90% of Skilled Nursing Pros Say Reimbursement Will Suffer Due to Labor Issues

As critical staffing shortages are leading some operators to rethink how and where their MDS documentation needs to be completed, turnover at the MDS coordinator role continues to hamper providers and their ability to capitalize on clinical reimbursement.

In a survey of about 500 SNF professionals, as many as 60% of respondents said they had experienced MDS related turnover in the past six months and that the trend is expected to continue.

The survey from HealthPRO Heritage and MedaSync asked professionals representing a wide range of responsibilities and perspectives throughout the sector to share their thoughts on some of the top clinical reimbursement concerns in the industry today.


With tightening margins, understanding clinical reimbursement may be more critical than ever. However, too often MDS coordinators are being called to the floor to provide care and for some, that’s not how they want to be spending their time.

Among the respondents, 90% indicated that resource challenges – such as reimbursement staff turnover, mounting care coverage responsibilities for key staff or not having time to “get it right” – have or will have a negative impact on reimbursement for their organization going forward.

Workforce availability, time, attention and expertise were among the top reimbursement-related concerns, according to the survey.


Wendy Strain, director of consulting services for the Polaris Group, a company that provides offsite MDS coordinators to long-term care communities, recently told Skilled Nursing News workforce challenges have led some facilities to fall months behind on their MDS documentation, while others have expressed concerns that SNFs are leaving money on the table.

Medasync/HealthPRO Heritage study

One popular solution to help SNFs with reimbursement requirements is to use remote services. In fact, more than half of the survey respondents indicated they would turn to technology and consultant solutions to off-set workforce related challenges with their reimbursement teams.

A majority, 65%, expressed apprehension about their current systems and processes, however. Increases in managed care penetration and current Medicaid rates also ranked as the top concerns by survey participants.

The most common tactic to recruit and retain MDS team members was reported to be higher wages (at 49%), with sign-on bonuses, company culture initiatives and paid job listings all receiving some votes.

Nearly three-quarter of respondents (74%) were either moderately or very concerned about having adequate resources in place to manage a multi-payer system, with 65% admitting concerns about their current system’s ability to prevent missed reimbursement.

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