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MDS 3.0 Transition Checklist: Top 10 Areas to Address

  
  
  
MDS 3.0

The utilization of MDS 3.0 is set for October 1, 2010.  The new assessment will bring significant changes to the way long-term care providers operate on a daily basis.  While all of the changes within MDS 3.0 have been established to promote the highest quality of care, proper steps must be taken by providers to ensure the goal of MDS 3.0 is achieved.

Proper preparation for MDS 3.0 is critical.  How a facility implements the MDS 3.0 will impact:

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    • Accuracy of the data that surveyors and third party medical record auditors review.
    • Representation of the Quality of Care as impacted by the QI/QM and impact to 5 star rating.
    • Appropriate reimbursement for the care provided in the facility.

The following can be utilized as a basic checklist of top 10 transition areas that should be addressed to properly prepare for MDS 3.0.

1. Leadership

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    • Transition Leader in place with necessary skill set to manage a project this large. May need two individuals, one MDS, one RUG IV
    • Facility Timeline for MDS 3.0 in place and public knowledge of timeline
    • Resources Allocated: Budgetary (Educational costs, Hardware costs, Physical environment changes, Resource Manuals, will you need translators?)
    • Resources Allocated: Personnel: workload?
    • Involvement: Residents, Families, Providers, Staff, Consultants, Survey team. Do not forget the important role of the C.N.A.
    • Communication Plan in place including marketing the new Tool: My Minimum Data, include all referral sources, providers, family and residents.
    • Connect with your Project Manager or Customer Service Representative regarding plan to go live with current Vision release.
    • Send your MDS Coordinator to classes on MDS 3.0; Business Managers to classes on RUG IV.

2. MDS 3.0 and Assessment Schedules

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    • Analyze the affects of coding changes, look-back periods, supportive documentation, and time to complete assessment as it impact assessment processes in place in facility.
    • Vision set up plan developed and tested
    • Vision testing of MDS, reports, and widgets
    • Vision testing on ability to transmit to MDS Verification Software vendor
    • Assign individuals to sections of the MDS include interviews
    • Staff Education on the change (Depression scale, CAM, PUSH tool and interviews). Reserve at least hours in September devoted to this activity.
    • Plan complete with scenarios to address Setting the Assessment Reference Date
    • Education of Management staff on MDS widgets and reports to mitigate risk
    • Where necessary changes made in General Orientation Educational materials.
    • Communication Plan in Place regarding ARD selection, daily meetings set up to manage the process
    • Update any touch screen forms that may have MDS 2.0 data on them, along with any other forms.

3. Interviews

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    • Staff Identified to conduct interviews
    • Modifications in Job Descriptions made to accommodate interviewing responsibilities and skill set
    • Education in interviews
    • Mock interviews conducted with a variety of resident conditions
    • Alternate Interview Location Identified
    • Accommodation Plan in Place for Residents with Hearing or Communication Needs, do you have a hearing amplification device?

4. Therapy Delivery System

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    • Determine how much concurrent therapy is currently being done. KNOW IT NOW!!! ADJUST where needed now.
    • Change made in therapy delivery system as necessary, hours adjusted?
    • MDS RUG Visualize on Home page of key staff members to monitor minutes.
    • MDS RUG Utilization benchmarks established and on Home Page of key staff members
    • Projections on Length of Stay in place and impact on discharge.

5. Restorative Program

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    • Seamless integration of restorative program with therapy.
    • Programs assessed and revised as needed.

6. Clinical Documentation to Support MDS

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    • Documentation Program: Referral Management
    • Documentation Program: Cognitive Management
    • Documentation Program: Mood and Behavior Management including on-going assessment tools/flow sheets
    • Documentation Program: Pain Management including on-going assessment tools/flow sheets
    • Documentation Program: Bowel and Bladder Management
    • Documentation Program: Skin Management including use of PUSH tool
    • Documentation Program: Accident Prevention including Fall Risk Assessment
    • Supportive Documentation: Assessments/Flow sheets/Clinical Notes/Benchmark Outcomes
    • Update any policies that contain MDS 2.0 reference
    • Education on Documentation.

7. Admission and Discharge Processes

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    • Workflow all existing processes
    • Changes made where necessary with existing processes
    • Plan in place to address Medicare Short Term Stay Residents
    • Resident and family satisfaction surveys with the admission through discharge experience in place.

8. Referral

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    • Referral process in place with identified responsible person for each resident.
    • Referral Networks in Place
    • Necessary Equipment available for home going skill training
    • Necessary Educational Resources available to staff, resident and families.
    • Discharge Care Plan library addresses referral management.

9. Submission

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    • Organizational process for submission reviewed and changes made as needed to comply with new transition timelines.
    • 14 day rule: Staff education on new submission criteria
    • More than one person with the facility ID and password for MDS submission
    • More than one person prepared to deal with rejected records/errors and new criteria for correction. Staff member has in-depth knowledge on reading validation reports, understanding how to identify and troubleshoot fatal errors.
    • Process in place to deal with rejected records/errors and need for additional assessments.

10. QA Plan and Outcomes

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    • Survey Preparedness: Ready for surveys that do not rely on QM/QI but on 802/672 that are not matched to MDS 3.0.
    • Benchmarks established for RUG Utilization and incorporated into MDS RUG Utilization Widget
    • Vision Home Page: Set up for Managers with MDS RUG Utilization Widget, MDS Tracker, MDS At Risk Snapshot
    • Conduct MDS 3.0 Mock Survey with team
    • Outcome Measures: Avoiding Rehospitalization (will also need to define this for your organization)
    • Outcome Measures: Referral Network
    • Outcome Measures: Rehab Resident Outcomes and delivery (Are you discharge to a safe home environment). Outcome where possible linked to Avoiding Rehospitalization
    • MDS Audits: Post analysis of MDS in terms of Setting the ARD Date "properly" (look back period capture, RUG capture)
    • MDS Audits: % of MDS with resident interviews being conducts
    • MDS Audits: Rule of 3 and monitoring use of 7
    • MDS Audits: % of MDS with rejections or needing corrections
    • MDS Audits: Depression Scoring
    • RUG Utilization: Benchmarking Default days

HealthMEDX has provided a white paper on MDS 3.0 with more details on how to prepare for the transition and what it will mean for long-term care providers.  The white paper can be accessed by clicking here

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