workload-am i too slow

JTworoger · Mar 14, 2011

My census is 62 with 11 medicare A residents. I am the only mds coordinator. I do all the medicare/medicaid assessments & everything that goes with it except dietary, social services, & activity sections which are k,l / c,d,e,q / f. I have to babysit social services & activity director every step of the way. I do daily pps meetings. QA monthly, triple check process before billing can be done on medicare A/B residents, weekly weight & PAR meeting, Careplan meetings at minimum 1 day a week, audit charts, assigned rooms in facility that i must do angel rounds on daily and fill out a report for survey readiness and compliance, weekend manager q 6 weeks, all inservicing nursing/cnas on documentation, review all documentation 3x week, etc... My point is also that i do all the careplans for nursing on all residents. I stay behind on careplans because everything else takes all my time plus working well over 40 hrs a week. I have to work 10 hr days on sat or sun just for careplanning. Plus we have had no ADON for 12 yrs, I've been doing that job also. Am i just slow ? I know i'm tired & stay stressed. I've turned into a grouch. I have been mds nurse for 12 yrs. I make $25 hr salary. Never able to take a day off. I have no back up person. I am everyone else's back up person. Am I a normal mds nurse or do i have it good and just don't know it ?

HoggRN,

Boy do I feel your pain.... I am the only MDS Coordinator for my 70 bed nursing home, we have at least 5 Med-A residents at a time with more at times. (Right now we have 10.) I do every single section, no other department helps me with them because I feel like I shouldn't have to babysit the other directors, because I simply have no time to do this. I also have to do every careplan on every resident. I have to attend our QA Monthly meeting, care plan meetings monthly, weekly management meetings, Med-A billing at the first of the month, make sure monthly weights, and vitals are done, inservice nursing staff on policies and procedures, make sure the RNA is doing his job, and check off CNAs as I am also a CNS (Clinical Nurse Supervisor), and on top of all of this, I am the director of Medical Records, because they wanted a nurse to have the department. I have to keep up with not only my building, but our RCF and Assisted Living. I have to do all the nursing budgets, which means I am in charge of also ordering supplies for nursing. (Briefs, needles, nasal cannulas, and the works. I also am the Employee Health Nurse, so I have to give all the PPDs and Hep B shots to new employees, keep up with it, and follow up with those employees. If an employee gets hurt or we suspect drug abuse... I have to do a drug screen on them. So throw all the stress of a MDS Coordinator with all the job responsilities, rules, and regulations of medical records, plus what ever other job they think you can do effectly and you have a volcano erupting.

My desk is always messy, I rarely can find the things I'm looking for on a daily basis and I can't make my DON and Administrator understand just how busy I truly am. I don't come in and I will refuse on the weekends to do careplans, I just do them when I have time. You need your days off to do the things YOU require. I would kill my DON if I had to work a hard stressful 8 hours, 5 days a week, plus come in and work 10 hours on a weekend. Lets see how fast your DON/Admin will jump when you say, "I'm working a little to much, maybe I should start looking for another job." I told my DON/Admin that a couple months ago and they took away CPR Instructor from my "list of things to do." You have 14 days to do a careplan after a Med-A or Non-PPS admission and I use all that time. I picked up smoking again so I can allow myself to go outside and take a few deep breaths. lol. We have an ADON here that helps me out a lot, infact she is becoming a very good friend and the DON helps me out with the MDSs when she can.

So in a nut-shell, I do not know the job functions of any of the other MDS Coordinators, but please know that I know exactly what you are going through and I'm a busy, busy, busy bee when I'm at work. An important thing to do remember for any job you have, only you and you alone let administration walk all over you. If you can't handle things because you feel like they have overloaded you, then you need to tell someone, because odds are its making the rest of your work slack, and thats not fair to you.

Good luck!

Jeremy

Bella'sMyBaby · Mar 15, 2011

No, you are not too slow.

Doesn't matter what your census is, when they start dumping on the MDS Department, things just tend to pile up & get out of control.

And then it doesn't help when the "Corporate Consultant" starts adding weekly conference calls & reports to the mix & then has the nerve to ask why the MDS Assessments are late.....

At my last job, this Insane Consultant decided that I should do all the Restorative & work the floor at least 2-3 days a week.....

It's a hard job & with this 3.0, it's alot more work.

It's not you; it's the unrealistic demands put on MDS Coordinators. :rolleyes:

rukiddingme · Mar 15, 2011

How can you be doing all that, and getting quality information for facility $reimbursement$ -- which should be the #1 purpose of your work.

rnman99 · Mar 15, 2011

Don't know. End of Jan, my PPS census was 41. I had 90 total assessments; 24 full admits with CP and CAAs, 18 discharges. Plus the usual ancillary stuff they dump on us. I think we get dumped on no matter where we are anymore.

JTworoger · Mar 15, 2011

How can you be doing all that, and getting quality information for facility $reimbursement$ -- which should be the #1 purpose of your work.

Are you kidding me Rukiddingme? lol

Our facility is all about money, I just don't think our Administrator understands how important doing a good MDS actually is. That is way I'm afraid to take off or take vacation, because I don't want to get so behind that I can't get caught up... maybe then my Admin will understand the importance of my job instead of all the extra baggage.

What nursing home do you work at, please allow me to be the MDS Coordinator there.

CapeCodMermaid, RN · Mar 16, 2011

My PPS MDS coordinator does nothing but MDSs. He does not have to take call...he doesn't do care plans, he never has to take the floor ...ever.

rukiddingme · Mar 16, 2011

What nursing home do you work at, please allow me to be the MDS Coordinator there.

No current openings, sorry. But I'd be willing to let the other one go for someone easier to work with.

My facility: current census, 95. PPS residents, 7. MDS staff: 2 fulltime. We do not work the floor, do not take call, do not get overtime. We work for hourly pay.

katoline · Mar 20, 2011

wow. some of you/us are really getting taken advantage of.

we have 78 beds, census of 70-72, 20 PPS, with 2 full time MDS. I have the honor of being the dept. head, so i am salaried. no overtime, just get the job done no matter what it takes. my partner is hourly.

what i am wondering is how others are dividing the workload if there are two or more. i do all PPS, which leaves 50 case-mix. that makes 4-6 assessments a week for my coworker, maybe one is an annual. she goes to two meetings a week, whether weights, falls, wounds whatever. i go to daily stand up for at least 1 1/2 to 2 1/2 hrs each morning. i get just about all the admissions, so that means all the comprehensive assessments with CAAs and care plans and we like to have a good turnover for reimbursment. right now i am doing twice as many assessments with three times as many comprehensive assessments. i have the certs, transmissions and reports to pull. my coworker does have ancillary assessments such as braden scale, fall, pain, elopement evals etc. i am sinking. when i ask for help or say that we need to pitch in together to get the work load done, i'm met with how much she has to do, how many assessments she has already done "for me". I'm such a muush. I suggested we do every other admission or that she pick up the 30, 60, 90 day assessments and i am met with resistance. the next day she usually is better about it, but forgets an assessment, does the wrong ARD or waits and waits for others sections or rehab minutes. i have to attend 72/hr delivery of care meetings, take care of the medicare book, supposed to place the dx as well as charting on the medicare charts. i know i need to just make out assignments and let it go. how do others deal with these issues, especially when the coworker is older than you? :confused:

rnman99 · Mar 20, 2011

wow. some of you/us are really getting taken advantage of.
we have 78 beds, census of 70-72, 20 PPS, with 2 full time MDS. I have the honor of being the dept. head, so i am salaried. no overtime, just get the job done no matter what it takes. my partner is hourly.
what i am wondering is how others are dividing the workload if there are two or more. i do all PPS, which leaves 50 case-mix. that makes 4-6 assessments a week for my coworker, maybe one is an annual. she goes to two meetings a week, whether weights, falls, wounds whatever. i go to daily stand up for at least 1 1/2 to 2 1/2 hrs each morning. i get just about all the admissions, so that means all the comprehensive assessments with CAAs and care plans and we like to have a good turnover for reimbursment. right now i am doing twice as many assessments with three times as many comprehensive assessments. i have the certs, transmissions and reports to pull. my coworker does have ancillary assessments such as braden scale, fall, pain, elopement evals etc. i am sinking. when i ask for help or say that we need to pitch in together to get the work load done, i'm met with how much she has to do, how many assessments she has already done "for me". I'm such a muush. I suggested we do every other admission or that she pick up the 30, 60, 90 day assessments and i am met with resistance. the next day she usually is better about it, but forgets an assessment, does the wrong ARD or waits and waits for others sections or rehab minutes. i have to attend 72/hr delivery of care meetings, take care of the medicare book, supposed to place the dx as well as charting on the medicare charts. i know i need to just make out assignments and let it go. how do others deal with these issues, especially when the coworker is older than you?

I wish my PPS census was 20...

I'd make your coworker go to standup, though. I hated going to standup before 3.0 came out.

katoline · Mar 20, 2011

I wish my PPS census was 20...
I'd make your coworker go to standup, though. I hated going to standup before 3.0 came out.

thanks for the suggestion, i must go to stand up, part of my job. besides it would just be another excuse why her workload is so much. i wish i had the 50 case-mix and hourly salary.

do you do the 40+ PPS yourself? do you go to any meetings?

rukiddingme · Mar 20, 2011

We have 90+ census, and we basically split these, so we both have long term and medicare residents. And we try to keep it as equal as possible, but we don't get crazy counting each one. We both attend morning meetings, have care plans one day per week. The coordinator does the medicare billing book, and I take care of the assessment calendar each month. We both help with transmissions & validations.