MDS staffing

CapeCodMermaid, RN · Mar 13, 2005

Mine is a 142 bed facility and we run a Medicare census of 25-29. We have one full time MDS nurse who just does the Medicare (PPS) MDS's, and one part time (24hrs) nurse who oversees the process for the rest of the house which includes Medicaid, Private Pay, and Managed Care patients. NEVER are they pulled to work the floor. They flat out refuse....frankly they think their work is more important than anyone else's but that's another whole story.

If we have a nurse call out, then the unit manager or charge nurse has to do the med pass....then the supervisor, then the ADNS (that's me, and Lordy do I HATE to hand out meds!)...the unit managers are expected to do the MDS's for anyone who isn't Medicare.

CHPN1680 · Mar 13, 2005

It sounds like you have enough MDS staffing if they would allow you to stick to just that. I was an MDS Coordinator for 9 years in facilities from 60 to 250 beds. At the 250 bed facility, there were 3 of us to cover the building for MDS. Our medicare census was anywhere from 15 to 30 depending on the casemix. At the time, we had a fair amount of managed care patients on the subacute units. We however, did not have unit managers completing MDS. We completed all of the nursing secitons of all MDS's. The only time we had floor duty was during our on call rotation on the weekend.

In order to ge the job done adequately, I would say that you need the two of you working at it full time, especially with your medicare census. Often, the Administrator and the DON aren't in touch with how many assessments need to be completed and how long they take for Medicare residents. Other variables are involved here too. Do you do your own computer input? Also, the time needed to attended Care Plan Meetings and to organize the schedule.

Good luck to you. It is a difficult position.

Abbys, RN · Mar 13, 2005

A census that ranges from 100-110. 28 of those beds are skilled medicare. We have 4 1/2 RNs for MDS of which 2 1/2 RNs work with the SNF/ICF half of the building and 2 RNs for the all-ICF half of the building. MDS nurses only fill in the nursing section of the MDS. Each (4 of them) manage the care of 1/4 of the residents and supervise floor nurses. The Assistant DNS helps when MDS falls behind. MDS nurses rotate as on-call managers on weekends (mostly to answer questions and staff for call-ins over the phone) They fill in on the floor as a last result. (Approx. 1-2 shifts a month when agency not available) The building is staffed with 4 licensed nurses and 2 CMAs on days, 3 1/2 licensed nurses with 2 CMAs on PMs and 2 licensed nurses (and 1 CMA for 2 hours) on NOCs. The floor nurse pool includes 3 RNs. We have a total of 9 1/2 RNs employed. We admit mainly medicare and medicaid residents and have about 3-4 private pay beds at any one time. We have deficiency-free surveys and profits have been enough to enable this facility to remodel the building.

alintanurse · Mar 13, 2005

The facility I worked in had 2 mds nurses,we had 128 beds. The mds nurses did not work the floor at all (although they did talk one into accepting a per diem floor position.) They seemed to have more than enough time to handle their responsibilities.

robin_mds_nurse · Mar 15, 2005

Our facility has 128 beds. 38 SNF & 90 ICF. We have 2 MDS coordinators. Myself ( I am an LPN), and a RN. We split the building in half. We each have 1 SNF hall, and 2 ICF halls. We do everything on admissions, plus the MDS, careplans, & raps. Rarely do we get pulled. I have only worked on the floor once in the last year. Our company does not allow anyone except those who have been through their certification class to fill out the mds. All disclipines went through it. I am glad that I get paid by the hour. Most weeks I work 50-60 hours. ~Robin

CapeCodMermaid, RN · Mar 15, 2005

Our facility has 128 beds. 38 SNF & 90 ICF. We have 2 MDS coordinators. Myself ( I am an LPN), and a RN. We split the building in half. We each have 1 SNF hall, and 2 ICF halls. We do everything on admissions, plus the MDS, careplans, & raps. Rarely do we get pulled. I have only worked on the floor once in the last year. Our company does not allow anyone except those who have been through their certification class to fill out the mds. All disclipines went through it. I am glad that I get paid by the hour. Most weeks I work 50-60 hours. ~Robin

Robin,

Do you mind telling what company you work for? My company started the same thing...we all had to take a test before we could do MDS's...it was SO hard (I used to be the MDS coordintor...not sure how the staff nurses would know all that RUG stuff)...but it seems that rule has gone by the board and now everyone is back to doing MDS's....hmmmm....sounded like a good idea at the time.

AlixCoastRN · Mar 15, 2005

We run about 45 to 55 total residents, of this about 15 to 25 are 'skilled' - I am the RCM (MDS nurse) for the skilled residents and am full time salaried . There is also a 30 - hour/week nurse that does all the ICF folks. THe DNS steps in to help a lot - especially when I get 3 or 4 admits in a day. The skilled folks are all over the building. Each department inputs their own data - activities does 'N', dietary does 'K' etc. I try not to work more than 45 hours a week - Im not married to the job and manage to get everything done. I work so I can live, not the other way around. :cool: Have to have time to go to the beach after work!

robin_mds_nurse · Mar 15, 2005

Robin,
Do you mind telling what company you work for? My company started the same thing...we all had to take a test before we could do MDS's...it was SO hard (I used to be the MDS coordintor...not sure how the staff nurses would know all that RUG stuff)...but it seems that rule has gone by the board and now everyone is back to doing MDS's....hmmmm....sounded like a good idea at the time.

I work for Kindred Healthcare. Yes, the test was intense. We went for 2 days. The first day we covered the RAI manual page by page! The second day was the test. I am glad they did it, to make sure everyone is doing the mds correctly. I was named MDS champion along with 2 others in our district which covers the state of Tennesee. This means I am a resource person for the other centers to contact with questions or problems. I also travel to other facilities in our district to help out when they are in need of a MDS coordinator, or to train new MDS coordinators.~Robin

donmomofnine · Mar 16, 2005

We have one full time MDS nurse. She does only MDS and only works forty hours a week. She has a part timer working with her who does twenty hours a week, again ~ only MDS. We have ninety beds with around eight to ten PPS at any given time.

I am wondering if your MDS nurses do the actual assessments? Our nursing staff does all the assessments for the MDS.

The MDS nurse is a very valuable member of the team ~ she gets us our money to care for our residents!:)

fluffwad · Mar 16, 2005

My facility has 99 beds, 2 mds nurses, average 10 PPS. We do alot of part B and keep the case mix at 2.0 -2.1. We do not get pulled much, and we are hourly....which really cuts down on admin's temptation to pull us and then expect us to get the MDSs done too. We do the actual assessments. Sounds like frazzledRN needs a different job or a different administrator.

FrazzledRN · Mar 20, 2005

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! :)