New RNAC workload?

17 Posts

I have been an RNAC for a little over 3 months. I have 2 years experience in LTC and 13 years experience as an RN. The facility I work for is a 96 bed facility. We have a 26 bed sub-acute rehab unit with a 28 day average LOS. We typically have 13-15MC with the rest Managed Care, some following PPS scheduling, some non-PPS. The rest of the facility are Medicaid residents. In my department, it is me and the Department Director, also an RNAC. My daily duties are to attend PPS meeting in the am, which is typically 30-45 minutes, where I set the assessment schedule at the Director's direction. I then cover the one dining room for breakfast (30-45 minutes). I then start the rest of the day. I am responsible for performing resident interviews for pain and BIMS for all of the Quarterlies/annuals/sig changes, as well as all of the medicare/managed care OBRA interviews (Section B,C,J). I am also responsible for performing all of the assessments in the facility. (All annuals, quarterlies, sig changes, admissions, discharges, 5/14/30/60 days, COT/EOT/deaths, and all entries). I enter all of the data for the MDS except for activities section, K, mood, behavior. On average, I complete 4-7 interviews a day, and 4-7 assessments a day. I also complete all CAA's and initiate and update care plans. Our average census is 92.

I don't have to attend any care plan meetings, department head meetings, or nursing meetings because the director does that as well as completing denial letters and coordinating with corporate insurance authorization people.

I average 30-40 complete assessments per week, about 6-9 of which are comprehensives, with CAA's and care plan updating. The department head/director has recently counseled me that I am not fast enough, am not completing enough work on a timely basis, and will be "let go" if I don't improve. I am an hourly employee and must take a 30 minute lunch per day (which I clock out and work through) and can't have any over time. I refuse to clock out and work off the clock at the end of the day, although it has been suggested. I really enjoy completion of the MDS but wasn't sure if I was on track with my daily/weekly progress.