Ask the payment expert ... about MDS staffing

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Ask the payment expert ... about the observation stay loophole
Ask the payment expert ... about the observation stay loophole

We recently lost our MDS nurse and didn't know what to do, as no one else knew how to do MDSs. What should we do differently now?

As you have now learned, having back-up for your MDS staff is essential in today's PPS environment. The process has become so time critical that you can't afford to only have one person trained in the MDS process.

The ideal is for multiple people to be proficient in the process such as each nurse manager doing his or her own assessments. That is not always possible. It is essential, though, that nurse managers participate in the process so that they understand correct coding of the MDS and they can step in when needed to complete assessments. 

Recently, a client's MDS nurse left with no notice. This facility had no one in the facility who was trained in the MDS process. They had two choices: Hire a temporary MDS nurse or suffer the financial consequences of not having timely completed assessments. Another facility has had multiple changes in its MDS nurses. This has resulted in missed and late assessments.

Here is the solution: Make sure that you always have a back-up plan. This must be an uninterrupted process. Train more than one person in the MDS process. You still might want your main MDS nurse concentrating on coordination of processes (e.g. scheduling, ARD management, communication with therapy, etc.) but not being the only one completing the process.

One strategy is to have your nurse managers complete comprehensive assessments because those are the ones that drive the care planning process, and have your MDS nurse complete the other PPS assessments. That way the right nurse is doing the right assessment and you will always have multiple nurses who can step in when needed.