Latest / The Shift Ahead with Ken Bell / MDS Is Everyone’s Business with Sarah Becker
Transcript
- speaker-0: I would say the most dangerous assumption that ⁓ SNP leaders have about their MDS and in process is that the MDS knows everything. speaker-1: I'm Ken Bell with Careability, and this is the shift ahead. Five minutes, three questions, and one expert, helping operators and clinicians prepare for what's coming next. Let's get into it. As CMS continues to tie reimbursement quality staffing and surveys more closely together, what should SNF leaders be thinking about differently? speaker-0: So as CMS ties everything together, I think sniff leaders need to look at the fact that the MDS is where clinical, operational quality, and financial story of the resident comes together into one piece. I do think that there's a misconception that MDS is just ⁓ MDS responsibility and we have to stop managing in silos. When we are delegating different things and we're saying, hey, nursing, go do this and MDS, go do this, and therapy, can you go do this? And we aren't coming together to see what happened and how we resolved that issue. Then the assumption maybe by the administrator executive director is, okay, they handled it. I'm good. And then these reports come out and they're saying, Wait, what happened? Why does it say this? What's happening? Having them not just understand, ⁓ we're a three star facility, whatever that means, you know, and that can happen where the staff down to the staff on the floor, they don't know what that means. They just smile that it's probably you want to be a five star, like a five star vote or just a three star, you know. And so they're just trying to interpret that data in their mind with the knowledge that they have. We're bringing them into that conversation as well. Then we have everybody on the same page and we're working towards the same goals. speaker-1: Where do you most often see gaps between what's happening clinically and what gets reflected later in the MDS and the in reimbursement? speaker-0: I would say in my experience with the clients that I'm working with, the common story that comes up over and over again is Section G G. Nesset functional abilities with the residents. What can the resident do on different levels? What the staff assist do they need? What's their usual performance? And it's not that we're not giving that care, because we know we are. We're giving that care every single day. We need education on how to code that pair properly. And we're depending on CNAs many times and nurses to do that. And as the LDS coordinator, we only know those things. Our DON knows, our administrator knows, social service even knows what it means. But the CNAs and nurses who are documenting that information don't know. And we're not able to then get the information that we need. What I find a lot of times is staff will measure what they do for a resident. based on how much they do. If all they have to do is kind of guide them around, they look at them as independent people. They're not independent though. You're still guiding them, you're supervising them. That's a different score on G G. We have to make sure they understand how to code it. We can't take the information and think that it's absolutely correct if we didn't do the education. And we need to understand it as we go out and watch that care being delivered. speaker-1: What's the biggest shift in skilled nursing that operators should be preparing for now? speaker-0: The margin for error is getting smaller. We have to think beyond even the CMS headlines, the MDS accuracy, the case mixed scrutiny that we're under right now, the value-based purchasing with the financial impacts. And we see that keeps growing as well. The different things that they're adding to those measures. The timeline is getting shorter. And then their CMS is increasingly using your own data. To measure your performance. And they want to make sure that we are reporting accurately what's happening. We're always asking for winning in our budget. Well, we have to prove our care and our value and give our residents what they need in order to get that. So they're making sure that what we're saying we're doing, that we're actually doing before they decide to pay us. I think that's where scripting is coming from. So just remembering that what happens at the bedside. doesn't stay at the bedside. It ultimately shows up in your data.