WWW. AANAC. ORG NURSE ASSESSMENT COORDINATOR STUDY 2015 REPORT Overview...2 Education and Experience................................... 3 Compensation...4 Challenges and Workload.... 6 Sections of the MDS.... 7 Time Study... 8 About AANAC... 9
Research Study Overview Background During the last quarters of 2011, 2013, and 2014, the American Association of Nurse Assessment Coordination (AANAC) has surveyed its membership of nurse assessment coordinators (NACs) working in long term care with the purpose of understanding the issues affecting their job duties, performance, satisfaction, and challenges. By collecting, analyzing, and trending this data, AANAC endeavors to: Benchmark and report average completion times for MDSs by assessment type Benchmark and report compensation levels by various factors Benchmark and understand the time factors effecting accurate MDS assessment Benchmark and understand nursing home staffing practices and trends Methodology In October 2014, AANAC sent an email to approximately 14,000 AANAC members asking for their participation this annual survey. Members had three weeks to complete the electronic survey for a chance to win a $25 Amazon gift card. From the completed surveys, AANAC analyzed only the responses from members who indicated that they work full time in the functional role of MDS coordinator/nurse assessment coordinator. The DHHS's Home Data Compendium 2013 Edition reports that there are 15,652 nursing homes in the United States. According to AANAC's 2013 Nurse Leader Work Study, each nursing home staffs an average of 1.71 NACs; therefore, AANAC estimates that there are approximately 26,775 NACs currently working in the field. With 521 NAC respondents, this survey provides a statistically valid sample of the NAC field with a 95% confidence level and a 4.25% +/ error rate. Data Basis The number of NACs participating in the study provides a large enough sample to be representative of all NACs working in the field; however, the results are biased toward the demographic profile of AANAC members and the facilities that they represent. Specifically, AANAC members are more likely to work in non profit facilities; therefore, these results may or may not be representative of all nursing homes in the U.S. 2
NAC Education and Experience Seventy eight percent (78%) of NACs are RNs with either a nursing diploma, associate degree, Bachelors of (BSN), or a Masters of. Highest Level of Education Masters of Bachelors of Associate degree diploma LPN/LVN 0% 10% 20% 30% 40% 50% More than half of NACs (56%) have 10 or more years of experience as a NAC. Years of NAC Experience 25 years or more 20-24 years 15-19 years 10-14 years 6-9 years 3-5 years 1-2 years Less than 1 year 0% 5% 10% 15% 20% 25% 3
NAC Compensation NAC compensation averages $68,702 per year or $30.03 per hour. Education and facility location appear to be the top drivers of NAC compensation. Fifty six percent of NACs report receiving an hourly rate, while 44% receive a salary. NAC RNs earn an average of 11% more than NAC LPN/LVNs. Slight variation in salary exists among NAC RNs with diplomas, associates degrees, and BSNs. NAC RNs achieving a Masters average another 11% pay increase. $85,000 $80,000 Average NAC Salary by Education $82,375 $75,000 $70,000 $67,146 $69,261 $72,345 $65,000 $60,000 $59,511 $55,000 LPN/LVN diploma Associate degree Bachelors Masters Average NAC Hourly Pay by Education $37.00 $35.00 $33.00 $31.00 $30.00 $30.66 $32.40 $35.33 $29.00 $27.00 $26.91 $25.00 LPN/LVN diploma Associate degree Bachelors Masters 4
Hourly pay for NACs varies by rural vs. urban settings with urban nurses making $2.26 more per hour than rural NACs, who make $2.34 less than the national average. Similarly, salaries for NACs vary by rural vs. urban settings with urban nurses making 5% more than rural NACs, who make 9% less than the national average. $74,000 $72,000 $70,000 $68,000 $66,000 $64,000 $62,000 $60,000 $58,000 Average NAC Salary by Facility Setting $72,165 $62,856 Rural Urban $33.00 $32.00 $31.00 $30.00 $29.00 $28.00 $27.00 $26.00 $25.00 Average NAC Hourly Pay by Facility Setting $32.29 $27.69 Rural Urban Salaries and hourly pay did not vary significantly between for profit vs. non profit organizations. 5
NAC Challenges and Workload Seventy six percent (76%) of NACs rate their workload as Challenging or "Very Challenging," with 67% reporting that they regularly have to work over time or extra hours in order to complete their job duties. Top NAC Challenges staff turnover Software issue Gathering info from records Stress and burnout Workload 0% 10% 20% 30% 40% 50% 60% 70% 80% NAC Workload Hours Reduced Hired to do a Combo Pulled to do other Duties Regularly Work OT/Extra hours 0% 10% 20% 30% 40% 50% 60% 70% 6
Sections of the MDS Completed by NACs Sections of MDS Completed by NAC Section A: Identification Information 88% Section B: Hearing, Speech, and Vision 76% Section C: Cognitive Patterns 23% Section D: Mood 9% Section E: Behavior 22% Section F: Prefs for Customary Routine, Activities 8% Section G: Functional Status Section H: Bladder and Bowel Section I: Active Diagnoses Section J: Health conditions 92% 90% 93% 93% Section K: Swallowing/Nutritional Status 18% Section L: Oral/Dental Status Section M: Skin conditions Section N: Medications Section O: SpecTreatments, Procedures, Programs Section P: Restraints 85% 88% 93% 95% 92% Section Q: Participation in Assessment,Goal Setting 16% Section V: Care Area Assessment Summary 91% Section X: Correction Request Section Z: Assessment Administration 79% 83% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% 7
NAC Time Study From start to finish, NACs report that an average comprehensive assessment take four hours and 48 minutes to complete, with an average of 7.6 CAAs triggered per assessment. Average Minutes Per Activity OBRA Comprehensive Assessment 78 Care Plan 58 Care Area Assessment 152 Total Minutes Per MDS 288 Additionally, NACs report spending an average of 4.5 hours per week doing other MDS related activities. Average Minutes Per Activity Per Week Entry Tracking Record 8 Death in Facility Tracking Record 7 OBRA Quarterly Assessment 48 PPS only 50 SOT, EOT, and COT OMRA Assessments 33 Discharge Assessment 34 Summit/Review Validation Report 37 Care Planning Conference 55 Total Minutes Per Week 272 Although the type of meetings NACs attend varies, they spend an average of 10 hours a week in meetings. NAC Meeting Attendance PPS, Medicare, Triple check 84% Stand up 78% Quality improvement/quality assurance 73% Falls, Incidents, Safety 58% Weight loss 38% Behavior 29% Wound care 29% Restraint reduction 15% Sixty one percent (61%) of NACs report that they are responsible for ICD coding and spend an average of 91 minutes per week on this activity. 8
About AANAC The American Association of Nurse Assessment Coordination (AANAC) is a non profit membership organization dedicated to supporting long term care professionals provide quality care for nursing home residents across the nation. Representing more than 14,000 members, AANAC has earned the reputation as the premier resource and network for long term care professionals. For more information about this report, please contact Deborah White at dwhite@aanac.org or 1 800 768 1880. For information about AANAC membership, 9