MDS staffing

Specialties Geriatric

Published

Hi! Just wondering how many MDS staff everyone has.....just getting an idea if we the norm....We have a 120 bed facility (SNF) and are running about 28-29 Medicare. We have 2 full time RN's in the MDS dept at present. But are constantly being pulled to pass meds or cover report off's or do admissions, etc. The administrator said we are the "safety net" with staffing and pull us often. We have only 2 full time RN's for the floors and 1 prn RN. Hiring RN's has been difficult. I just feel completely overwhelmed with all that we have to do and we are getting very behind in our MDS work. I am just curious if this is the norm. I have been doing this for 5 years and spent the previous 5 doing Charge nurse on the units. I had no idea how little respect the MDS work is given in our facility. We are supposed to maintain a high casemix and accurate and timely MDS's and careplans at the same time as covering the floors. I work 60 hours and get paid for 40. I am just curious as to everyone else's staffing. Thanks!!

What regulations keep your DON from helping out????

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Specializes in Gerontology, Med surg, Home Health.

"As she rarely helps the floors when

they are short staffed citing that due to regulations she can't."

WHAT?!?!?!? There ARE no regulations that prohibit a DON from helping out. Does she have a valid license???Then she may help. My DON helps when she has to...makes beds, toilets residents, whatever needs to be done, and we are all expected to do the same.

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OMG I am glad that I don't work for your DON. The DON I work for is always asking everyone what she can do to help!

I wonder if your administrator & DON have ever heard of a DAVE audit! If you don't have the time to make sure the MDS is filled out correctly, when you are audited, they may take back money on the SNF residents. Sounds like they think the MDS is a low priority, when it is where you make most of your money for the facility!

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Thanks for all the replies! It is so interesting to see that not many places pull their MDS staff! I love doing the MDS's...but am just so frustrated that I have no time to do them the way I want to and that the administrator expects us to keep up the same casemix and accuracy that we have in the past AND work the floor, etc. I have tried to explain to him that pulling us so often is detrimental to what we do but he doesn't seem to get itor just doesn't care. I am frustrated that the expectation of my job as MDS coordinator will need to be fulfilled PLUS all of the other things that are requested of us and to do it without complaint. Our floor nurses do none of the MDS (it is myself and another full time RN for 120 beds and around 27 skilled) and don't even look or use the care plans...they just complain about us most of the time when we do get the spare day to do our own work. I understand what it is like on the floors as I had done that (charge) for 6 years before doing MDS's! It is funny that the other day the floors were short staffed AGAIN...and the Physical Therapist came into our office and said "oh you are hiding out in here". :angryfire ....no we aren't "hiding out" .....we are doing our own work for once! I feel like everytime I say something to the DON or administrator they are rolling their eyes as if saying "here they go complaining again"....I am sure they will see everything plainly during our annual survey.....we have a good MDS record....no cites since we have been doing them (3 yeas running)...but I cannot say for sure what this year will bring as this is the first time we have been pulled so much. I know that our DON and administrator do not know much of the MDS itself other than casemix....the DON has never done one and would never help us in a pinch. As she rarely helps the floors when they are short staffed citing that due to regulations she can't. So she has little understanding of what we are going through. I want to be helpful and want to help the residents and those who are working so short so often on the floor but am being sacrificed in the process... :stone

Thanks for all of your posts! I truly appreciate you taking the time! :)

Where are your administrator and DON putting their bets? It takes from 2.5 to 4 hours to complete one MDS (with CP & RAPS) on any good day. Do they realize that accuracy and timeliness is what keeps their doors open? I work in a 126 bed facility. There is an RN and an LVN in this department and NO NO we do not fill in (must be a dire emergency!!!).

About the DAVE reviews, are they aware of this "new" thing that is "just an audit" yet what they report can affect if you get your money "taken back"?

I believe that your MDS department does not get the respect it needs because the powers that be are looking at you as a paper pusher and not as a "green dollar maker". I hope they make the corelation soon before something drastic happens to wake them up.

Happier in CA.

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What regulations keep your DON from helping out????

Something to do with allotting time for her own work and that "surveyors can figure out that if I am working the floor that the hours don't add up to do my own job sufficiently".....the administrator agrees with her (he is also an RN)....I don't understand it....but I am powerless to do anything about it....the staff development coordinator has also refused to help when the floors are short citing that she wasn't "hired to" help on the floors....and will leave at the end of her day whether the floors are staffed adequately or not....and doesn't take call when staffing his short......everyone is too busy being the king in our building instead of working as a team.....I will help when needed and I will take my turn but everyone should pitch in....it makes little sense.....

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Where are your administrator and DON putting their bets? It takes from 2.5 to 4 hours to complete one MDS (with CP & RAPS) on any good day. Do they realize that accuracy and timeliness is what keeps their doors open? I work in a 126 bed facility. There is an RN and an LVN in this department and NO NO we do not fill in (must be a dire emergency!!!).

About the DAVE reviews, are they aware of this "new" thing that is "just an audit" yet what they report can affect if you get your money "taken back"?

I believe that your MDS department does not get the respect it needs because the powers that be are looking at you as a paper pusher and not as a "green dollar maker". I hope they make the corelation soon before something drastic happens to wake them up.

Happier in CA.

I totally agree!! I have tried to explain how much time it takes to do the MDS's adequately....we had 17 of them to do last week a piece! Not to mention family meetings etc.. I do feel that they don't see the big picture....nor will they until something drastic happens and then I will lose my job for it....(inaccuracies, citations or a loss of revenue....)so ultimately it falls on me. Unfortunately they have made me dislike my job and I am searching for greener pastures after 10 years here....wish we had our old administrator as he understood the importance of the MDS.....then when we do work the floors there is sooooooooo much to clean up and try to sort through due to poor staffing and to try and fix what hasn't been done it adds to greater frustration....When we get off the floor and are able to do MDS work the floors are still calling for clarifications and with questions and to write orders from things we have called on etc...so more time is spent following up on what we did when we were charge....the DON says "take an extra day off through the week" but we can't because our MDS work is behind...and being hourly sucks....at least my co-worker is hourly and gets paid time and 1/2 for her overtime....I do not :angryfire

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Just as an FYI....I heard a rumor today that the DAVe project has been scrapped due to lack of funding.....has anyone else heard this....I saw it on a CMS inservice change as they were going to have an inservice on DAVe but they changed it to something else citing Dave has been cut due to lack of funding.......hmmmm

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Something to do with allotting time for her own work and that "surveyors can figure out that if I am working the floor that the hours don't add up to do my own job sufficiently".....the administrator agrees with her (he is also an RN)....I don't understand it....but I am powerless to do anything about it....the staff development coordinator has also refused to help when the floors are short citing that she wasn't "hired to" help on the floors....and will leave at the end of her day whether the floors are staffed adequately or not....and doesn't take call when staffing his short......everyone is too busy being the king in our building instead of working as a team.....I will help when needed and I will take my turn but everyone should pitch in....it makes little sense.....
The reg states if there are 60 or more residents on the census the DON cannot work the floor because there would not be adequate time for her to fulfil her duties.
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Specializes in Gerontology, Med surg, Home Health.
The reg states if there are 60 or more residents on the census the DON cannot work the floor because there would not be adequate time for her to fulfil her duties.

Where did you find these regs?? Don't think they apply in Massachusetts.

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Nor in Pennsylvania.........:coollook:

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I work in a LTC facility with approx 150 beds. We have a transitional care unit which is mostly Medicare. Then we also do all the MDS's for the other residents each quarter. No we do not do all the assessments, but we do a few of them. We audit the charts while we are doing the MDS. We also update the careplan while we do the MDS or write one if they are a new admit. There are 2 of us doing MDS's. I am 32 hours a week, the other girl is 18. Two hours of my time per week has to go towards rewriting a careplan that is a mess. There are times that 48 hours a week for the 2 of us to do all the MDS's isn't enough, but we are not allowed overtime. To me, that makes for messy MDS's and care plans. No we are not given the respect that should be given. Our job is VERY important for the facility. I would guess it will take someone more important than me to get that point across. In the mean time, I put in my 8 hours a day and go home, hoping I got everything done that HAS to be done that day.

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