Long-Term Care Survey Alert

Make sure your MDS coding is on the mark.

Surveyors conducting traditional surveys aren't the only ones who will be missing the MDS-driven quality indicators and measures until CMS gets them in working order. Nursing home providers will be too.

To stay on top of quality issues during the transition, Marty Pachciarz, RN, RAC-CT, with the Polaris Group (Tampa, Fla.), suggests seeing if the facility can use its MDS software and other sources to produce the following list of potential quality issues, which won't require a comparison to the prior MDS:

• Falls with major fracture
• UTI
• Catheters
• Restraints by type including side rails
• Weight loss and pressure ulcer
• Weight loss and feeding tube
• Depression diagnosis and no antidepressant
• Preferences for daily routine or activity coded as being
• very important or important but can't do or no choice
• Hospice
• Dialysis
• Ventilator
• Isolation
• O2 and respiratory failure
• Dehydrated
• Pain at moderate level or higher

Tip: MDS 3.0 software may still provide the ability to pull your internal QIs/QMs by crosswalking the MDS 2.0 to the MDS 3.0, advises Lynda Mathis, RN, a consultant in Conway,

Ark. "It won't be entirely accurate but it will give you a head start" on identifying patients who may have an issue or who may be targeted by surveyors.

When looking at MDS software-generated lists of residents with certain conditions, "the first thing people should do is make sure their MDS 3.0 coding (definitions and data) are accurate because the items and definitions are so different from MDS 2.0," advises Christie Teigland, PhD, director of health informatics and research for the New York Association of Homes and Services for the Aging.

"People should focus first on the micro-level data to make sure they are capturing things like falls and pressure ulcers the way they should be -- and doing so consistently," adds Teigland.