i am a new mds coordinator. i am really the only clinician, and only have the support of an assistant. there are over 100 beds in the facility.
without any formal training, the job is quite a challenge. and, state survey is any day.
i have talked with people in the industry, and it appears usually mds depts have more help.
any thoughts? i am backed up, overwhelmed, but am getting some actual positive feedback. i just feel like a dufiss. it is so hard to mult-task. i feel as if all i do is attend meetings.
i am a new mds coordinator. i am really the only clinician, and only have the support of an assistant. there are over 100 beds in the facility.
without any formal training, the job is quite a challenge. and, state survey is any day.
i have talked with people in the industry, and it appears usually mds depts have more help.
any thoughts? i am backed up, overwhelmed, but am getting some actual positive feedback. i just feel like a dufiss. it is so hard to mult-task. i feel as if all i do is attend meetings.
any thoughts?:chair:
i hope you get training. when i first started this position, i went to a 2 day class. we are currently in the process of having training or retraining for everyone involved in the mds process. our company wants to make sure everyone is doing the mds the right way. i work 50-60 hours a week, and thankfully i am paid by the hour. (i love overtime :) ) plus, my don is very supportive (she used to be a mds nurse) this is definately a position that you have to love to stay. good luck to you! ~robin
Do you have a back up person? Most places have someone trained to fill in for vacations, etc. I sympathize with you for the backlog. I had a similar situation took the position and the state showed up after a month when I was trying to catch up and cover shifts on the floor.
I'm glad to know it isn't just me that is constantly receiving calls to come in and cover shifts for call ins. I'm hourly so the time adds up quickly so they don't like to call me that often.
Good luck and I hope you find some training to help you
Help? Na. Not anybody who will jump in and cover while I am away. Upper Management has the knowledge, but has other responsibilites (which I totally understand).
I am learning how to be VERY efficient VERY quickly.
I am having trouble with OMRA's. The time lines boggle my brain. Check this, monitor that, count this, audit that, document this, respond to that.........
I guesss you know what I mean.
Anyhow, I think my main problems involve OMRA's, and getting everything caught up.
Any information sources, or information would be greatly appreciated. I research as much as I possible can.
I know......it happened to me. And the best thing I ever did was to shake the dust of the place off my feet and head back to the hospital, where I'm just a little fish in a big bowl and I can do my 8-hour shift and go HOME--- without middle-of-the-night phone calls, take-home paperwork (RAPs are pretty labor-intensive) or being called in to work the floor when the night-shift nurse doesn't show up.
Why were raps so intensive? I know that it is another process to go through, but is it really that complex? Please enlighten me as I am new (if you read this).
Specializes in LTC, assisted living, med-surg, psych.
They don't have to be, if you've got a computer, but if you have to do them on the Briggs forms, where you have to check off every single trigger that applies to your resident AND THEN write out your summation longhand, it takes a long time because most residents will have a number of problems that must be addressed in the RAPs. (There were 17 RAPs the last time I looked, most of which had to be addressed by nursing, and CMS was thinking of adding two more.) RAPs are also intensive because they form the basis for your residents' care plans, and the care plan, RAPs, and MDS must all match or the state will be on your case like a bad smell.
In all seriousness, I wish you luck........this is a thankless job most of the time, because the floor nurses think you just sit on your rear end all day pushing papers, upper management turfs more paperwork to you because they can't get all THEIRS done, and the residents (and their families!) come to you to do their complaining because "the nurse that actually works won't help me".
I know......it happened to me. And the best thing I ever did was to shake the dust of the place off my feet and head back to the hospital, where I'm just a little fish in a big bowl and I can do my 8-hour shift and go HOME--- without middle-of-the-night phone calls, take-home paperwork (RAPs are pretty labor-intensive) or being called in to work the floor when the night-shift nurse doesn't show up.
Why were raps so intensive? I know that it is another process to go through, but is it really that complex? Please enlighten me as I am new (if you read this).
An OMRA is rarely done. It is "Other medicare required assessment" This happens only when an assessment is due in between a medicare required assessment 5, 14, 30, 60, 90 day, For example...........A resident is in therapy, but are being noncompliant with their therapy, so therapy D/C's this resident, but say the resident is diabetic, on breathing TX's, O2, etc, so you skill them for nursing, and not medicare. You just have to wait 8 days after all therapy is completed and then do the assessment as an OMRA.
Yes Raps are complex, especially when you are lacking the supportive data. What I always did, was say for a Fall Rap, it might look something like this:
"Resident has had a fall on 8/1/04, (see NN) working with PT/OT at present time, continues to require SBA with all ADL's. Continues taking antipsychotic medication with SE of unsteady gait, is monitored monthly by pharmacy and physician. Recently started on walk to dine program."
Then from your rap you can make your care plan more detailed and not use the generic ones on the computer, like this.
Resident is at risk for falls d/t previous falls and is currently taking antipsychotic medication
Resident will not have an injury from a fall within this review period
Monitor resident for oversedation from antipsychotic meds (specifically name that med, and then look up any side effects that pertain here and list them)
Walk resident to and from each meal
PT/OT as ordered
Use gait belt at all times when assisting resident with transfers, only requires SBA at this time
Report any increase in unsteadiness or shuffling gait
Most importantly when a state surveyor walks in the building, they want to be able to read the care plan and feel like they know this person inside and out, just from the MDS/RAPs/CAREPLAN
The more personal you can make them, the better.
If you set up a strict schedule for your OBRA assessments, then you won't fall behind when you end up getting 10 new medicare residents.
Good Luck
I absolutely loved doing this job, am looking into doing it again. It can be nerve racking, but you can make it fun too.
I also am curious about what is called a waiver...I have been told that after skilled service is done, there is a 2 day period when family is notified of non-coverage...and those two days...can they be billed under skilled? I find this illogical.
Specializes in Gerontology, Med surg, Home Health.
Yasmina-I've been doing MDS's and the PPS system for a long time and NEVER heard of the waiver. You have to give 48 hour notice that the skilled care is ending but the last 48 hours is still skilled...for example if you know that they will no longer be skilled as of day 30 of their stay, you must tell them by day 28.
Yasmina, I asked my consultant today about the waiver you mentioned. I don't know who told you that, but I don't believe it is a real thing. I also want to mention something about a previous post about OMRA assessments. The reason you do an OMRA 8-10 days after therapy stops(we always do it on day 10) is because when rehab stops, you need to get a lower RUG score. And let me tell you, nursing RUG scores are significantly lower than a rehab (about $250-300 per day less) The only reason not to do an OMRA after therapy, is you got a lower RUG score already. ~Robin
Specializes in MDS coordinator, hospice, ortho/ neuro.
I really love doing them, but most people hate it lol
I love the job too, but some days it can definitely bite you in the butt. Check out www.aanac.org ............great site for MDS nurses. They have an email discussion forum that you can join wothout being a member of AANAC.....that forum will give you access to hundreds of other MDS nurses and experts nationwide.
You can also get online eduction / ceus / certification ( RAC-C) with AANAC.
robin_mds_nurse
47 Posts
i hope you get training. when i first started this position, i went to a 2 day class. we are currently in the process of having training or retraining for everyone involved in the mds process. our company wants to make sure everyone is doing the mds the right way. i work 50-60 hours a week, and thankfully i am paid by the hour. (i love overtime :) ) plus, my don is very supportive (she used to be a mds nurse) this is definately a position that you have to love to stay. good luck to you! ~robin