MDS Alert

What Do You Think?

Published on Sat Oct 02, 2004

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Question: Should the MDS coordinator report directly to the DON or to the administrator or assistant administrator?

Answer: "The administrator or assistant administrator should be in charge, and the MDS coordinator should answer to that person directly on RAI process issues," opines Rena Shephard, RN, MHA, FACDONA, president of RRS Healthcare Consulting in San Diego.

Shephard cites a number of reasons for her position on this issue:

The administrator is the "buck stops with me" person for payment and quality of care, which the MDS drives. And the administrator or assistant administrator carries a bigger stick than the DON in ensuring the interdisciplinary team complies with the MDS process. "If the MDS position falls under the DON in the chain of command, the MDS coordinator lacks the clout to negotiate effectively with interdisciplinary team members to get them to do their part of the MDS timely or accurately," says Shephard. "And the DON can't require the interdisciplinary team to comply either ... but the administrator can."

The MDS coordinator needs authority over the nursing staff to ensure they provide supporting documentation for the MDS. Some MDS nurses say they've talked to nursing staff about MDS-related documentation requirements until they are "blue in the face," Shephard tells Eli. But if the DON is in charge - and doesn't value or emphasize the documentation angle - the staff nurses may tune out the MDS coordinator's instructions in favor of their "bigger boss," the DON, Shephard relates

MDS coordinators who report to the administrator can collaborate with the DON more effectively, advises Shephard. "To be effective, the MDS coordinator needs to be on a peer level at least with the other department heads, as well."

Editor's note: Do you have a different take on this issue or other MDS-related issues that you'd like to share with readers? E-mail your comments to the editor at EditorMON@aol.com or share ideas, problems and solutions with your colleagues on the Eli long-term care List Serv. Sign up for this free benefit at http://codelist.net/list/join_longtermcare.html.

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