Salary and responsibility of MDS coordinator/ Medicare case manager

[limarie]

As a MDS coordinator/ Medicare care manager, what all are you responsible for at your facility? How much do you make? How big is your facility?

I have been in my position two years and it seems the longer I am there, the more the DON piles on me

We have a 80 bed facility w/ an average 10-15 SNF

I do all assessments, careplans and case management

I am responsible for the restorative nursing program and the infection control program. I do all assessments of the patients in the hospital before admit (sometimes traveling up to 40 miles)

There are many more to say the least

I am a LPN and make only 18.00 an hour. I have been in this position 2 years.

[CapeCodMermaid, RN]

I didn't say you don't work hard and you're probably very good at what you do. I'm saying that I live in Massachusetts and in no facility that I've worked in does the MDS person make that much money.

[orland1128]

Hi Im a new MDS person just started 3 weeks ago, and will have a meeting with the administrator, basically what that meeting would be is how to raise the CMI. Since you have mentioned that you raised your CMI by $50 more a day, please advise me on how to do this.

Thanks

[mdsmadness]

Basically I capture everything I can ...as long as I have documentation to back it up.....some key things that will raise your CMI are ALWAYS, ALWAYS get your signed IV records from the hospital for new residents. Make sure that you pay attention to that 14 day look back period on your Special Care section P1, these along with correctly documented ADL's and therapy can really raise the CMI. I always let our therapy department set the date for the first assessment, if they want it to start on day 1-7 or 2-8 and then I set the second according to any special services that the resident recieved in the last 14 days. If I have to overlap assessments to capture IV's or something, I do it. If I have someone that is in assessment or coming up for assessment and therapy is going to pick them up, I will move the assessment accordingly to be able to capture the most therapy minutes I can. Not only with MCR, but part B also. Just a practice that I have with all residents, capture everything you can but have the documentation to back it up. Train staff to code ADL's correctly, (which is a BIG challenge and cannot say that I have that mastered yet) but definatley work on it daily because the ADL's scores can make a huge difference. Anyone that is not in therapy and would benefit from a maintenance program, get them on 2 or more, 15 minutes a day. Make sure that you have all that would benefit from a toileting program on one and Care Plan it, evaluate/assess it and document it....same with turning and repositioning. All these things benefit the resident as well as your case mix. Hope this helps! Good Luck!

[lexibear99, LPN]

I was looking into a MDS/Care Plan Coordinator postion in the facility i work in but I am beginning to rethink it after reading the posts. Right now I am a 3-11 shift L.P.N., no other duties than floor nursing and I make 20.35/hr

[rukiddingme]

Salary, 40 hrs/week, $19.00/hr.

I do MDS duties, take care of the care plan meetings, post-care plan letters to families, weekly medicare meeting, attend all care plan meetings, discharge meetings, therapy/medicare family update meetings, update assessments: pain, braden, dehydration. Sections on MDS: AA, I, J1235, L,M,O.P1a25-9, Q, R1, W. Update care plans as needed. I input all the MDS sections into the computer (nobody else had the program on their computer) I do all the printing out, stapling together, etc.

I have to put out notes/reminders to the other team members that they need to turn in 'X' information to me.

I never had to do any 'on call' or working the floor -- but I was just told Friday I would have to, so I put in my 30 day notice.

Nobody ever came to me prior to this, and asked for my assistance in filling holes on the floor -- and nobody ever lifted a finger to help me get MDS' done when I was 2 wks. behind -- so screw them.

[disney158]

I am an RN in upstate NY, location and salary really do go hand in hand, and work at 2 SNF, full time one $29.5 hour, part itime job $32.00 hour (been there 10 years), at both I do all of the medicare assesments, calendars, schedules, Medicare Meeting, Medicare cuts and determinations, run all care plan meetings, liasion with therapy, but really that's it. I am so blessed, but we have big numbers, in the 82 bed SNF we are running about 25 Med A, currently going up to 40, not difficult to find patinets as we are hospital based and the hospital oves to "dump" on us when their census gets too high, But I do have to tell you, that I very quickly and accuartely get MDS done, as we have Caretracker, med administration is comupterized, so are all of our notes, the only data I can not get at the touch of my fingers are MDS Visits, orders and skin assesments. Everything else is in the computer !!! Including Incident reports and Therapy !!! This is an amazing TIME SAVER, I hate to say that here I can get a qtly finished in less than 1/2 hour, full in less than 1 1/2 hours from start to RAPS, because we are computerized and everything is at my fingertips.:yeah:Not true at the other facility where only the MDS is on the computer and it you can add an extra hour to the times trying to look for, and trying to read the data there. Handwriting, CNA flow sheets, uggh , what a nightmare.. as i said, I am truely blessed to be at my full time job :)

[edhcinc]

Hi--sorry for this "tirade", it is NOT meant only for you...

"...But I do have to tell you, that I very quickly and accuartely get MDS done, as we have Caretracker, med administration is comupterized, so are all of our notes, the only data I can not get at the touch of my fingers are MDS Visits, orders and skin assesments. Everything else is in the computer !!! Including Incident reports and Therapy !!! This is an amazing TIME SAVER, I hate to say that here I can get a qtly finished in less than 1/2 hour, full in less than 1 1/2 hours from start to RAPS, because we are computerized and everything is at my fingertips

..."

Did not see any time listed that you may spend face-to-face with a resident. Certainly this is still part of your role? Who explains to the resident that the MDS assessment is underway?

The RAP process alone, if one uses critical thinking to synthesize MDS and other data, takes an estimated 15 min. to 1/2 hour per RAP. (per a recent informal study)

The recently completed RAND study showed that the "best" MDS nurses, who completed the MDS according to RAI manual guidelines, took, on average, 112 minutes--without RAPs.

The role you explain, which takes 1 to 1/5 hours, is one of DATA COMPILATION from internal/external sources. This is certainly how many MDS coordinators now perform the role.

However, though the MDS 2.0 certainly contains much data documented by others, and complied from other sources, parts of the MDS 2.0 can only be accurately obtained from face-to-face resident contact and observations/inerviews made by the assessor. :spbox:

MDS 3.0 cements this process even more...

[disney158]

not yelling back either, but, i see the residents regulary during meals, activities, etc i did not count that time, as it is part of my overall day, seriously, with the computerization, i am not kidding, add in the time on the floor and it will go up a bit, but actual sitting down time at the computer really is 1/2 hr or less, for that facility, as i said, not having to compute adl's or paw thru sheets and sheets of mars, really helps, face it, like it or not, the use of the computer to make work less and faster, is a benefit as it allows more time to be with the people. you should see the cna's at the kiosk entering the data, they actually talk to each other about the residents and getting in the correct information, which i can get for sections e, g, and h in a few clicks, and shave off at least 20 minutes from completing the mds, and that is a benefit, and not incorrect... and, in my mind, and other's, endlessly obsessing over the rap is a waste of time, if it triggered, why in the world should it take so long to figure out what to do, if you look at a person wholeistically, rather than divided in to 18 sub-divisons, and answer the rap process this way, many of the 18 raps share the same triggers and can share the same care plans,- but we haven't even talked about care plans here.. no one can tell me that for a severly demented resident who has lived in my faciilty for 10 years, who needs help with adl's, no medical concerns other than your standard 6 -7 dx,which will trigger 8 - 10 raps, i should take 2 1/2 hours ( at your minimun of 15 minutes) to "do " those raps... ... thinking this way , if you care plan lets say, 8 residents a week 4 full mds and 4 quarterlies, most of your week is spent with the mds, just those mds..

i think it really is an issue that comes down to if a individual clinican feels/documents they have addressed all issues, the resident is well care planned for, and survey is confident you have a true picture of the residnet, why not rejoice that it can be taken care of faster, rather then try to "tirade"---have you worked with care tracker or a computerized medication administration system, or are you still laboring over counting each little swiggle in a med book or a cna flow sheet..or trying to read individual staff hand writting... ..please don't indicate that i am not doing a good job b/c i am quicker than you

[Rexie68]

you are not the norm....lpn's where i work in massachusetts wouldn't make that much...especially since you can't even sign the r2b.

catching up....

ccmermaid, we usually agree, but when you wrote "can't even sign the r2b." it offended me a bit. i know i'm not an rn and can't sign the r2b (yet....220 days until graduation!!) but i work in a 139 bed facility, do all of the mds'....medicare, medicaid, hmo, quarterly, annual, significant change.....write all of the nursing care plans, work the raps, run pps, set ards, get hmo updates/auths, get medicare d prior auths/ appeals, run care plan meetings....etc. i may not be an rn, but i contribute a heck of a lot to my facility. my boss signs the r2b.....but i capture the money-making events!! anyway, i wouldn't have blinked if you'd left out the word "even".....

ps....not close to 78 grand, but as an lpn in pa i make $40,000 doing mds...and our cost of living is pretty low up here near lake erie, so i do ok. plus, the flexibility while in school is really nice!!

[Northj81]

I am a male nurse, LPN working in LTC. I have only been a nurse for 2 years, and a position opened up at my facility, I applied and was promoted. I am the nurse manager. Job duties include MDS for 47 Residents. Out of that population 20 are usually medicare. Updating the care plans. My biggest battle. I can never seem to get the care plans updated when they should be. But how does one find time. Not only do I have the MDS, and Medicare to handle, but I also function as the asst to the DON, am the Infection control Nurse, Direct Quality Assurance, Weekly AT-Risk meetings, Weekly Care Conferences, Implementing new policies and procedures, Supervising all the nursing staff, covering the floor when needed for call-in's, maintaing and updating employee health files, and running daily staffing reports, and scheduling for both the nurses, and CNA's. Now this is only what I can think of this morning, by looking across my desk and the numerous binders, and paper piles that have accumulated. When I started at the facility as a floor nurse, I made 13.50/hr, and this position raised me to 17.17, however I don't accrue the OT I used to on the floor, and often put in 50-60 hour work weeks. People have told me I shouldn't complain because it's not often a LPN gets a job like this. Maybe that is so. But I feel I am forever going to be held back because I chose to simply be a LPN. I am lucky that I work at a facility that treats their nurses alike, however each day I am getting more and more tasks, and my care plans are so far behind, I don't even know where to start. THe DON has offered to help me, but when she does, I end up having to go and correct them all because she does not do them right. Does anyone have any suggestions on how to manage all these tasks, and get it all done? Any help would be appreciated.

[mdsdebbie]

Hello ladies, I too am from Upstate NY, make 28 bucks an hour, and am the lowest paid RN in the building. I take on call every 5th week, pulled to do supervision if they are short, becasue of salary, am paid nothing extra. I am dragged into all the meetings, and given chores as seen fit at them. I do all PPS MDS's, RAPS, run medicare meeting, rehab meeting and do Managed care of all payment scources, speaking to the familys when they are going to be cut funding.

Im also one of the first people to get the team work lecture if another part of nursing is not running right, and expected to help fix it, yet no team work is ever given to me when I am running around crazy for a dead:cry:line. I do not have to push a med cart, and have to say at that I would draw a line. My knees are so arthritic, that if I pushed the med cart for 8 hours, I would need 16 to recover...(am getting old and not very graceful)

I do wish I worked in a place that recognized my importance to bring in the bucks, just the importance of what I do. and sure wish I made 78 grand (am very jealouse) LOL

[catnip3]

After reading some of your replies, I guess I'm pretty lucky, and believe me, I have bad days, too! Our facility has 183 beds and 4 RNACs- 1 full-time Medicare, and 3 part time long-term caseload, one for each of the 3 units. I'm one of the LT RNACs. I'm supposed to work 32 hours a week, but it's been so crazy with the Medicare caseload, that we've had to work 40+ hours to help with that. We schedule and complete the ENTIRE MDS, all the sections, the RAPs, and care plans. We conduct the case conferences weekly, and meet weekly with the restorative nurse to screen residents for changes and evaluate their restorative programs. We provide weekly updates to all discipines and management on the QM/QI. And we do all the cut notices (my least favorite part of the job). We also provide routine eduacation to the CNAs on all shifts on Caretracker documentation. There are several other meetings here and there. Here is where I know I am very fortunate- except for helping the residents with meals if staff is very short or can't get in due to bad weather, we are never called to work the floor, be on call, or do supervisory coverage. My hours are very flexible, as long as I meet all my requirements and required number of hours. I'm at $23.45/hr, though our next paycheck will reflect a raise.