MDS Duties

KATTB_RN · Sep 17, 2009

I am a DON at a facility that has 46 residents. Prior to being DON, I was the MDS/Careplan Coordinator. I will tell you that any full assessment that you do-which is your admissions, annuals, and significant changes-take quiet a while to get done. Especially admissions-because alot of the times you spend a great deal of time just trying to gather all of the information and such because they are new to your facility. You also have to formulate the careplan, and if it is done correctly that takes a great deal of time. On other MDS's such as your routine quarterlys and skilled assessments, it doesn't take as long and you only have to update the careplan-not completly formulate another one. I don't have an ADON at all, and it is extremely overwhelming to me at times-so I do feel your pain. But honestly, I don't feel that the MDS Coordinator has alot of extra time to do alot more if she is doing what she is supposed to be doing. Hope this helps!

Ruas61, BSN, RN · Sep 18, 2009

If all that she were doing were the MDS at that number I would raise an eyebrow unless the position were part time. Given all the other duties you have mentioned for her it sounds about like she has a full plate too given the bed number you mention. Do you have a high turn over?

CapeCodMermaid, RN · Sep 19, 2009

I was the PPS MDS coordinator for an extremely busy 120 bed facility. I had between 20 and 29 Medicare residents a week. There is no way an admission MDS takes anyone (who knows what they are doing) takes 5 hours. Most annuals took less than half an hour. I am currently the DNS of a small facility. My MDS person does all the MDSs and the care plans. That's it. She works 32 hours a week and feels overwhelmed if we have more than 5 Med As. Everyone's skill level is different. I don't have an ADON.

Long Term Care Columnist / Guide · Sep 19, 2009

I don't believe I ever spent more than an hour coding an initial MDS, even for Medicare. If your nurses' documentation and the ADL sheets are done right, inputting all the information doesn't take much time. The RAPs and care plans are what take time, but if you've got a tickler file that keeps you on top of when the MDS is due and a system for updating care plans, it's manageable. I always had at least 40 residents, including 12-20 SNF patients at any given time, and MDS was ALWAYS done on time. Some of my other duties (like those endless incident investigations for every little bruise and scratch) didn't get done in as timely a manner, but I sure cracked the whip on that paperwork!:chuckle

mercy1975 · Sep 19, 2009

If all that she were doing were the MDS at that number I would raise an eyebrow unless the position were part time. Given all the other duties you have mentioned for her it sounds about like she has a full plate too given the bed number you mention. Do you have a high turn over?

We don't have a high turn over at all.

Ruas61, BSN, RN · Sep 19, 2009

It is still hard to call without actually being there to see how things really A comprehensive assessment to just phyically imput is way easy. I would say an hour is about the upper limits of it from my experience. Of course, I would also have to factor in the actual collection of the data needed. I can see that varying from place to place depending on the systems in place and how one feels about the validity of the information obtained. I have times where I am not always satisfied that someone's interpretation of assistance needed or presentation of mood/behaviors is correct. It may need to be investigated more in depth. Of course at a 40 bed facility it should be fairly easy to keep track of if your population is stable and she has been there long enough to have a good grasp of the residents themselves. Is she doing the care confreneces? How long do they last? How intricate are the care plans? Are they including every minute detail? How confident is she in doing them? I have seen some MDS folks be so focused and worried that they are going to mess up or miss something that they think themselves in a frenzy all the time. How many assessments are done in conjunction with an MDS? We have a ton of add ons like vulnerable adult, smoking, wanderguard, etc...

I am not being a smart mouth but do have a good grasp of what the MDS is and what is involved? Could you sit down and do one? The folks at my place- the DON and ADON are scared to death of them. They think it is some big frightening thing.

She may be at the threshold, she may not be.

If you feel like there is a 'special' relationship or favoritism with her being tight with the administrator it may be valid. I can relate to that thought. The owner/adminstrator's wife came on board as the ADON at my facility and it has not been a positive thing for morale on many levels. But that it another discussion thread

mercy1975 · Sep 19, 2009

I'm a DON at a 40 bed facility. When I was hired I was told I would have assistance from the ADON/MDS coordinator. Currently she does 4-5 MDS a week. I've been told that an admission MDS takes 5 hours and others take 4 hours. The charge nurses do all the assessments for all admissions.
She also does Infection Control, arranges inservices, updates orders on the MARS. She also runs off the certifications and recertifications every 60 days. We both take turns working 3 hours a week and share the times we have to fill in for other staff. It's seldom that we have to fill in.
I want to be fair to her. She does nothing else to help me. I'm overloaded. She is also a good friend of the administrator which is easily seen in the work place. She feels she has too much to do and gets extra help from another nurse to do her assessments.
Is this load too much to handle? I want to be fair with her. Thanks for your input. I really appreciate it.

I should add that we actually have 57 beds but always run around 40-45- beds. As DON I also have a 28 assisted living units.

mercy1975 · Sep 19, 2009

It is still hard to call without actually being there to see how things really A comprehensive assessment to just phyically imput is way easy. I would say an hour is about the upper limits of it from my experience. Of course, I would also have to factor in the actual collection of the data needed. I can see that varying from place to place depending on the systems in place and how one feels about the validity of the information obtained. I have times where I am not always satisfied that someone's interpretation of assistance needed or presentation of mood/behaviors is correct. It may need to be investigated more in depth. Of course at a 40 bed facility it should be fairly easy to keep track of if your population is stable and she has been there long enough to have a good grasp of the residents themselves. Is she doing the care confreneces? How long do they last? How intricate are the care plans? Are they including every minute detail? How confident is she in doing them? I have seen some MDS folks be so focused and worried that they are going to mess up or miss something that they think themselves in a frenzy all the time. How many assessments are done in conjunction with an MDS? We have a ton of add ons like vulnerable adult, smoking, wanderguard, etc...
I am not being a smart mouth but do have a good grasp of what the MDS is and what is involved? Could you sit down and do one? The folks at my place- the DON and ADON are scared to death of them. They think it is some big frightening thing.
She may be at the threshold, she may not be.
If you feel like there is a 'special' relationship or favoritism with her being tight with the administrator it may be valid. I can relate to that thought. The owner/adminstrator's wife came on board as the ADON at my facility and it has not been a positive thing for morale on many levels. But that it another discussion thread

She's only been doing them since March. She is doing a thorough job on them. Care plans last about an hour.

I'm impressed how she has caught on. And she is very detailed. I've only been at the facility for a year and had to redo every system when I started. I'm probably feeling overwhelmed as she is.

mercy1975 · Sep 19, 2009

She's only been doing them since March. She is doing a thorough job on them. Care plans last about an hour.
I'm impressed how she has caught on. And she is very detailed. I've only been at the facility for a year and had to redo every system when I started. I'm probably feeling overwhelmed as she is.

She usually has 3-5 assessments. As I mentioned earlier the nurses do all the assessments, Braden, Fall, etc of each new admission.

Ruas61, BSN, RN · Sep 19, 2009

Well she is probably doing her maximum at this moment given she is new to MDS since March (unless I am hearing you wronga). She is probably still learning the residents and the ins and outs.

I peeked at your profile. I am in Minnesota too. You may be right down the street from me.... :) If you want to PM for any further discussion or insight feel free.

mercy1975 · Sep 23, 2009

I want to thank everyone who replied. It's very much appreciated. I'm sure we'll get along fine and work together . I think we both need a better understanding of each of our jobs! Thanks again.