What is average time spent on MDS?

Long Term Care Columnist / Guide · Oct 29, 2005

A lot depends on whether you can do the MDS on the computer and use computer-generated RAPs/care plans. If you have to write everything out---and the vast majority of residents trigger a large number of RAPs---you're going to be at it awhile, especially if you want your documentation to be up to state and federal standards. I used to write narrative RAPs for each trigger on the computer and print them out, until I moved to another facility that used the forms you had to check off and THEN write out your assessment........they were redundant, labor-intensive, and a general PITA to do. Sometimes it took me 4 hours or more to do the MDS and write out fifteen RAPs, and as a SNF MDS nurse, I often had to do several of them a day. (That was one of the reasons I eventually left LTC; I was fried from working 14-hour days and taking work home with me, plus being on-call for my unit 24/7.)

Maybe I was just slow; maybe I was more concerned with doing it right and getting it done on time than zipping through everything so I could go to meetings and investigate every single bruise and bump on forty residents. All I know is, if you've got management telling you that the MDS and RAPs shouldn't take much time, you're working for the wrong people. When the documentation isn't done or isn't right, it's going to be YOUR butt on the line.......and I guarantee you that the administration will leave you twisting in the wind when the surveyors visit. :madface:

Sorry to be the bearer of bad news, but I think you should be prepared for any eventuality if you've already got people breathing down your neck about how long it should take to do MDS/RAPs.

Daytonite, BSN, RN · Oct 29, 2005

I don't think your management knows what they are talking about. A lot of thought has to go into writing those RAPS. The score that each patient untimately recieves on their MDS becomes statistical information that Medicare uses to calculate the amount of money the patients in your facility are going to get as Medicare and Medicaid reimbursement. Most administrators of nursing homes understand this and take the MDS as very serious documents that have a big impact on their financial health. For this reason, most facilities have a specific person(s) who is responsble for making sure the MDSs are completed on time. They are experts, if you will, on the MDS form and know many of the little nuances about it that can affect reimbursement. Are you guys just offering information to someone who is ultimately making out the MDS? MDS statistical information can only be sent electronically to Medicare. Are you having to be involved in that? The RAPS have to tie in to the the rest of the MDS report and the care plan has to tie into it all. The only reason I can think of as to why your management would seem to be so nonchallant about this reporting form is that you may have exclusively private pay patients so that the facility is not dependent on Medicare and Medicaid reimbursement.