The MDS nurse does MDS (Minimum Data Set) assessments in Skilled Nursing Facilities (SNFs), Nursing Homes, Long Term Care Facilities (LTCs) or Non-Critical Access Hospital (Non-CAH) Swing Beds. Some of these SNFs or Nursing Homes might also be coined as skilled rehab facilities, 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 software. The assessment needs to be accurate and involves 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 the MDS nurse only clicked on "oxygen use". Yes, MDS nurses are that important.
The MDS nurse coordinates with the Interdisciplinary Team for timely MDS assessment completion. Coding, calculating, signing, completing and submitting (transmitting) the MDS to a government data base all depend on specific instructions. The forms may have over-lapping time frames of due dates. The instructions are explained in the MDS book of regulations: Resident Assessment Instrument (RAI) User's Manual or, in short, the RAI or MDS manual. The RAI manual is released by CMS with updated versions posted in cms.gov.
The MDS nurse does care plans. Completing the MDS depends on the type of MDS assessment that is due. Some of those residents who had certain MDS assessments completed will parallel the residents who are scheduled for the Care Plan Meeting or IDT meeting. For example, if a resident had an Admission MDS due, that MDS assessment gets completed. The completed Admission MDS Assessment helps determine what needs to be added to complete the care plan, the care plan that should have already been initiated by the team since day one. Afterwards, the MDS nurse may notify the Interdisciplinary Team that the resident should be listed for upcoming care plan meeting.
The 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 usually do not stay long enough in the facility for care plans to be completed; therefore, these residents may not need to be included in the care plan meeting schedule.
The MDS nurse may be involved with the following tasks, depending on the facility policy or size:
- Be part of QA meetings: 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
- Without a doubt, the MDS nurse has an important and rewarding task: 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.