Ask the payment expert ... about supporting MDS completion

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

What is the best nursing structure to support the MDS process?  

The most accurate and efficient way is for nurse managers to complete all MDS information for their residents. 

In this process, you have the person who is caring for the resident completing the MDS, CAAs and care planning. However, this process is hard to achieve and not practical for many facilities. 

Having each nurse manager work hand-in-hand with his or her own MDS coordinator is also an option we've seen work effectively. However, this may not be very cost-effective. 

The model in most facilities is an MDS coordinator who does the forms for all residents. This is probably the most ineffective, least accurate of the models used today. Once you take the assessment process away from the professionals who are caring for the resident, you leave yourself open to inconsistency and inaccuracy.  

So, how do you decide what is best for your facility? First, evaluate what you are doing today. Do you see problems from your Quality Measures that might be due to inaccuracies in your assessment process? If so, it's probably time for a change. Start moving toward a more holistic approach by having your nurse managers learn the MDS coding process. Then move on to them participating in completing the comprehensive assessment (from the initial, annual and significant change assessments) that “drives” the care plan. 

Even if those are the only assessments your nurse managers can handle, you will be much closer to that holistic process that will benefit your residents. Some facilities find that the process with a blend of the nurse managers completing some information and MDS coordinators completing the payment assessments and quarterly assessments works quite well for them.