What is MDS in Healthcare? How SNFs Can Leverage Resident Data

For those who oversee skilled nursing facilities, the Minimum Data Set (MDS) is a regular part of life. For facilities that serve residents covered by Medicare and Medicaid, the MDS is part of the SNF compliance requirements, issued at least once every three months to help gauge the overall wellness and care of residents. The long-term care assessments given as part of the MDS help measure functional and cognitive status, mobility, behavioral symptons, psychosocial functioning, symptoms of geriatric symptoms, diagnoses, and medications, among other things.

For the Centers for Medicare & Medicaid Services (CMS), the MDS provides a standardized assessment that can have a meaningful impact on long-term care residents, care-takers, and staff. And for SNFs, with the right approach, MDS data can be a crucial component in providing quality care, preventing infections and outbreaks, and maximizing reimbursements.

So, what is MDS in healthcare, and how can it optimize MDS data to benefit your organization?

What is MDS in healthcare? Understanding why data matters

While submitting the MDS once every three months is a requirement for SNFs, accurate MDS collection and submission isn’t just about maintaining SNF compliance requirements. The data collected through the MDS has a significant impact on reimbursement rates. Many states use the data to calculate the case mix score that helps determine SNF reimbursement, and Medicare’s Patient-Driven Patient Model uses the data to calculate reimbursements. In fact, as much as 95% of a facility’s reimbursement rate is connected with MDS data, which means that accurate data collection is essential for financial stability. Additionally, MDS-based quality indicators are used as quality measures and to issue five-star ratings, and MDS reports are used by surveyors to inform inspections.

Just as importantly, when properly leveraged, the MDS goes beyond compliance, accurate reimbursements, and quality ratings. The MDS can provide organizations with standardized assessments for residents that can be used to customize and improve the level of care. The data also can be used to identify areas of concern quickly; for example, if there is a sudden uptick in illnesses, the MDS data can help facility staff spot and address an outbreak before it becomes a widespread problem.

Understanding common MDS challenges

Despite its value, organizations can struggle to accurately capture data and maximize its use for a variety of reasons. Perhaps first and foremost among the challenges facing MDS data collection are staff and time considerations. Completing the MDS assessment process can be complex and time consuming, as it requires frontline nursing staff to gather input from residents, their caregivers, and facility staff. This means that organizations need to be sure that the staff responsible for compiling the MDS has the necessary skill and training.

Even when an organization hires someone fully qualified to handle MDS nurse responsibilities, challenges can still exist. Changing rules and regulations from the CMS can make it hard to meet SNF compliance requirements. And because of the depth and complexity of the data involved in the MDS, it can be extremely difficult for someone without a data background to analyze and utilize the data in ways that are meaningful to the organization.

The smarter way: Introducing MDS Intelligence

Organizations know that quality care, accurate reimbursements, and compliance depend on accurate MDS compilation and reporting. That means going beyond data scrubbers that may miss nuanced details of the datasets, may not be up-to-date with regulations, and that don’t fully utilize the data to provide important insights into resident care and infection prevention. That’s where Inovalon’s MDS Intelligence^TM can help.

MDS Intelligence is an MDS assessment software that helps skilled nursing organizations capture, report, and leverage the power of MDS data. MDS Intelligence begins by making sure that MDS data is accurate and meets SNF compliance requirements. From there, MDS Intelligence delivers meaningful insights that help organizations identify areas for improvement that would have the greatest impacts on resident care and revenue. It includes tools such as Clinical Watch pages to track resident trends, a PDPM Calculator to deliver insights into reimbursements at the facility and resident levels, Logic Flags that catch inconsistencies before MDS submission, and Survey Watch to help facilities optimize survey for CMS’s Care Compare ratings.

Organizations that have implemented MDS Intelligence have reported:

• Easier documentation
• Insights that lead to improved care
• Fewer inconsistencies in MDS submissions
• Opportunities for appropriate, reimbursable resident care
• Increases in revenue

Discover how to strengthen your organization with MDS Intelligence

SNFs are continually facing tight financial margins, and CMS is constantly refining and adjusting MDS reporting requirements. That means the stakes have never been higher for skilled nursing organizations to collect and leverage accurate care data. With compliance challenges and staffing shortages, old, manual processes no longer serve today’s skilled nursing facilities.

Organizations need smarter, faster ways to deliver the best care while maximizing reimbursements and maintaining compliance.

Discover how MDS Intelligence can help you leverage the data to move your organization forward.

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