afadel

I just attended a presentation at the AANAC Fall Conference in Louisville. The most recent proposed version of the RAI, MDS 3.0, relies more on resident self-reporting. In theory, it should be faster to complete than the MDS 2.0. But most people did not believe MDS 3.0 would be implemented before 2009.

The above advice is very good. I used to work at a help desk in a case mix state. I compared the MDS coordinator position to the machine gunner in the French foreign legion movies-they usually did not last that long. The most common complaint I heard from MDS coordinators who quit their jobs was that the owner/administrator wanted the MDS coordinator to also work as the DON or ADON or on the floor. For all but the smallest facilities, I don't see how the MDS coordinator can be anything less than full-time. Before accepting a position, you may want to find out the MDS schedule in the first month you'll be there. Oftentimes, because of problems in the facility, the owner may want the new coordinator to do comprehensive assessments on every resident in the facility. This is obviously a lot of work and you should ask for help in those kinds of extreme circumstances.

To switch from using the full assessment to the MPAF form for your medicare assessments, you should contact your MDS software vendor and ask if its software supports the newer, shorter form. As far as whether to use the MPAF for your Medicare 5-day assessments, there are different schools of thought on that. Some people combine the Admission assessment with a Medicare 5-day, in which case you'd need to complete 10 pages and RAPs and Care Plan and submit the assessment with AA8a = "01" and AA8a = "1". If the resident discharges prior to day 14, you would then not do the RAPs and Care Plan and submit it as a AA8a="00" and AA8b ="1". The advantage of this approach is the facility can set the assessment reference date in the grace day period for both the Medicare 5-day and the Medicare 14-day. I believe CMS is tolerant of use of grace days on the Medicare 5-day and less tolerant of its use on the Medicare 14-day. Does anybody have any experience with this? The other theory is to delay the comprehensive admission assessment to combine it with the Medicare 14-day. The advantage of this is you do less work since you never even start the full assessment form if the resident discharges before day 14. The disadvantage is that you must have your assessment reference date on day 14 or earlier. Ideally, the facility MDS coordinator would use whichever combination would give the best information for resident care and Medicare reimbursement.