The American Association of Post-Acute Care Nursing (AAPACN) surveys nurse assessment coordinators (NACs) every other year on aspects of their work, salary, and time. The 2025 AAPACN NAC Work Study and Salary Report offers valuable insights into the challenges NACs face that can help with staff retention. The study also covers the average minutes NACs report it takes them to complete each assessment that can be used to project full-time equivalent (FTE) hours for their position based on the number of assessments the facility completes each month. As the Minimum Data Set (MDS) continues to expand in size and how it is used, evaluating NAC workload and organizational expectations strategically has become essential. This article reviews the top challenges NACs confront, insights on how to determine FTE needs, and ways the leadership team can support the NAC in this unique position.
NAC Challenges
In the survey, NACs rated challenges on a scale from “Not at all” (0) to “Substantially” (5). Workload and stress/burnout were the top two cited. Gathering section GG documentation tied with staff turnover for the third highest rated task. The challenge of workload, stress, and burnout should be a high focus for facility leadership because it was also noted as the second most common reason among NACs who had left their position in the last 12 months. See the full report for additional NAC challenges, including analysis comparing salary and job satisfaction.
Determining Full-Time Equivalent Needs
One of the most actionable uses of the AAPACN report informs staffing calculations for the NAC position. This study continues to quantify and benchmark how much time the average NAC needs to complete MDS assessments, tracking records, Care Area Assessments, and care plans. Facility leadership can use this data, along with facility-specific MDS assessment data, to determine how many NAC FTEs are needed to attend required meetings and complete assessments efficiently and accurately.
The study also identified that some of the tasks assigned to the NAC consume valuable time, such as attending or preparing for meetings, ICD-10 oversight, and section GG management. NACs reported, on average, at least six hours of meetings each week, four hours for diagnosis coding, and five hours on section GG management. Additionally, 38% reported spending an average of 11 hours per week providing direct resident care. A NAC challenged by all of these tasks and responsibilities only has 14 hours remaining during the week to complete assessments.
See the 2025 AAPACN NAC FTE Calculator tool for more details on how to use all this data and specific facility information to calculate FTE needs.
Supporting the NAC Role
Although competitive compensation is important (and the report notes steady growth in NAC salaries), salary alone does not ensure satisfaction. The AAPACN study shows that even well-compensated NACs report high levels of burnout if they lack organizational support or face unrealistic expectations. As noted earlier, to support and retain NACs, facility leaders must recognize the greatest challenge is workload and stress/burnout. Facility leaders may need to protect the NAC’s time, by first ensuring adequate hours to complete all required assessments and tasks, and then by clearly defining boundaries for additional duties. The study shows that many NACs are frequently pulled into unrelated responsibilities. Some 24% of them are expected to perform other nursing tasks on short notice.
NACs report strong satisfaction with coworkers and job security but lower satisfaction with compensation, advancement, and work/life balance. To improve this situation, leadership should involve NACs in decision-making around assessment and care planning workflows, empower NACs to provide education and training when needed, and offer flexibility, such as remote work when appropriate (currently 54% of NACs have some remote access).
Conclusion
The role of the NAC is evolving, and facilities must adapt and grow along with it. The Centers for Medicare & Medicaid Services (CMS) continues to expand how the MDS is used: regulatory requirements and care planning, quality initiative programs and public reporting, reimbursement, and more. Additionally, managed care companies and state Medicaid reimbursement often require the completion of MDS assessments. With so much depending on the accuracy of the MDS, it’s not surprising that the NACs feel the pressure.
Thus, overall facility goals—for comprehensive care plans, accurate payment, and quality outcomes—must include adequate time, resources, and support for the NAC.
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