Division of Medicare/LTC Coordination


Let me briefly explain my facility's set up before my question:

The ADON does the preliminary assessment and does the footwork to get the resident into the facility. She is also suppose to do the Medicare MDS assessments as she is the one working closely with therapy and likes to follow the patients from the hospital through their rehabilitation stay. When I was hired for the MDS position, it was explained to me that my duties only consist of LTC assessments and the careplans. We're a 115 bed facility with an average of 12-15 Medicare residents.

The ADON feels "overworked" by the assessments and managing her CNAs. Instead of time managing effectively, she has recruited another LPN (coincidentally, her best friend) to do her medicare MDS assessments for her, allowing this LPN to get overtime- much of it unnecessary. Also, this particular nurse has a horrible working relationship with the therapist- creating more division between departments and inability to effectively communicate.

I have now been in my MDS "LTC/Careplans Only" position for almost two years. I have the time to complete these other assessments, I am always below my allotted hours per week, and I feel like I will have nothing to show for my experience as an MDS coordinator if I am not trained and well-educated on Medicare MDS coordination. I have approached my boss (DON) once regarding this and she informed me to stay out of it because the ADON and the other nurse have an agreement.

At what point should I buck? If I was to go to another facility, I would have absolutely nothing to offer them as far as Medicare MDS coordination goes. Do other facilities have such a division between their Medicare MDS and LTC MDS coordination and planning? For me, especially if the person is planning on staying LTC, I want to be involved from the beginning. However, because I'm "LTC only" I'm not even notified of family meetings, therapy changes, etc. I've asked, with the response of "They're not LTC yet." Then, once they're transferred over to me, I'm back tracking through sometimes three months of work to figure out what the heck happened.



617 Posts

Specializes in Care Coordination, MDS, med-surg, Peds. Has 22 years experience.

Can you explain that you would like to understand more about the entire MDS process and not just the OBRA assessments, or that you would like to cross train? I would suggest obtaining your AANAC certification, they will give you training in all aspects. hang in there.


7,735 Posts

Specializes in retired LTC.

Sounds like they DON'T want you to expand any further. Like if you were to leave, you want to bet that the LPN wound take over your position?

Rack up whatever experience you can there and consider the that AANAC cert as other poster suggested. You may need to consider looking elsewhere even though you feel hampered. IMHO