MDS Alert

How to keep MDS assessments on track when you have staff turnover.

When one MDS Coordinator leaves and a new one comes in, the transition can be rough on your MDS assessments — especially when there’s no overlap time. How can you make this transition as smooth as possible so that you won’t lose deserved reimbursement?

Warning: “The completion and transmission of accurate and timely MDS assessments wait for no one,” says Marilyn Mines, RN, BC, RAC-CT, senior manager of clinical services for FR&R Healthcare Consulting, Inc. in Deerfield, IL.

“If the process does not continue smoothly during the transition period, the new MDS Coordinator may feel overwhelmed when he/she starts, and either be unable to deal with the back log or quit before diving in,” Mines warns. “Reimbursement will be jeopardized.” Here are some tips to ensure that this doesn’t happen.

1. Assign a Back-Up Person

Having a back-up MDS staff member or adjunct MDS staff is an important way to ensure easy transitions. There are no limitations in the RAI manual that prevents your facility from having two, three or more MDS Coordinators, or two or three Registered Nurse Assessment Coordinators, says one state RAI coordinator.

The back-up person should be able to take over for the MDS Coordinator when she’s sick or goes on vacation, Mines notes. “This, however, is difficult to do since back-up MDS Coordinators may not perform these detailed tasks to be comfortable doing them in a pinch.” That’s why adequate ongoing training of any back-up MDS staff is crucial.

Bottom line: Of course back-up staffers don’t need to be active at all times, but they should be trained and have the opportunity to garner some experience with completing the RAI process. This will help provide continuity during staff transitions.

2. Organize Your RAI Policies & Procedures

To ensure a smooth transition, be sure you have detailed policies and procedures regarding the RAI process, Mines urges. This includes:

• Who (what discipline) will complete each MDS section and CAA;
• Time frames for completion;
• Validation reports; and
• Transmission procedures.

Best bet: Having an “MDS transition plan” is also a good idea, the state RAI coordinator says. In addition to RAI policies and procedures, the plan should include:

• Software documentation/guides and contact information;
• Centers for Medicare & Medicaid Services (CMS) MDS-related and QIES web links;
• Instructions for downloading a copy of the current RAI to the desktop;
• Other information helpful to the new MDS staff member.

3. Hold MDS Educational Sessions

Consider conducting educational sessions about the RAI process, Mines suggests. The sessions could be 30 minutes, once each month. “Cover one detail at each session, and explain the ‘hows’ and ‘whys’ of the process.”

4. Perform Monthly ‘Tests’

“Have each nurse in the facility fill out one MDS each month,” Mines recommends. “You take over their unit duties for a few hours.”

Not only will this practice give more nursing staff some MDS experience that could prove helpful in the event of an MDS Coordinator transition, it will also improve documentation. “Once [the nurses] see how difficult it is to complete the MDS without adequate documentation in the clinical record, they are more apt to include the information in the future,” Mines notes.

5. Swap Places to Keep Info Fresh

And you can take this idea a step further by singling out one particular nurse. “If there is a nurse in the facility who is interested in doing MDS assessments, switch places for a day or two each month to help him/her remember the details of the RAI process,” advises Mines.

6. Strive for Overlap to Smooth Transitions

Ideally, you should always try to overlap the termination and initiation of the MDS Coordinator position. “There are times when there is no period of transition, when one leaves before the other starts,” says Mines. “This is the worst!”

Good idea: But if you can plan for some overlap, this will give the new MDS Coordinator a chance to understand the individualized functioning of the facility, Mines notes. “Familiarizing the new employee with where things are, who people are, what the expectations are, etc. are very important for the newbie’s survival.”