AANAC members report MDS 3.0 takes longer to complete

More than 80 percent of long-term care nurses and nurse leaders say that the MDS 3.0 assessment takes more time to complete than the MDS 2.0, according to a new report from the American Association of Nurse Assessment Coordination (AANAC).

AANAC last August surveyed members on their challenges, work and how much time they spend on assessments, care area assessments and care planning. Overall job satisfaction dropped an average of 10 percentage points on major indicators compared to the membership survey from November, 2009. The greatest declines were in compensation, from 75 percent reporting satisfaction in 2009 to 59 percent reporting satisfaction in 2011, and work/life balance with 62 percent reporting satisfaction in 2009 to 51 percent in 2011.

According to the survey results, the top four challenges for respondents in nurse management positions in long-term care are:

· training and continuing education for staff to keep up with regulatory changes in the field,

· maintaining readiness for state survey visits and follow-up issues in nursing facilities,

· ensuring compliance with other policy issues, and

· dealing with the burnout and stress of everyday work.

Close to 60 percent of respondents were nurse assessment coordinators or MDS coordinators (responsible for the RAI process) and the balance of participants worked in various management or corporate specialist positions such as directors or assistant directors of nursing, administrators, corporate directors/consultants and reimbursement specialists.

“In the past year, nurses in long-term care have been under tremendous pressure to learn and implement a comprehensive new assessment tool, the new RUG-IV reimbursement system and new timing and scheduling conventions in an environment with increasing financial pressures and staff turnover,” says AANAC President and CEO, Diane Carter RN, MSN, RAC-CT, C-NE. “They push themselves and others to advocate for continuous improvements in care including inclusion of the resident’s voice in assessment and care planning.”

According to survey respondents, the parts of the new MDS 3.0 comprehensive assessment that take the longest are:

· OBRA Comprehensive MDS only—Approximately 45 percent reported taking more than 60 minutes and another 38 percent reported taking between 31 and 60 minutes.

· CAAs only—More than 40 percent reported taking 31-60 minutes and more than 25 percent over 60 minutes.

· Care Plan only—60 percent reported taking more than 30 minutes and 17 percent taking more than 60 minutes.

· PPS Only—Close to 50 percent reported taking 31-60 minutes and more than 35 percent completed it in less than 30 minutes.

While survey responses indicate frustration with the new tool, there were some positive findings as well: Two thirds of respondents indicated that a resident interview takes less than 30 minutes to complete. Additionally, close to two-thirds of survey respondents agree or strongly agree that the MDS 3.0 tool has improved their awareness of each resident’s choices and preferences in how care is provided.

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