[CapeCodMermaid]

Originally Posted by Perfectms10

I'm not sure what state you are from but here in Mass; I'm an LPN and I handle a medicare population of no more than 24; and I'm happy to say I'm making 78 grand a year.

You are not the norm....LPN's where I work in Massachusetts wouldn't make that much...especially since you can't even sign the R2b.

[mdsmadness]

And so I cannot sign the R2b??? And that means what? I should not get paid as much even though I raised the CMI? And getting my facility $50 more a day per MCR resident this quarter. Maybe I am out of the norm but...........maybe my facility understands the importance of the whole process? As all facilities should appreciate their MDS nurses, whether LPN or RN..........we all work just as hard.

[CapeCodMermaid]

I didn't say you don't work hard and you're probably very good at what you do. I'm saying that I live in Massachusetts and in no facility that I've worked in does the MDS person make that much money.

[orland1128]

Hi Im a new MDS person just started 3 weeks ago, and will have a meeting with the administrator, basically what that meeting would be is how to raise the CMI. Since you have mentioned that you raised your CMI by $50 more a day, please advise me on how to do this.
Thanks

[mdsmadness]

Basically I capture everything I can ...as long as I have documentation to back it up.....some key things that will raise your CMI are ALWAYS, ALWAYS get your signed IV records from the hospital for new residents. Make sure that you pay attention to that 14 day look back period on your Special Care section P1, these along with correctly documented ADL's and therapy can really raise the CMI. I always let our therapy department set the date for the first assessment, if they want it to start on day 1-7 or 2-8 and then I set the second according to any special services that the resident recieved in the last 14 days. If I have to overlap assessments to capture IV's or something, I do it. If I have someone that is in assessment or coming up for assessment and therapy is going to pick them up, I will move the assessment accordingly to be able to capture the most therapy minutes I can. Not only with MCR, but part B also. Just a practice that I have with all residents, capture everything you can but have the documentation to back it up. Train staff to code ADL's correctly, (which is a BIG challenge and cannot say that I have that mastered yet) but definatley work on it daily because the ADL's scores can make a huge difference. Anyone that is not in therapy and would benefit from a maintenance program, get them on 2 or more, 15 minutes a day. Make sure that you have all that would benefit from a toileting program on one and Care Plan it, evaluate/assess it and document it....same with turning and repositioning. All these things benefit the resident as well as your case mix. Hope this helps! Good Luck!

[lexibear99]

I was looking into a MDS/Care Plan Coordinator postion in the facility i work in but I am beginning to rethink it after reading the posts. Right now I am a 3-11 shift L.P.N., no other duties than floor nursing and I make 20.35/hr

[gerinursetara]

Salary, 40 hrs/week, $19.00/hr.
I do MDS duties, take care of the care plan meetings, post-care plan letters to families, weekly medicare meeting, attend all care plan meetings, discharge meetings, therapy/medicare family update meetings, update assessments: pain, braden, dehydration. Sections on MDS: AA, I, J1235, L,M,O.P1a25-9, Q, R1, W. Update care plans as needed. I input all the MDS sections into the computer (nobody else had the program on their computer) I do all the printing out, stapling together, etc.
I have to put out notes/reminders to the other team members that they need to turn in 'X' information to me.
I never had to do any 'on call' or working the floor -- but I was just told Friday I would have to, so I put in my 30 day notice.
Nobody ever came to me prior to this, and asked for my assistance in filling holes on the floor -- and nobody ever lifted a finger to help me get MDS' done when I was 2 wks. behind -- so screw them.

[disney158]

I am an RN in upstate NY, location and salary really do go hand in hand, and work at 2 SNF, full time one $29.5 hour, part itime job $32.00 hour (been there 10 years), at both I do all of the medicare assesments, calendars, schedules, Medicare Meeting, Medicare cuts and determinations, run all care plan meetings, liasion with therapy, but really that's it. I am so blessed, but we have big numbers, in the 82 bed SNF we are running about 25 Med A, currently going up to 40, not difficult to find patinets as we are hospital based and the hospital oves to "dump" on us when their census gets too high, But I do have to tell you, that I very quickly and accuartely get MDS done, as we have Caretracker, med administration is comupterized, so are all of our notes, the only data I can not get at the touch of my fingers are MDS Visits, orders and skin assesments. Everything else is in the computer !!! Including Incident reports and Therapy !!! This is an amazing TIME SAVER, I hate to say that here I can get a qtly finished in less than 1/2 hour, full in less than 1 1/2 hours from start to RAPS, because we are computerized and everything is at my fingertips.Not true at the other facility where only the MDS is on the computer and it you can add an extra hour to the times trying to look for, and trying to read the data there. Handwriting, CNA flow sheets, uggh , what a nightmare.. as i said, I am truely blessed to be at my full time job

[edhcinc]

Hi--sorry for this "tirade", it is NOT meant only for you...

"...But I do have to tell you, that I very quickly and accuartely get MDS done, as we have Caretracker, med administration is comupterized, so are all of our notes, the only data I can not get at the touch of my fingers are MDS Visits, orders and skin assesments. Everything else is in the computer !!! Including Incident reports and Therapy !!! This is an amazing TIME SAVER, I hate to say that here I can get a qtly finished in less than 1/2 hour, full in less than 1 1/2 hours from start to RAPS, because we are computerized and everything is at my fingertips..."

Did not see any time listed that you may spend face-to-face with a resident. Certainly this is still part of your role? Who explains to the resident that the MDS assessment is underway?

The RAP process alone, if one uses critical thinking to synthesize MDS and other data, takes an estimated 15 min. to 1/2 hour per RAP. (per a recent informal study)

The recently completed RAND study showed that the "best" MDS nurses, who completed the MDS according to RAI manual guidelines, took, on average, 112 minutes--without RAPs.

The role you explain, which takes 1 to 1/5 hours, is one of DATA COMPILATION from internal/external sources. This is certainly how many MDS coordinators now perform the role.

However, though the MDS 2.0 certainly contains much data documented by others, and complied from other sources, parts of the MDS 2.0 can only be accurately obtained from face-to-face resident contact and observations/inerviews made by the assessor.

MDS 3.0 cements this process even more...

[disney158]

Not yelling back either, but, I see the residents regulary during meals, activities, etc I did not count that time, as it is part of my overall day, seriously, with the computerization, I am not kidding, add in the time on the floor and it will go up a bit, but actual sitting down time at the computer really is 1/2 hr or less, for that facility, as I said, not having to compute adl's or paw thru sheets and sheets of mars, really helps, face it, like it or not, the use of the computer to make work less and faster, is a benefit as it allows more time to be with the people. You should see the cna's at the kiosk entering the data, they actually talk to each other about the residents and getting in the correct information, which I can get for sections e, g, and h in a few clicks, and shave off at least 20 minutes from completing the MDS, and that is a benefit, AND not incorrect... and, in my mind, and other's, endlessly obsessing over the RAP is a waste of time, if it triggered, why in the world should it take so long to figure out what to do, if you look at a person wholeistically, rather than divided in to 18 sub-divisons, and answer the RAP process this way, many of the 18 raps share the same triggers and can share the same care plans,- but we haven't even talked about care plans here.. no one can tell me that for a severly demented resident who has lived in my faciilty for 10 years, who needs help with adl's, no medical concerns other than your standard 6 -7 dx,which will trigger 8 - 10 raps, I should take 2 1/2 hours ( at your minimun of 15 minutes) to "do " those raps... ... thinking this way , if you care plan lets say, 8 residents a week 4 full MDS and 4 quarterlies, most of your week is spent with the MDS, just those MDS..

I think it really is an issue that comes down to if a individual clinican feels/documents they have addressed all issues, the resident is well care planned for, and survey is confident you have a true picture of the residnet, why not rejoice that it can be taken care of faster, rather then try to "tirade"---have you worked with Care Tracker or a computerized medication administration system, or are you still laboring over counting each little swiggle in a med book or a cna flow sheet..or trying to read individual staff hand writting... ..please don't indicate that I am not doing a good job b/c I am quicker than you