An MDS nurse does MDS (Minimum Data Set) assessments in Skilled Nursing Facilities (SNFs) or Long Term Care Facilities (LTCs). These facilities can also be termed as skilled rehab facilities, nursing homes, convalescent hospitals, rehab and wellness centers, transitional care units or post-acute care facilities. MDS assessments are done according to strict schedules set by the Centers for Medicare and Medicaid Services (CMS). These assessments have questions that need answers collected from different observation periods during the resident's stay. The answers are coded on the paper MDS assessment form or encoded into an MDS program. The assessment need to be accurate and involve interviewing patients (residents) or their family, assessing the resident, reviewing the whole chart, reviewing other medical records not yet in the chart (narcotic records, treatment sheets, therapy treatment logs, ADL charting by CNAs, RNA logs and vaccination logs) and interviewing staff involved in the resident's care during all shifts.
A click to answer the MDS that a COPD resident has shortness of breath when lying down can affect a Medicare reimbursement of almost $200 more PER DAY than if an MDS nurse only clicked on "oxygen use". Yes, MDS nurses are that important.
An MDS nurse coordinates with the Interdisciplinary Team for timely MDS assessment completion. Coding, calculating, signing, completing and submitting (transmitting) the MDS depend on specific instructions and may have over-lapping time frames of due dates - all explained in the Resident Assessment Instrument (RAI) User's Manual. The RAI manual is released by CMS. Updated versions are posted in cms.gov.
An MDS nurse does care plans. Completing the MDS depends on the type of MDS assessment that is due; therefore, the MDS nurse usually sets up certain MDS completion to parallel which resident is scheduled for the Care Plan Meeting or IDT meeting. For example, if a resident had an Admission MDS due, that Admission MDS gets completed and helps determine what needs to be added to complete the care plan, the care plan that should have already been initiated since day one upon admission by the team. Afterwards, the MDS nurse may be the one who notifies the Interdisciplinary Team that the resident will be listed for upcoming care plan meeting.
An MDS nurse may or may not be the lead in care plan meetings depending on the company's policy or the MDS workload. During the care plan meeting, the resident's and/or the responsible party's preferences, input and concerns are updated in the care plan. Afterwards, the lead of the care plan meeting shares the concerns brought up in the care plan meeting with the appropriate staff for follow-up. Short-term stay residents may not give enough time for care plans to be completed; therefore, these residents may not be included in care plan meeting schedule.
An MDS nurse may be involved with the following tasks, depending on the facility policy or size:
- Be part of QA meeting: To help improve Quality Measures
- Coordinate Medicare Part A, B and HMO meetings
- Staff Education: In-services regarding proper ADL or skilled documentation
- Triple check: Monthly review of Medicare Part A billing accuracy
- One of the most important and rewarding tasks: Communicating to the appropriate team member the resident's preference or issue, following up if interventions were effective, seeing the positive outcome and improving the resident's quality of life.
To answer the question "What is an MDS nurse?" MDS nurses are just that... that important. Interested in learning MDS? Visit www.mdsadvisor.org
Related article: "Who Can Do MDS Assessments?" and other articles.