My Journey To Becoming An MDS Nurse

• Minimum Data Set, or MDS nurse, is a nurse who assesses and monitors patients in a long-term or skilled nursing facility. 
• An MDS nurse works as an interdisciplinary team to create patient care plans. 
• AN MDS nurse documents patient information and uses that information to create data and reports that are used for state and federal programs such as Medicare.

More than two decades ago, my career in the skilled nursing industry began when I worked as a Business Office Manager in a 92-bed facility.  

I was neither an accountant nor a business professional when I took the job.  

I applied, bringing with me diligence and the best attitude to learn new things. And so, I stayed in the job for six years until the inevitable change in management. 

Minimum Data Set (MDS) 2.0 was a new terminology I learned while working as a Business Office Manager because it was necessary for facility reimbursement. It was love at first sight and it sparked my interest! But I found out that only licensed nurses can complete an MDS assessment. 

The Road to Becoming An MDS Nurse

Like a lover who wants to be deserving of her beloved, I went to nursing school because of the following reasons: 

• As a single parent, it gave me the flexibility to work any shift 
• At that time and even now, it is one of the fields which will get you hired easily 
• It will give you financial stability if you really work hard and spend wisely 
• It gives you a variety of choices to specialize on 
• It was my way of giving back to the community for the multitude of blessings I received in this country 
• It was the only way I could become an MDS nurse 

All doors opened for me when I received my nursing license!  

I opted to stay in the skilled nursing industry at that time because I was already immersed into it. I had to continue working as a Business Office Manager because it was the position which could fully support me as a single parent.  

I started working on weekends as a charge nurse, medication nurse and treatment nurse. I had to hone my nursing skills to finally reach my goal to be an MDS nurse. 

I finally landed my first MDS nurse job in a 200-bed facility. It was not easy at first as I assumed the job with limited training and was assigned to a floor where patients did not speak English at all.  

My completion of patient interviews was at a snail’s pace. But I did not give up!

MDS Assessment

The MDS assessment has morphed into one of the important tools in the skilled nursing industry. From its version 2.0 to version 3.0, it continues to undergo a facelift every year.  

It has become not only the basis for Medicare and Health Maintenance Organization (HMO) reimbursement, but a tool for Federal and State surveyors to determine the acuity and quality of care and life of patients. 

 It is for this reason that an MDS nurse needs to be abreast of all changes every year and to ensure accuracy of all assessments.

Keeping Up As An MDS Nurse

To be a good MDS nurse, one needs to do the following:

Take MDS Training

Make sure you do this after being on the job for at least six months to better understand the course. I made the mistake of taking the course while working as a Business Office Manager and I was like walking in a different planet! 

Read the Resident Assessment Instrument (RAI) Manual

There is always the notion that is it easy to answer all the questions on the MDS form. This just a myth! Each question on the form has instructions and steps which can be found on the RAI manual to get the correct responses.

Keep Doing MDS Assessments

Practice makes perfect. If you are new and just training, do an assessment and compare it with an assessment already done for that patient and check discrepancies and discuss them with your mentor or refer to the RAI manual for clarification. 

Know Your Patients

When you interview your patients, use your nursing skills in making a head-to-toe assessment. Utilize the input from other healthcare staff for accuracy of your assessments.

Document

Document, document, document. To be an effective MDS nurse, you must love paperwork. I always make it a point that each MDS response has supporting documentation in the patient’s medical record. I also document in my self-created MDS tool any objective and subjective data collected to support my assessments. 

Interdisciplinary Team

As an MDS nurse, you will be part of the facility’s Interdisciplinary Team or IDT. You become the MDS coordinator conducting care plan meetings with patients and/or representatives. You need to have IDT members who show a commitment to attend all meetings and contribute to accommodating the patient’s needs. Compromise instead of being defensive. 

Build A Network

Join MDS groups and stay connected with other MDS nurses to keep you updated with current changes. I learn from the experiences of others. For any questions which you cannot find in the RAI manual or network, you can contact your State MDS Coordinator for clarifications.

Sticking With It

Although being an MDS nurse has its highs and lows, it gives me a sense of gratification. 

I take the dual role of becoming a patient and facility advocate in problem solving using the nursing process.  

I can practice my leadership and communication skills during meetings and formulation of patient care plans. I make it a point that every meeting is concluded with all parties agreeing to a compromise in resolving any issues discussed.  

If not, we continue to find solutions where everybody is satisfied. It is for this reason that in being an MDS nurse I find fulfillment in my nursing career. For all its pain and glory, I remain faithful.  

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