To say that 2020 and 2021 were challenging for long-term care is the understatement of the year. Adaptability is a theme running throughout this industry, where long-term care providers constantly adjust and pivot while the punches just keep coming.

According to Mary Madison, clinical consultant of long-term care at Briggs Healthcare and registered nurse of 48 years, healthcare providers – and long-term care providers in particular – have the opportunity to take on the adaptability of “Gumby”, that shape-shifting character who can mold himself into anything to fit any situation. Gumby looks at every situation as an opportunity to help people. Over the last two years, we’ve all been Gumbys, says Madison.

Why? The long-term care industry has experienced more in the last couple of years than at any time in our history: providers had to learn a new reimbursement system (Patient-Driven Payment Model) and a different way to code with a new Minimum Data Set (MDS) – all while being at the epicenter of the COVID-19 pandemic.

I recently sat down with Mary in a podcast to unpack some of the biggest challenges and opportunities facing long-term care providers and how they can exhibit a Gumby-like, growth mindset.

Here are a few takeaways from our conversation.

1. “The MDS is absolutely essential to everything that long-term care does now.”
   

   The Minimum Data Set (MDS) is a standardized, comprehensive assessment of an adult's functional, medical, psychosocial and cognitive status. It’s is essential for everything that long-term care does today (and in the future). 

   Bottom line? You don’t get paid if you don’t code and submit the MDS.  Without the right level of compensation, providers can’t properly staff and treat individuals in our care.

   The MDS Coordinator (reimbursement specialist) requires specific and ongoing training (even certification) to be successful. But knowledge of the practices and protocols in place is not enough. 

   The MDS Coordinator must interact with staff, interview residents and follow every aspect of care from pre-admission screening to diagnosis to treatment. It takes on a team approach to be successful, where every staff member plays a vital role. 

   Good relationships with referring hospitals, dedication to proper documentation, correct coding, an eye for detail, and the ability to watch for changes and how they will affect clinical care all contribute to the reimbursement process. 

    

2. Flexibility and adaptability are key characteristics of a successful reimbursement strategy.

Those involved in reimbursement must be able to flex and flow with the changes and challenges presented to them. It’s important they do not falter under the pressure of a sometimes complicated and not-quite-clear process.

The ability of staff and leadership to anticipate coming changes will be essential for successful future reimbursement to ensure the proper level of staffing can be maintained. For example, Interim Payment Assessment (IPA) is optional (for now) assessment done after the initial MDS, if a change has occurred in the resident’s condition. 

Madison warns this may become a required part of reimbursement, and staff who are familiar with the IPA tool may be better prepared for changes coming. 

3. Remember why you went into nursing and long-term care.

When asked what advice she could share with others who are experiencing the struggles of a labor shortage and may have a hard time staying focused, she pointed to a plaque on her desk. It says: Don’t forget to be awesome.

On the toughest days, Madison reminds everyone to remember why they got into the field, whether you are a CEO, nurse or therapist. “Don’t throw in the towel. You are so needed, and you are so awesome. We are the greatest folks on earth with the toughest job. So, don’t forget to be awesome. Each and every day.”

Listen to the podcast, Delivering Extraordinary Care: How Long-Term Care Providers Ensure Success, with Mary Madison.

If you want to hear more episodes like this one, check us out on Apple Podcasts.

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