This translates to additional time requirements for registered nurses. More nurses will be needed to maintain the assessment schedule. The additional nursing time is included in the payment rates to facilities, but the decisions on how resources are to be allocated is up to the facility administration. Nursing administrators in each facility should evaluate their assessment function needs, and insure sufficient time is available for accurate, timely assessment. The schedule of assessments must be followed explicitly.
Late assessments can result in delayed or minimum payments.
Since the MDS is primarily a clinical document, it cannot be backdated to cover a missed assessment period. Nursing, in cooperation with the business office, must establish and follow procedures to insure timely assessments. In addition to the universal use of the MDS to direct care planning, the MDS assessment information is used to determine the RUG-III value for each resident. The MDS is the only information used to determine the payment level during a Medicare Part A stay. The costs of care must be paid from the single case mix adjusted payment.