Long-Term Care

Tip of the week: Motivating staff to complete the MDS on time

Contemporary Long-Term Care Weekly, December 13, 2007

Source PPS Alert for Long-Term Care, May 1999

Nancy Foltin is a registered nurse, but when reimbursement became tied to the Minimum Data Set (MDS), she found that much of her time was no longer spent on nursing.

Instead, Foltin, MDS coordinator at a 32-bed skilled nursing facility at Gottlieb Memorial Hospital in Melrose Park, IL, was busy chasing down staff members to make sure MDSs were signed and submitted on time. Sound familiar? It should. One of the biggest challenges MDS coordinators face is rounding up staff members for their MDSs.

How Gottlieb handled it

In a brainstorming session, hospital administrators decided to issue weekly report cards outlining whether staff members - including those in nursing, therapy, dietary, and social services - had completed the MDS and signed it by their given deadline. "We wanted to take this monkey off Nancy's back," explains Connie Clark, RN, MS, MSIR, CNAA, vice president of nursing at Gottlieb Memorial Hospital. "She was spending a great deal of her time reminding people that they needed to complete their part of the MDS. Now she is able to go on to the next level."

Results came quickly

Foltin estimates that before the report card evaluations began more than half of the interdisciplinary team did not meet its MDS deadlines. Now, compliance nears 100%.

"Before, the MDS was just about the last thing staff members did," Foltin says. "Now MDSs are almost always on time."

It works like this: The day before an MDS must be completed, team members receive an e-mail from Foltin telling them what type of assessment is due the next day, and at what time the assessment is due. Report cards are issued for 5-, 14-, and 30-day MDSs. Tardiness in completion of the Resident Assessment Protocols is also recorded.

Foltin then plugs in the Assessment Reference Date for staff members the day before the MDS is due. One discipline at a time, staff members complete their section of the MDS. Then, staff are graded. One report card ensures completion of the MDS and another ensures that it was signed on time. Report cards identify employees by code, not name, and are issued to managers and staff. Resident names are also kept confidential. Once the MDS is completed, team members get another e-mail,telling them it's time to sign off on their portion of the MDS. To make sure staff members meet that deadline, a second report card is issued grading staff on timeliness.

Foltin estimates that the report card system reduces about six hours of work each week. She says that leaves her more time for other important MDS activities such as training, double-checking MDS information, and following up with nurses regarding care plans. And there's one more benefit, she says: "I'm no longer here until 7 p.m. every night."

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