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 MDS Tweaks Up Ante In Paperwork Wars

​Minimum Data Set (MDS) experts at major post-acute care provider Kindred Healthcare, Louisville, Ky., say the paperwork burden to meet MDS 3.0 system rules will grow by as much as 25 percent starting on Oct. 1, further upsetting providers who see staff spending valuable hours on assessment requirements instead of care-related assignments.
The Oct. 1 date is when the latest changes made by the Centers for Medicare & Medicaid Services (CMS) go into effect. Upcoming changes include the way therapy is billed and new codes related to the modifications.

Kindred’s expectation for another large increase in paperwork this coming year follows a 30 percent rise the previous year when the care management system initially switched from MDS 2.0 to MDS 3.0.

“This represents the second time in two years we’ve seen an increase in the number of assessments,” says Tami Johnson, director of case management for Kindred.
CMS sees the need for more assessments to validate the number of residents in long term care facilities receiving rehabilitation services, Johnson says. This is because of a disconnect between what is happening in post-acute care--more rehab, shorter stays--and what CMS thinks nursing facilities do, she adds.

“There is still a perception of what things were like 10 to 20 years ago,” Johnson says, noting in the new world of nursing care Kindred discharges 50 percent of its patients.

MDS 2.0 was replaced in 2010 with MDS 3.0 with the express goal of incorporating direct resident interviews into the process. The change has been good in many ways, Johnson says, but not the overly prescriptive assessment process.

Kindred has 225 facilities: Its MDS coordinators, social workers, nutritionists, and other staff spend a combined 37,000 hours a month filling out the electronic MDS 3.0 forms.

“In an average month, one Medicare patient in for 30 days will have three assessments taking 10 to 12 hours to complete,” Johnson says. That number is expected to increase two to three hours starting Oct. 1.
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