How to Manage MDS

The Minimum Data Set reporting system that the Center for Medicare and Medicaid Services (CMS) requires of skilled nursing facilities (SNFs) is an involved series of assessments. A qualified nurse must perform an MDS assessment for admissions, at different intervals in a patient's stay and at discharge.



Aside from tracking patient health and progress, MDS management is central to the financial reimbursement system Medicare uses for skilled nursing setting. MDS assessments set baseline indicators of patient conditions and are used as measures for whether or not SNF medical interventions are necessary and effective, which then influence for what and how facilities are paid.

Instructions

• 1

  Perform a complete MDS assessment on every patient as close to admission as possible. CMS allows up to 14 days to perform an assessment, however for the sake of patient care as well as staff ability to develop a comprehensive plan of care, the MDS assessment should be done earlier if possible.

• 2

  Enter all patient assessments into the CMS database system. CMS not only uses this information for policy and planning, but also as a baseline when receiving facility claims regarding each patient. Getting this information in promptly is critical to your SNF getting paid promptly.

• 3

  Coordinate with your facility's director of nursing or whichever nurse is in charge of developing and overseeing plans of care. As a nurse performing an initial evaluation, you have a responsibility to work with the nurses who will be taking care of the patient to ensure your assessments and evaluations will have a positive impact on the patient's stay. Your facility may also want you to coordinate with the director for rehabilitation services who will arrange any physical rehab and therapy services for patients based on factors indicated in your assessments.

• 4

  Re-evaluate patients anytime staff report a noticeable change in condition -- for better or worse. Events such as a fall, a stroke, improved walking or better eating can all be reasons for an updated evaluation, which of course needs to be reported to CMS.

• 5

  Perform quarterly and annual evaluations for long-term patients. CMS requires facilities to report on every patient in each of these intervals at bare minimum.

• 6

  Evaluate each patient upon discharge and enter your findings into the CMS database system as quickly as possible.

• 7

  Share your findings and discuss patient cases with nurse managers, social service providers, rehabilitation therapy managers, and your executive director regularly and whenever needed. Your clinical evaluations should be part of the information other caregivers use in making decisions for the patient. They will certainly be used by CMS when deciding on permissible reimbursements to the facility.