Long-term care rules and regulations have been changing at a fast and furious pace over the past few years. Often, changes can happen so quickly that it can be nearly impossible to train staff and update processes in time to stay current. At Richter, we have seen this burden play out across all skilled nursing facilities (SNFs), from independent homes to small and large chains alike.

SNFs track literally dozens of clinical, financial standards and quality measures for internal benchmarking, as well as for reporting to and compliance with governmental agencies. Given the large volume of data generated by SNFs of all sizes, and the myriad ways such data could be utilized, Richter’s clinical consulting services team recently undertook a process to create performance initiatives that target five high-risk areas in the SNF setting and provide proactive mitigation of those risks.

In this blog, we shine the spotlight on the first area: MDS errors.

For SNFs of all sizes, MDS accuracy helps to ensure proper care planning, accurate and timely payment and accurate quality indicators. To that end, SNF facility administrators and nurse executives play a key role in monitoring MDS accuracy, systems and timeliness.

MDS errors can be frustrating to your team. In SNF facilities throughout the country, we see similar errors occurring in MDS coding. Many MDS nurses are making significant coding errors, and often, they aren’t even aware that it is occurring. Without an outside audit, it’s likely the same mistakes will be made time and time again.

What are the benefits of decreasing MDS errors, and striving for MDS accuracy?

1. Identifying issues early can decrease the likelihood of survey citations, complaint substantiation and post-payment recoupment.
2. Decreasing MDS errors can increase overall reimbursement.
3. Doing so can help identify coding issues to improve Five-Star rating and Quality Measures.
4. It can decrease the time it takes for your facility to receive payments.

While there are several strategies for decreasing MDS errors, one way to begin down that path is by developing a robust auditing system to ensure appropriate coding for PDPM reimbursement. For example, review your documented NTA and speech comorbidities against the CMS crosswalks to ensure that diagnosis coding specificity is accurately captured for PDPM.

Contact Richter

Do you have questions about reducing MDS areas, the five SNF target areas identified by Richter, or other clinical challenges? Read our e-book, “Optimizing Five Target Areas in Skilled Nursing Facilities – Your Key to Success” or call Richter’s skilled nursing facility consultants at 866-806-0799 to schedule a free consultation.

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