Long Term Care Administrators and MDS 3.0 - How to Provide Facts, Calm Fears, and Ease Frustrations

When PPS altered the quality and reimbursement standards for long term care twelve years ago, I was a practicing Occupational Therapy Assistant. After PPS was introduced and implemented, a widespread panic emerged throughout the therapy world. Many therapists left the field all together simply because the stress, frustrations, and unknown facts about PPS were overwhelming.

MDS 3.0 is completely different than when we transitioned to PPS. Nevertheless, the angst of this change in our industry has been feared by many. As an administrator, I knew that in order to make the transition smooth, I needed to prepare my team. To best ready them for the change, I trained them, educated them, communicated with them and attempted to calm their anxieties well before MDS 3.0 went into effect. We installed and updated software changes to transmit accurately. Therapy and MDS staffing hours were increased to allow for additional time to provide treatment and assessments. Lastly, clinical and financial outcome projections were assessed and calculated, and shared with the team.

Preparing our leadership team came with many frustrating days. The unknown made it hard to launch a clear systematic change to our structure. We consistently disputed hypothetical challenges and found it hard to discuss these obstacles with one another. Their questions, concerns, fears and frustrations only made me step up more as their leader and go through the transition with them. Through it all, the strength of their own leadership emerged.

The MDS 3.0 can have a significant impact on the day-to-day operations of a facility. The changes to qualifiers, ADL scores, and acuity levels can impact and significantly influence direct care, clinical outcomes, and financial success. Before MDS 3.0, concurrent therapy had become a standard of practice in the industry. It was by luck that we were already prepared for this change by seldom practicing this therapy delivery model and by increasing our therapy days of operation to seven days.

The other area of strong impact as a result of MDS 3.0 is the changes to resident acuity level. The shift with MDS 3.0 transferred the acuity level weighted to nursing and not therapy. What does this shift mean to us as facility administrators in terms of our clinical outcomes and financial indicators? It means winning outcomes! If the residents are assessed and documented correctly, clinical outcomes will improve and financial gains will be made. It is all in how the information is taught, processed, and carried out by your team.

We are still recovering from the October 1 implementation of MDS 3.0. As an administrator, through education and communication, I was able to teach the facts, calm the fears, and ease the frustrations of our clinical, therapy, and financial team members. Because MDS 3.0 globally affected the entire team, it strengthened our leadership and facility processes. As a team, we have embraced MDS 3.0 and as a result, we are now more focused on our future and the future direction of the facility.