Pandemic impacts on staffing shortages continue to burden many healthcare sectors and long term care facilities are especially feeling the constricting effects. In addition to long term care facility front line staff and support staff shortages the MDS Coordinator position, a very limited and specific skill set position, is seeing significant turnover in the current post pandemic environment. Due to what are being described as increased workload burdens and stressors many MDS Coordinators continue to vacate positions in order to transition to a different facility with the hope of realizing a more favorable work place.Many other MDS Coordinators have opted to leave the facility brick and mortar healthcare space altogether in order to work safely and remotely from the confines of home. In many long term care facilities the MDS Coordinator position has evolved into the role of facility gatekeeper, responsible for ensuring appropriate facility reimbursement, compliance and even care quality. 

The increase in workload burdens and stressors for the MDS Coordinator can likely be traced back to many new initiatives in LTC. One example of this is the inception of the Patient Driven Payment Model (PDPM) reimbursement methodology for Medicare Part A services implemented on October 1, 2019. The PDPM model replaced the RUGS- IV reimbursement model in order to institute a system that better captures patient characteristics and clinical needs for a patient covered in a Part A stay rather than a system that reimbursed facilities essentially for the amount of service volume provided.PDPM is a very demanding methodology for information gathering, information review, diagnosis identifying and scoring accuracies all needed for appropriate reimbursement.With all of the information that goes into the PDPM methodology a clinical team collaboration is a necessity in this model to ensure accuracies that impact reimbursement, compliance and care. 

Facilities who perpetuate inefficient PDPM processes are inadvertently placing significant burdens on their MDS Coordinators.Facilities that implement a non- collaborative approach to PDPM have left the MDS Coordinator to complete PDPM work in a silo, amounting to increased pressures often from back end information gathering and re-work that jeopardizes PDPM accuracies and timely MDS submissions. 

The COVID-19 PHE has also been a significant contributor in adding to the MDS Coordinator workload burden and stress. During the PHE many MDS Coordinators were utilized in other important roles at their facilities in addition to their main MDS Coordinator duties.Like other staff members during the pandemic many MDS Coordinators also feared catching the virus themselves and bringing it home to friends or loved ones. 

Today, if facilities do have the luxury of regional MDS support in place they are obviously better equipped to handle MDS Coordinator staff turnover. But, many facilities do not have this resource and this places many long term care facilities at significant risk at a time when they can ill afford it.Yes, there are certainly so many issues that need to be addressed in long term care facilities even as we see a spike in COVID-19 numbers. 

But, the all- important role of the MDS Coordinator needs to be a major focus right now.Facility investment in maintaining the valued MDS Coordinator position and employing sound PDPM and other MDS related processes have to be a priority. Further disruptions in reimbursement, compliance and care quality are simply untenable.

Microscope can assist with your MDS support needs including comprehensive remote MDS Management, MDS Process Reviews, Training and Education, Audit Assist and more. Contact us today!

Article written by Michael Masse


For information on Continuing Care & Long Term Care, please reach out to our Senior Director:

Michael F. Masse, OTR/L

mmasse(at) / 607.316.6576

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