MDS Coordinator. Again!?

Nascar nurse, ASN, RN · Nov 16, 2008

I would agree with you, if they are asking behind her back and asking you to keep quiet.. then they have another agenda going on and she is probably going to be let go.

If you take the job, you just need to remind them that it just isn't as "easy" as the other gal said, or she wouldn't be 20 days behind!

I see you are in my state... that means you have the additional burden of dealing with EDS, but that's not the end of the world either!

Why would this mean a paycut for you? This position usually means a pay raise as it is nursing management. I would remind them that you are the revenue person!

Good luck making your decision.

fulzgold · Nov 16, 2008

Thank you for responding. It's been my experience that management may have some perks but sometimes the salary isn't what it could be in a smaller facility. Esp. if they throw alot of other jobs at you and you end up working 10 hour days just to get it all done. When I did this job 10 years ago at a much larger facility, (census 98),they also decided I should be the ADON with all those duties as well as the restorative nurse and cover the floor when needed. the DON would frequently take the day off since she finally had an assistant and I would have all her reports to complete as well. At that time I was a little green, they were 6 months behind in MDS's when I accepted that position. They didn't tell me that up front. after a month being there they told me I could not just leave at the end of the day if there were unfinished tasks. Morning meetings went like this: the administrator would stand in the center of the room with a yard stick in her hand. She would start with the first person. Might be the SLP, PT, OT, MSW... and ask that person a question like " what are you going to do today?" If you didn't give the answer she wanted, she would slap you with that yardstick and move on to the next person. It was awful. Having said that, I really liked all the other aspects of my job. It just became impossible. If I had been paid hourly at the time, I may have tried to stick it out. The admin got fired after I quit, and the DON left too. The new DON called me and begged me to come back but I already had another job doing case management. Anyway, I'm an older tougher bird now. I managed the medical department in a prison for 5 years. Yardsticks don't scare me anymore. What is EDS?

Nascar nurse, ASN, RN · Nov 17, 2008

EDS is the yardstick in Indiana :banghead: HA HA, They are a contracted company that comes once a year and audits a certain percentage of all MDS's (they can audit up to 100% w/in past 90 days if they determine they need to do so). They are making sure that all the documentation is in place to support the actual coding on the MDS and the CMI score. If the record does not support, they re-rug the MDS and take away the revenue paid to the facility. They can also impose major fines if they find BIG issues. All facilities must pass with at least an 80% - or the facility writes a plan of correction and they keep coming back for re-survey, just like the state surveyors do.

If you should take this position, you will want to immediately obtain the EDS supporting documentation guidelines (you can go to the Myers and Stauffers web site and find it from there). These guidelines are above and beyond those guidelines in the RAI manual... for example, you can not just mark had dialysis, you must also have available PROOF from the dialysis center that the resident was actually there during the time frame. (Nurses notes saying "res. out to dialysis" is not proof). If you mark IV med, because you know they had it in the hospital, you also have to have the actual MAR WITH the nurses intial AND name/RN attached! This can become a real pain in the orifice to defend all the time, but it is doable.

Have you done this since PPS came about? If not, then you are going to need lots of retraining because it's a whole different game than is used to be. This is a pretty specialized area anymore and not just anyone can do it. This is why you should expect to be paid a fair salary.

P.S. Your past boss was a major orifice... I would have probably smacked him/her back the first time they even raised a yardstick at me!

Long Term Care Columnist / Guide · Nov 17, 2008

Yeah.......that administrator would've found that yardstick in a MOST uncomfortable place if she'd smacked me with it.

FWIW: I'd think long and hard about taking this position, if I were the OP. Management is NOT all it's cracked up to be and you usually end up working 60-hour weeks and being paid for 40. Been there, done that, got the battle scars to prove it.

fulzgold · Nov 17, 2008

EDS is the yardstick in Indiana HA HA, They are a contracted company that comes once a year and audits a certain percentage of all MDS's (they can audit up to 100% w/in past 90 days if they determine they need to do so). They are making sure that all the documentation is in place to support the actual coding on the MDS and the CMI score. If the record does not support, they re-rug the MDS and take away the revenue paid to the facility. They can also impose major fines if they find BIG issues. All facilities must pass with at least an 80% - or the facility writes a plan of correction and they keep coming back for re-survey, just like the state surveyors do.
If you should take this position, you will want to immediately obtain the EDS supporting documentation guidelines (you can go to the Myers and Stauffers web site and find it from there). These guidelines are above and beyond those guidelines in the RAI manual... for example, you can not just mark had dialysis, you must also have available PROOF from the dialysis center that the resident was actually there during the time frame. (Nurses notes saying "res. out to dialysis" is not proof). If you mark IV med, because you know they had it in the hospital, you also have to have the actual MAR WITH the nurses intial AND name/RN attached! This can become a real pain in the orifice to defend all the time, but it is doable.
Have you done this since PPS came about? If not, then you are going to need lots of retraining because it's a whole different game than is used to be. This is a pretty specialized area anymore and not just anyone can do it. This is why you should expect to be paid a fair salary.
P.S. Your past boss was a major orifice... I would have probably smacked him/her back the first time they even raised a yardstick at me!

I remember PPS. I'll be attending a 2 day seminar in INDY for beginning and then advanced MDS. It shouldn't be too bad since I am very familiar with it, the new stuff will be easier to grasp. Actually the EDS sounds challenging. I remember the importance of making sure the chart was "Gellin" with the MDS report. Funny about the yardstick :yeah: .

fulzgold · Oct 17, 2009

Update: Well, here it is a year later and the other MDS coordinator finally quit for good. A lot of office politics later... not much notice, one week only. There will be no transition, no orientation to the computer software, nothin'. I'm jumpin in and holding my nose!! Holy Cow, what have I agreed to.

BEDPAN76 · Oct 18, 2009

Hey Cheese, Wishing you the best and hoping you can get everything straightened out before state comes in. Keep us posted! :nurse:

noc4senuf · Oct 21, 2009

Never known an MDS position to be management.

susanthomas1954 · Oct 23, 2009

MDS is management in AZ, everywhere I've been. The only catch is that in the smaller facilities, they think they can make you ADON and MDS. It's not fair to reimbursement if they take you away from MDS for anything but case management. Had to explain today to other members of my team, including the business office that I CANNOT do case management on Thursday and Friday while I am doing skilled MDS's and care plans for more than 30 patients. (I am in a 200+ bed facility, which helps.) 2 and 1/2 days for each job, and I get significant overtime. I will never do it salaried again, management or no management. And I never take call, I never work the floor, and I never hang an IV. In return for that, their Med A daily rate has almost doubled since I've been there (8 months). They know it's a fair trade. Not just any old yahoo can do PPS MDS's and get it right. In 8 years, I have never had a state citation, and I always know my documentation. It's a good gig, if you can get it.

fulzgold · Oct 25, 2009

Wow Sue, nice! Well I'm just learning again and had no transition. Not familiar with the software, or the schedule and the gal who left it to me was 30 assessments behind!!!! Of course she made everyone else think it was up to date. Small facility, census 45. But we had 6 new admits right when I started. After digging through the mess, I discovered there were 2 or 3 res who were admitted, never got a 5 day, a 14 day or a discharge tracker when they left and now have come back again, went to the hospital and returned again AHHHHHHHH!

susanthomas1954 · Oct 31, 2009

Sounds familiar. That said: BEHIND is often in the eye of the beholder. In a 45 bed facility, it would be VERY strange to be 30 MDS's behind. If the ARD is less than 14 days back, it's not late. Alot of MDS coordinators feel they have to do the MDS from bedside, but as an auditor, I can tell you, everything better be retrievable from the chart. If you have adequate charting you can pull together an MDS. Just sign it with your date and move on.re-admit and dc trackers aren't MDS's per se, and they can be done whenever. There's no big deal on those.