mds 3.0 the old west wisdom affinity health services, inc. august 2010 denise mcquown-hatter...

MDS 3.0 The Old West Wisdom

Affinity Health Services, Inc. August 2010

Denise McQuown-HatterPresident

MDS 3.0

• Powerful document with implications for:– Resident– Families– Providers – (all providers)– Researchers– Policymakers– Regulators– Government Payers

“Love your enemies and keep your gun oiled”


Why MDS 3.0?

• Improvements over the current 2.0– Gives Resident Voice– Increases clinical relevance– Increases accuracy– Increases clarity– Reduces time to complete

“If your horse doesn’t want to go there, neither do you”


What does it mean to providers?

• Quality of Care• Proven tools and best practices

• Quality of Life• Resident Voice• I - Centered Care Plans

• RegulatorsDepartment of Health/QIS

• ReimbursementMedicare $$$

“Wearing gloves and button-fly jeans means you better think ahead”


State Veterans Homes - Specific

• MDS 2.0 versus 3.0• VA Data Collection/Benchmarking• Consistent with Mission/Resident Centered Care• Active Resident Counsel population• On-going software support• Funding Construction Grants that fosters resident

centered care“A word to the wise is unnecessary”


MDS/Reimbursement

• Certified versus Non Certified– MDS may look different in Certified

Homes/reimbursement guidelines must be met– Level of documentation

• Support the level of payment– ADL coding– Therapy– Significant Changes

– Policies and Procedures• Supports the survey process

“Never kick a cow chip on a hot day”


How do you plan to implement?

• START NOW• DEVISE A PLAN• Include in the Plan:

– Management training– Interdisciplinary Team training– Front line training– Include Resident’s Counsel– Include Family Counsels

“You don’t learn much when everything goes right”


The Softer Side of MDS Resident Voice – Person Directed Models• Communication

– Interview techniques – train staff – Customer Service– Private Interviews – location

• Psychosocial Well-Being• Activities of Daily Living• Activity Pursuit Pattern• Resident Participation in Care Planning

– Person conducting interview has to successfully communicate to the team

– Leads to I-Centered Care Plans

“The measure of a man is when he does the right thing even when no one is watching”


Resident Voice• How do your front line staff react?• How do we implement their wishes after

implementing the 3.0?• How are you currently implementing their

wishes?• How do you deal with your labor issues in terms

of flexibility with routines?• How far along is your home with resident

centered care?

“Some people grin and bear it. Other people smile and change it.”


I Centered Care Plans

MDS - Current• Considered as “added

paperwork”• Seems cold, harsh• Rush to complete the

document in the required time line

• “Mostly” Clinical Model based

“Nobody ever drowned himself in his own sweat”

MDS - Future• Set up appointment with

resident in advance – giving the resident control

• Accurate and more descriptive MDS starts a true resident centered care plan

• Active listening and resident/family participation


I Centered Care Plan

• A.M. / P.M. CARE: – I need extensive assist with my lower body care. I can take

care of my trunk and arms on my own if you set me up with warm water and a wet washcloth. I like to be near the sink and mirror to take my “sponge bath” every day. I get my hair done in the beauty shop every week. I don’t like it to get wet in between times. If my makeup is a little messy, please offer to assist me.

– Vs. Resident will have assistance with lower body care and will be provided with a wet washcloth etc.

“Go after life as if it’s something that’s got to be roped in a hurry before it gets away”


Thoughts to take home

• Take a care plan and remove all the patient and resident language and insert the residents name

• Video tape the care plan meeting for review by each of the caregivers

• Start the care plan on admission with admission personnel

“Some people follow wagon tracks while others break new trails”


Questions

Marcie Stoup - [email protected] Hatter - [email protected]

www.affinityhealthservices.net


mailto:[email protected]

mailto:[email protected]

http://www.affinityhealthservices.net/

“If life made sense, men would ride sidesaddle”

• Medicare A, B and D

– Its not all or nothing, but maybe something in between


Medicare Certification – Is it right for you?

• Medicare Part A– Discussion Points

• Admission Requirements• Available beds• Level of Care• Staff skill sets• Managed Care population

“You can’t keep trouble from visitin’, but you don’t have to offer it a chair”


Medicare Part B

• Predominately Therapy Services– Supplies– Vaccines– Equipment

• Therapy Options– Contract out the services – contractor bills – 0 cost to the

home– Certify as an outpatient clinic – bill for services

“Too much debt doubles the weight of your horse and puts another in control of the reins”


State Veterans Home Assumptions

• Similar in the fact that the shape of the Nursing Home Resident is changing– Higher acuity, shorter term, lower levels of care

• Services in lower levels of care can be handled differently with Medicare and other insurance dollars

• Pharmacy services – utilize Part D – contractor responsibility

“The quickest way to double your money is to fold it over and put it back in your packet”


Thank You

“A halo only needs to drop a few inches to become a noose”


Ph. 1-877-311-0110www.affinityhealthservices.net

mds 3.0 the old west wisdom affinity health services, inc. august 2010 denise mcquown-hatter...

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