A study of the role and influence of the Minimum Data Set (MDS) on decision making in long-term care facilities in Utah

The objective of this study was to evaluate the decision making process among nursing home leaders in long-term care facilities in Utah once patient data is collected. Medicare and Medicaid regulations require all licensed long-term care facilities to collect and document patient clinical data in a comprehensive assessment called the Minimum Data Set (MDS). The MDS is a multi-disciplinary assessment requiring regular evaluation of patients' current needs and then prescribing orders for the next MDS treatment cycle based on those assessed needs. Collectively, the Administrator, Director of Nursing and MDS Coordinator are expected to lead and guide the interdisciplinary team in making these decisions.;In Utah there are 99 licensed long-term care facilities, many in rural and outlying areas. Based on prior experience, the author of this study questioned how long-term care nurses make patient care planning decisions and whether decision analysis procedures were utilized in long-term care planning in Utah. As a former administrator, the author additionally posited whether administrators at facilities were involved in decision making and guiding that process among the interdisciplinary team.;In conjunction with the Utah Health Care Association, a survey questionnaire was sent out to all licensed long-term care facilities in Utah on behalf of the author of this study and the Association. The sample population was the administrators, directors of nursing and MDS coordinators at each facility. Respondents answered a 22-question survey focused on the decision making processes in their facility, as well as their own opinions and perceptions of decision capabilities in their own job functions.;Data was collected and analyzed regarding the decision making processes of teams in long-term care facilities in Utah and was organized and presented in this dissertation. One of the key findings of this research was the fact that less than 29% of nurse respondents are certified as an MDS nurse. This finding may have an impact on the respondents feelings of being adequately trained, the perceived available resources for MDS decision making and the efficiency of those MDS decisions.;The data indicated staff is meeting MDS requirements in care planning and facility team members are completing their portions of the MDS. An important data outcome of this study was that staff is adequately trained on the MDS process. This finding is a result of staff reviewing resident preferences in making MDS decisions and as a team, they consider available resources when making those decisions. These findings are significant to any long-term care organization because these could influence the delivery of care and have significant impact on the overall quality and financial viability for long-term care facilities in the state of Utah.