Some SNFs ‘Months Behind’ on MDS Assessments as New Opportunities to Outsource Role Grow

The role of a minimum data set (MDS) coordinator is one that continues to evolve in post-acute care since the launch of PDPM in 2019, and as operators have struggled to bring in nurses across the board, so too have they struggled to keep their MDS coordinators.

With multiple coordinator openings at the moment, Rockport Healthcare Services, a California operator and consulting service provider, is focused on recruitment for the position.

“We are looking at the role and what they do and how we can make it a more attractive, sustainable position because it does seem to be a high turnover position,” Kristen Morris, chief clinical officer for Rockport, told Skilled Nursing News. “Even when you look at Indeed, and you look at positions throughout, MDS coordinators are a big one that’s there.”

MDS coordinators are vital to not only ensuring that facilities are getting proper reimbursement for treatment but that the right care is being provided to the patients they see. They are typically registered nurses and are responsible for overseeing the reimbursement process and making MDS submissions to insurance but staffing shortages have brought a need for them to shift to more clinical care at some facilities.

Maria Arellano, product manager for data analytics platform PointRight, recently told SNN that one of their clients with a portfolio of 20-plus skilled nursing facilities implemented the platform to improve the accuracy of their MDS submissions in order to develop better strategies for improvement.

The platform identifies common coding errors and other areas where data inaccuracies occurred and the operator saw its ratings improve dramatically, Arellano said.

Illinois-based Crescent Care, which officially opened its first facility last year, has also looked to bring in outside help to improve its MDS assessments going forward. Rather than pay rising wages, the operator doesn’t have an MDS coordinator on staff — instead preferring to get support from Zimmet Healthcare Services Group.

“The staffing crisis has caused everyone to get a little bit creative as far as allocating their staff,” Crescent Care CEO David Glat told SNN.

Vincent Fedele, Zimmet partner and director of analytics, said the shift to PDPM right before COVID-19 combined with the staffing shortage has led to many operators incorrectly filling out or missing MDS reports and therefore missing significant dollars in reimbursement.

“I think there’s just less nursing,” he explained. “It’s like a self-fulfilling prophecy, you get people leaving the floor and you grab a nurse who is used to more administrative work. It’s challenging.”

Seeing a need in the industry among skilled nursing operators, Zimmet started offering temporary MDS staffing assistance last winter and the service has taken off since then.

“What we’re seeing is that operators are months behind on their MDS assessment,” Michael Sciacca, chief operating officer for Zimmet, said. “For those facilities that are behind, Zimmet comes in and helps with the assessment.”

In some instances Sciacca has worked with operators that had an MDS coordinator leave, and their assessments were left unfilled for a number of weeks.

If MDS assessments aren’t completed, there can be regulatory concerns as the RAI (resident assessment instrument) process is interrupted — which includes developing care plans based on the MDS.

For Morris MDS coordinators are vital to her operations not just for the financial component, but to ensure her patients are getting the care they need.

“We drive a lot of care off the MDS,” she explained. “Certainly from the financial perspective they make a huge difference but if you look at the intent related to the MDS, which is a clinical focus, they’re vitally important to what we do.”

Glat said bringing Zimmet in to help with his MDS assessment was a “no-brainer” for his organization.

“When I saw this service to outsource MDS, I saw it as an opportunity,” he said. “They’re the experts that specialize in accurate and compliant capture for PDPM.”

He said it allows him to keep his clinicians focused on patient care and less worried about administrative paperwork.