Ten Immediate Steps for MDS 3.0 & RUG-IV

It is vital to develop a team laced with MDS expertise, critical analysis skills, and teaching/training abilities.  Begin by constructing a plan well in advance of the October 1, 2010 start date.  Here are ten steps to work on immediately:

  1. Provide MDS 3.0 and RUG-IV training for entire interdisciplinary team and any other identified staff members…more than once!
  2. Align software vendors.
    • Create a testing and transition plan with an ability to “practice” prior to October 1.
    • Report capabilities (scheduling, RUG-IV data, clinical analysis of data)
    • Determine how future updates will be handled and in what timeframe.
  3. Delineate clear roles with specific job descriptions.
    • MDS Coordinator
    • MDS section assignments
  4. Assess and provide education and competency testing.
    • Wound assessment and management.  Recommend certification courses be offered for clinical expertise
    • Interviewing techniques
    • AANAC certification
  5. Analyze staffing needs.  The new Discharge Assessments will require 1.5 to 2 hours to complete.  What are your discharge patterns monthly?
  6. Scrutinize facility clinical assessment and documentation systems to assure alignment with MDS 3.0 items.  Care Plan integrity relies on these core systems:
    • ADLs
    • Skin
    • Changes in condition
    • Falls
    • Behaviors
  7. Review facility policies and standards of practice for correlation with MDS 3.0 content.
    • Pain, skin, falls, restraints 
    • Restorative nursing
    • Therapy practices
    • Transmission of assessments
  8. Evaluate facility processes to help streamline financial and clinical outcomes.
    • Set up daily stand-up, daily reimbursement, and other clinical meetings that allow for thorough interdisciplinary review of resident changes and ongoing needs.
    • “Hard” vs. electronic copies of the MDS maintained?
    • Electronic vs. handwritten signatures?
  9. Identify equipment needs for efficient work processes.
    • Hearing enhancement devices to assist with resident interviewing and increase resident Quality of Life
    • Cue cards to aid with resident interviewing and improve more accurate responses
    • Adequate number of computers or “ports” for data entry in light of the expected increased number of assessments
  10. Build a validation audit process to ensure data accuracy and integrity as well as an ongoing quality plan for Improvement process. This will help to secure successful financial, quality of care, and quality of life outcomes!

As with any change, it is always good to be prepared for resistance as it is a natural tendency.  However, it is up to you to channel that energy into a fruitful and positive outcome.  Full commitment to high expectations in an atmosphere of resident-centered care will trickle down to your team and staff affording quality survey outcomes, resident and staff satisfaction and quality of life for everyone.

Want more information? Register for this complimentary webinar July 14th: http://bit.ly/bszXK6

Link to the full white paper by Lisa: http://bit.ly/9mH1u4

Posted by:  Lisa Hohlbein RN, RAC-CT, MSCN
Manager of Clinical Consulting