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MDS 3.0 Concepts for All SNF Staff

Many nurses are choosing the career of MDS Management in Skilled Nursing Facilities

RNs and LPNs in skilled nursing are continuously seeking to advance and for opportunity. Some have realized the MDS 3.0 has become a major component to Skilled Nursing vitality. The MDS has sparked a peak of interest among the nursing staff.

SNF nurses are reporting a desire to learn more regarding the MDS changes within the industry

Nurse managers, charge nurses, along with Director and Assistant Director of Nurses are expressing a desire to fully understand how the MDS 3.0 truly effects each department.  With multiple in-services and training sessions on a regular basis, SNF staff has become exposed to MDS 3.0 lingo and the recent changes effecting nursing departments.

Here are few reasons why learning  the  MDS 3.0 Concepts is important for all SNF team members.

The MDS 3.0 is dynamic and reports care across multiple departments

The MDS 3.0 reports care such as ADLs, wounds, therapy services, mood and behaviors.  Knowledge on specific guidelines surrounding capturing these services for coding the MDS is key.  Proper supporting documentation is necessary to survive state and federal audits. 

The Better the Understanding. The Better is the supporting documentation

We have all heard of the saying knowledge is power. Well it is true. The more information that we can empower our IDT and nursing staff with the more that they will be able to grasp the federal (Medicare A) & State regulatory requirements to verify care services rendered. 

We have witnessed time and time again, nurses reporting that they wished they would have known MDS regulations a long time ago. It would have made a dramatic difference in the depths of the resident care charting.

MDS accuracy effects the Skilled Nursing Home 5 Star Rating Program. 

The nursing home Five-Star Quality Rating System for SNF has three major components. Staffing, Health Inspections, and Quality Measures. Quality Measures report statistics driven from MDS 3.0 Data.  Inaccurate staff charting might lead to inaccurate MDS coding which in turn may lead to inaccuracies in Quality Measure reporting. Remember, the Quality Measure data will effect your facility SNF Five-Star Quality Rating System. 

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Five-Star Quality Rating System Changes

Changes to the Skilled Nursing Home Five-Star Rating Program effective October 2019

According to Centers for Medicare & Medicaid Services (CMS):

CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily and to help identify areas about which you may want to ask questions.

The Nursing Home Compare Web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.  There is one Overall 5-star rating for each nursing home, and a separate rating for each of the following three sources of information:

  • Health Inspections – The health inspection rating contains the 3 most recent health inspections and investigations due to complaints.  This information is gathered by trained, objective inspectors who go onsite to the nursing home and follow a specific process to determine the extent to which a nursing home has met Medicaid and Medicare’s minimum quality requirements.  The most recent survey findings are weighted more than the prior year.
  • Staffing – The staffing rating has information about the number of hours of care provided on average to each resident each day by nursing staff.  This rating considers differences in the levels of residents’ care need in each nursing home.  For example, a nursing home with residents who had more severe needs would be expected to have more nursing staff than a nursing home where the resident needs were not as high.
  • Quality Measures (QMs) – The quality measure rating has information on 15 different physical and clinical measures for nursing home residents.  The QMs offer information about how well nursing homes are caring for their residents’ physical and clinical needs.

Check out this PDF for details on these changes: 

Nursing Home Compare Update Schedule:

Normally, the Nursing Home Compare website and Five Star Quality Rating System are updated the last Wednesday of each month. However, due to the holidays (Thanksgiving, Christmas, and
New Year’s Day), the website and rating system will not be updated on its normal schedule.

Below are the dates of the updates over the next few months:

  • October 23, 2019
  • December 4, 2019
  • January 29, 2020
    Future updates will continue to occur on the last Wednesday of each month.
Always refer to for the most updated information.

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Nursing Home Dialysis Demand Drives Post-PDPM Push to Specialty Services

Dialysis services have recently been highlighted as a major growth area under the new Patient Driven Payment Model (PDPM)

both financially and clinically — especially as reimbursements are recalibrated for higher acuity patients.

In July, the Centers for Medicare & Medicaid Services (CMS) rolled out the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) model, a plan that would increase dialysis treatment reimbursements.

Operators and third-party dialysis companies have diligently prepared for both payment shifts,

with technological innovations involving upgraded bedside dialysis units and increased staffing and training to help partners provide improved care for residents.

Concerto Renal Services. for example, announced it that it’s currently in the fourth of six consecutive weeks of new unit openings, welcoming Bella Terra Morton Grove in Illinois as the latest of Concerto’s SNF dialysis partnerships.

On the heels of these increased partnerships, Concerto chief executive officer Shimmy Meystel described an uptick in higher acuity skilled nursing partners throughout the calendar year 2019, as well as just a few months into PDPM.

“Most of our operator partners have been preparing for PDPM for some time, which has meant reorienting many of its internal processes the last year to better prepare its staff and systems for higher acuities,” Meystel said. “We’re along for the ride in that respect, as our partners depend on us to assist them with the transition.”

Check out the full write up of this article from Skilled Nursing News

Nursing Home Dialysis Demand Drives Post-PDPM Push to Specialty Services


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Patient Driven Payment Model – PDPM FAQ

CMS finalized a new case-mix classification model

The Patient Driven Payment Model (PDPM) was implemented for Skilled Nursing Facilities effective October 1, 2019. This new model was major shift in the previous system of reimbursement presented by Medicare Part A.

PDPM Frequently Asked Questions

This section contains frequently asked questions (FAQs) related to PDPM policy and implementation.

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PDPM Resources

This section includes additional resources relevant to PDPM implementation, including various coding crosswalks and classification logic.

PDPM Education & Training Click Here

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