Pulling the MDS nurse Onto the Floor: Minimum Nursing Staffing Levels

CMS is now showing consumers staff turnover and weekend staffing levels on Nursing Home Care CompareThese added metrics show families the history of staffing levels and staff retention for every nursing home facility and are key factors in assessing quality of care.

The President’s recent calling on nursing homes to improve their care outcomes has been in the news recently. The fact sheet from his February briefing stated that 82% of all inspected nursing facilities had an infection control deficiency that could be improved nursing staffing reduced the spread of infections, such as COVID-19.

CMS intends to utilize staffing levels even more and will include them in value-based purchasing programs. This will mean that inadequate staffing and staff retention will lead to payment changes for Medicare beneficiaries.

In this challenging time, we’re hearing reports of MDS nurses being pulled to work nurse shifts on the floor.  When your MDS Coordinator is pulled to the floor they do not have time for chart reviews, triple checks, or ensuring accurate MDS coding. How does this short-term fix affect facilities in the long run – and is the trade-off worth it?

How does the MDS Department Impact Staffing?

  • As an RN (Registered Nurse) who specializes in assessments, connecting the dots, and thorough care planning, your MDS nurse can train and support other staff. 
  • Ensure MDS Nurse enough time to conduct thorough assessments and analyze patient specific clinical needs during the CAA (Care Area Assessment) process to allow for more efficient use of staff in providing care.
  • The MDS nurse can improve communication between different departments as they facilitate interdisciplinary care planning in all areas and prevent the interdisciplinary departments from “working in silos,”.
  • The MDS coordinator can work more diligently to improve quality measures, five-star ratings, and accurately code items affecting PDPM (Patient Driven Payment Model) and case mix reimbursement (clinical factors may be missed if the coordinator is rushing).
  • Allowing the MDS nurse to work on quality measures and supporting other staff may also increase job satisfaction and promote retention among other staff members, creating a more favorable profile on Nursing Home Care Compare.
  • Spending more time on chart reviews helps to identify when extra assessments are needed.
  • Spending more time on admission planning allows for smoother transitions and a reduced burden on other nurses.

In summary, your MDS nurse serves you best in their role as MDS Coordinator.  We understand that sometimes there is no way around the requirement of pulling the MDS nurse to the floor to ensure the best care for our residents.

To assist you with the balancing act of providing care when needed and meeting the documentation requirements of a well-run MDS Office; MDS Consultants can help with on-demand MDS Completion to keep you on track.  Your facility will operate much better with ancillary systems in place to help cover short staffing when needed.

Resources

Nursing Home Staff Turnover and Retention: An Analysis of National Level Data. Nursing Home Staff Turnover and Retention: An Analysis of National Level Data – Christopher Donoghue, 2010 (sagepub.com)

How Much Staff Do I Need For MDS? How Much Staff Do I Need for MDS? – MDS Consultants (mds-consultants.com)

FACT SHEET: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes. FACT SHEET: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes | The White House

BREAKING: CMS wallops nursing homes with planned staffing requirements and increased penalties. CMS wallops nursing homes with planned staffing requirements, increased penalties (mcknights.com)

-How to Utilize Your Staff to Mentor and Fill Gaps in the MDS Department. How to Utilize Your Staff to Mentor and Fill Gaps in the MDS Department – AAPACN

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