we have a ride where we are taking more than one van load, I can usually get a couple more CNA's or an RN. The last big ride we had, we had 20 or so elders to go out to the local park for a picnic. I had my assistant, 2 CNA's, an RN, one of our office staff, and of course myself. When you go somewhere fun, it's not hard to find people that want to go but at least we all have fun together.

We won't be in our survey window again until October and I hope I will be as prepared as some of you seem to have been. It does seem that there is a pattern with the burnout/stress questions. The surveyors have been having more training in recognizing the indicators of burnout. Their webcasts can be viewed at www.cms.internetstreaming.com. I watched the one on burnout for staff. They also asked for participation records for one of our younger elders. It's good to know that the state is finally seeing how important activities are to the total care of our elders. Question: What are you doing for your sensory enrichment program and what is a team cheerleader? Sounds interesting. I'm always looking for new ideas.

We also use CD's with mixes I have downloaded from the internet, mostly oldies. Some of them like music and some don't. It sometimes seems to distract some of them. We also use light handweights that we found at The Dollar Tree for two for a dollar. They are made out of some kind of stretchy material that can be held in your hand or placed around your wrist. They really like these. What other things do you use for props for exercise group? Our therapy department takes care of our exercise group once a week and we do it the rest of the time. We are doing exercise group 3 times a week right now. This month I started doing a short "Let's get moving" segment (about 15 minutes) on one of the days and playing Jingo afterwards because there are some that do not like exercise, but we never seem to have enough time to do the exercises. We have had to go from the morning coffee social directly to Jingo because of time constraints. How often do you do exercise group?

I just love this website! I can't stay off of it. So full of useful info. Now to answer the question "What do I do". I am the AD for a 60 bed facility, since Nov '06. I have one assistant. I am also the social services director, for 12 years now, and the admissions coordinator. My schedule is much like the previous post. We have to make morning rounds daily which takes 30 minutes or so. We sometimes have to pitch in and help when they are working short on the hall because of call ins. Morning meetings are at 9:00am and last 30 mins or more depending on what we found on rounds and how fired up our Adm. is. We have care plan meetings once a week. After care plans, we have other weekly meetings such as restorative, falls, those on psychotropic drugs, weight meetings, etc. QA once a month, horray for the free lunch! Then there are the trips to get supplies for activities and shop for the elders. It seems they always know when I've just returned from shopping because someone will always bring me a list of what they need. I also have to make appointments for eye and dental appointments and arrange for transportation or take them myself. We all know how long you can sit in a doctors office. We are in a very rural area, so availability of different doctors is limited which means longer travel time. Just about the time I get started on my progress notes or other paperwork, I have a phone call from a hospital about a potential admit or a family waiting to tour the facility or needing info, then run to the other end of the facility to get the fax the hospital just sent me. I also have two very talkative office mates. Then there are the RAPs and care plans that we have in the computer. You know THE computer. The ONE you have to share with everyone else, especially the talkative one that pecks instead of types. (I really do love my office mate, wouldn't trade her for a thing in the world, not a thing she doesn't know) I used to do all of the MDS scheduling, case mix, medicare tracking, putting MDS's in the computer and submitting them to the state then running the QI report, and still do this from time to time. Then there is the admissions paperwork 2-3 hours per family, get the room ready for the admit, inventory belongings, interview the admit and/or family upon admit, etc. I am sure that is not all but for crying out loud, isn't that enough. I really do love my job. Don't know of a thing I'd rather do!

Our facility was surveyed under the new activity regs in January '07. We did not receive any deficiencies but were asked more questions than usual. I was also asked about how I handle burnout. They were also asking more questions regarding psychosocial wellbeing. A couple of the surveyors said they had surveyed a home and found some psychosocial issues but did not write up the home for this. The feds later came in and found that the issues should have been addressed by the survey team and in turn, the surveyors were written up for not citing the home. This was causing our survey team to be more thorough. I had only been the AD for a couple of months when they came in, so I'm pretty sure they gave me a break. After all was said and done we came out deficiency free. I am about to begin taking the MEPAP course and hope that I can learn more about knowing how to better meet my elders' needs. With all the new regs, it all seems so overwhelming. If anyone can give any advice on how they do things, it would be greatly appreciated.

I have been working with the MDS process for quite a while and did the scheduling in my facility for many years up until recently but still get questions about it from the DON and the MDS coordinator. We also use a homemade form that lets everyone know when things are due. In Mississippi, and I'm sure it's the same everywhere else, each elder has to have an assessment at least every 92 days or when the MDS is submitted to the state it will be late and your facility will be paid at default rate, which is not good. If you have elders receiving rehab, the facility gets paid at a higher rate and if the assessment is late the rate is much, much lower. Annual assessments must be done once a year unless you have a significant change MDS and this will reset your annual date. All of this is a bit confusing I know. If you have an MDS manual it will help to read the section that explains when assessments are due. On our form we have several columns. The first has the elders name, then the date the look back period begins, then the date the MDS starts, which is the day we do our progress notes. The next column has the MDS stop date (the date the MDS is due to go into the computer), then the RAP due date, and finally the care plan due date. All of our MDS's have a 7 day look back period unless it is a medicare 5 day assessment and then it is 5 days. Some portions of the MDS specifies longer look back periods such as the mood section which is 30 days. We write our notes on the day the MDS starts because you're supposed to count anything that occurred during the 7 day period. We have been told if you write it early you may miss something that happened and it may not be coded correctly on the MDS in the end. We have also been told we can write our notes on the day after the MDS starts, but I'm not so sure about this, besides it's hard to break old habits. I think you have 14 days from the assessment reference date (ARD) to complete the RAPs and 21 days from the ARD or day of admit to complete the care plan. We usually try to do ours in less time to make sure we don't go over. Our nurses notes are integrated progress notes which means any discipline can document in them, but I very rarely have time to do this. My quarterly activity progress notes are separate and are placed under the activity tab on the chart. I hope I didn't confuse anyone any more than they already were, but I hope this helps.

copy and paste this questionnaire so we can get to know each other better and have fun! What is your name? Christal What is your occupation? Activities Director, Social Services Director, and Admissions Coordinator. •What are you listening to right now? My husband is watching a movie really loud! • What was the last thing you ate? A bowl of Campbells Chunky Soup. Waiting for Easter supper at my in-laws. •Do you wish on stars? Sometimes •If you were a crayon, what color would you be? Orange •How is the weather right now? Sunny and beautiful. 58 degrees. Cool for a spring day in Mississippi. •Last person you spoke to on the phone? My mom. •How old are you today? 35 •Favorite drink? Non-alcohol: Diet Pepsi Alcohol: Strawberry Daiquiri - Wine cooler would be fine right now! •Favorite sport(s) to watch? University of Tennessee Football. Go Vols!! •Have you ever dyed your hair? Did highlights before. •Do you wear contacts or glasses? I have glassess for reading, but I never wear them. •Pets? Two dogs - Trixie and Bud. Two cats - Peaches(14 years old) and Spot. •Favorite month? April and October •Favorite food? A great big burger from Fudruckers with so much stuff on it you have to eat it with a fork. •What was the last movie you watched? Blood Diamond •Favorite day of the year? Christmas •Fall or Spring? I love both. In the spring everything is coming alive. The leaves are beautiful in the fall and relief from the summer heat. •When was the last time you cried? about a month ago. •What did you do last night? Put media slide info in the computer at church for Easter sunrise service. •What inspires you? Seeing beautiful sunrises and sunsets. •What are you afraid of? Spiders. Got bit by one once. Had nightmares for months. •Favorite car? Big four wheel drive pickups. Only natural for a Mississippi girl. •Favorite dog breed? Miniature Schnauzers. •How many years at your current job? 12 as Social Worker, AD since November 2006. •How many states have you lived in? Only Mississippi •How many cities/towns have you lived in? Only one.