Hi, I'm an MDS coordinator, and as an acute care nurse, you would have no reason to know what that is, but my job is to provide clinical information to CMS for reimbursement. We have several levels of care in nursing facilities, and when a person comes for skilled care, it is my job to reconcile the admission diagnosis with the hospital stay, as we are considered a continuation of the hospital stay. This is true even for residents who live all the time in our building, but have come to the hospital for acute illness and return to us at a "skilled" level for a short period of time. I also have to report to CMS changes in wounds (sometimes every 7 days) so if I have measurements on discharge from the hospital, and no one in our facility measures the wound til the next day, I can tell if there has been a significant change. In my role, in addition to an admission assessment, I am responsible for the total plan of care, and the more information in that packet, the less invasive I have to be to my co-workers fighting for the chart. Also in the event of some skilled admissions, there is a "look-back" period that extends back into the hospital stay for surgery, ventilators, oxygen, IV meds, transfusions, Bi-Paps, you name it, that CMS expects us to address on admission. Functional assessments from PT/OT and ST or swallow studies are pure GOLD. Since we are usually an extension of the hospital stay, it is common sense that we need all the records from the stay. Hospitals are famous for forgetting to mention that the sitter was still in place on discharge (not really "legal" for us to accept) or leaving out the nursing documentation that the patient has a large, involved family who mostly don't speak English (we need more time to arrange translators,) and other social information that is critical to make the patient confident that we know what we are doing. ALSO, the industry standard for answering call lights is very different than the hospital setting, and people are rarely ever prepared for that. Hope this helps a little.