Ask the payment expert...Should we add more MDS staff to meet new regulations?

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Patricia Boyer, MSN, NHA, RN
Patricia Boyer, MSN, NHA, RN
Q: With all the changes regarding MDS changes lately, should we be adding more MDS staff?

A: Most facilities are already strapped for money and the thought of adding more MDS staff is not something they want to consider. It's also not necessarily the answer to the changes that have occurred in the industry.

Let's look at some things facilities are doing to improve the efficiency of the process. Although I always promote an interdisciplinary process for the interviews, one MDS nurse told me her facility has an interview team that does all the interviews.  She said they are proficient in how to ask the questions, how to work with the dementia residents and how to build rapport with the residents so they feel comfortable. She stated that the process works very well for both residents and staff.

 You also should make sure you have designated, private space to conduct the interviews. Another best practice I have seen is a facility that has partnered an MDS coordinator with each nurse manager. That process allows them to work together on the same residents so you have an RN who can assess and an MDS coordinator who ensures timeliness of assessments.

The RN manager can evaluate the CAAs and manage the care plan. The MDS coordinator can monitor payment and alert the manager when revisions need to be made.

The days of an MDS coordinator doing the entire process are over. One person cannot, and should not, complete this whole process. This would result in, once again, the MDS becoming a piece of paper.

It needs to be a working tool that “drives” patient care and is managed to maintain appropriate reimbursement. That means the process needs to be interdisciplinary in order to achieve success.