Utilizing the MDS as a resident's rights and risk-reduction strategy in long-term care

7 minute read

The frailty syndrome is an emerging concept for providers who care for individuals with significant comorbidities, advanced age, or a decline in functional or cognitive status; the more typical resident receives services in a long-term care facility. In general, frailty is a concept that residents or their families do not understand well. The sequelae of frailty are often underrecognized and minimally addressed by the interdisciplinary team, including the attending physician and physician extenders.

The Minimum Data Set (MDS) can be an effective tool in identifying residents with physical and cognitive decline related to frailty, sarcopenia, and failure to thrive.[1] Residents and family members often have minimal understanding of the effects of these conditions on weight loss, falls, the development of pressure injuries, and related issues that have become the major foci of regulators and malpractice litigation.

An effective ethics and compliance program seeks to integrate clinical outcomes with regulatory compliance. Importantly, setting expectations for a resident’s care goals, and what can or cannot be addressed by nursing care, assists in compliance with the mandated nursing home informed consent provisions. The chief ethics and compliance officer should work collaboratively with leaders in clinical operations to improve the understanding of clinical decline by families of residents most impacted by these diagnoses and syndromes. This collaboration should include identification of communication strategies for meaningful, documented care plan conferences, during which the resident and responsible party are apprised of the implications of frailty.

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