Staff RN doing MDS

CapeCodMermaid, RN · Nov 15, 2009

I've worked in many facilities and the norm these days seems to be for the staff nurse to do the nonPPS/medicare MDSs. I was a staff nurse on a very busy subacute floor....30 patients of my own...IV's, TPN, Trachs, summaries, medicare notes and then they told us we'd have to learn how to do MDSs. Surely you jest...I said.

At my last 2 facilities, the nurses didn't do any MDSs. There was an MDS person for the building...135 beds and one for just the Medicare residents...15-20 on average. I have one MDS nurse now, but my building is tiny.

MERRYWIDOW46 · Nov 15, 2009

I started in LTC in 1991, MDS was fairly new. WE ALL had to do them, no MDS nurse then. Even DON, ADON, QI, and Inservice RN did them.

Fast forward to ADON job 1994, still no MDS nurse all did them.

Fast forwadg again 1998-2000 DON, everyone did MDS.

MDS nurse position came about 2001-2002 around here and still if not all done staff should/are expected to get them done.

Just how nursing works.

rukiddingme · Nov 16, 2009

The current place I work has MDS nurses & the floor nurses have no idea how to do an MDS -- this was the same case at my previous employer. Guess the floor nurses at these places are lucky.

rapkeygurl · Nov 17, 2009

We-I lol do our own in our facility, I do ask nurses stuff and ask about things they code in the weekly assessments like putting someone as no short term or any memory problems and hello -- they have dementia or alzeimheir's, My biggest problem is getting the documentation -- but today I put out a big RESPECT note because last week they did all the weekly summaries and I did not have to put out a list for ones they missed, plus as I am rounding and giving them things to fix they are actually doing it!!! these things make me smile, I can not imagine making nurses on the floor do mds data- especially if they have no training, how in the world is that COST EFFECTIVE?????

amylpn24 · Nov 21, 2009

Are staff/floor nurses responsible for MDSs at other LTC/sub acute facilities?
We were required to compete a certain number of MDSs per month. There is a MDS nurse on staff.
These assignments were often handed out arbitrarily - Requiring a nurse to do a MDS on unfamiiar residents. Considering how important MDSs are it seems counterproductive to have floor nurses perform these duties. counterproductive but cost cutting.
More often than not we did not have time to complete the assignments during our shift hours. we were told to stay late however overtime was frowned upon so some of the staff nurses complied with management's 'request' to punch out and finish the MDSs. (another issue and a biggie)
Is it a common LTC policy to assign MDS responsibiities to floor nurses?

It may be the "norm" these days as facilities are struggling to make and save money however able. The problem is, they need to take a step back and realize that the MDS or PPS nurse (THE REIMBURSEMENT NURSE) should do only that. Nothing else. When you have nurses doing MDS when they are not familiar with either the RAI or the residents, this leads to coding errors, coding errors lead to lost revenue either immediately or in the future when MCR or MCD audits and takes back money.

susanthomas1954 · Nov 28, 2009

Having worked in facilities where both policies have been in effect, I have to say we should be able to expect the floor nurses to do an accurate ASSESSMENT of the patient monthly, and we SHOULD be able to extrapolate a quarterly or annual MDS from that data. However, I prevail upon the nurses to actually DO the assessment at the bedside, rather than "from knowledge of the patient." We are currently correcting coding errors from the last quarter on almost ALL the residents whose floor nurses did the latest MDS, all of which were done at the nurse's station.

MDS's for PPS reimbursement should never be done by anyone but the Nurse Assessment Coordinator. The latest policy changes in our facility are that the LPN assessor does LTC assessments and plans, and I do the PPS assessments. We have a 220 census with 40 skilled average. It's a lot of work!