Federal watchdog agency joins chorus for observation stay reform, reports on scope of the problem

Skilled nursing operators, apparently overwhelmed or defiant, have not been completing resident interviews as mandated by the new MDS 3.0 resident assessment tool, a top official with the Centers for Medicare & Medicaid Services said last month.

These new interviews must be completed, the official warned providers during a national conference call.
“CMS has received reports from some state surveyors that some facilities are not completing interviews when residents are capable. Providers will be cited when such a practice is verified,” CMS’s Thomas E. Dudley, MS, RN, said during a Skilled Nursing Facility Open Door forum call.

MDS 3.0 added resident interviewing for the first time, and has four sections that tackle cognitive patterns, mood, routine, activities and pain.

While CMS has said the interviews allow residents to be involved in decision-making, some providers have complained that the interviews take too long and can be upsetting to residents.

Experts say a team approach to completing an MDS 3.0 evaluation is essential now.

“The days of an MDS coordinator doing the entire process are over. One person cannot, and should not, complete this whole process,” notes McKnight’s “Ask the Payment Expert” columnist Patricia Boyer, MSM, NHA, RN. “This would result in, once again, the MDS becoming a piece of paper.”

Interviewing techniques will be covered in CMS’s March 2012 MDS National Conference, Dudley told stakeholders on the conference call. The first session will be March 6 and 7, and the second one March 8 and 9.

Both sold out early and hundreds of individuals were put on a waiting list. But Duddley said the agency was working to make other arrangements to accommodate more people who want to attend.