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“Two” Many Cooks in the Kitchen: Where Dietary and MDS Mix

By Jessie McGill, RN, RAC-MT, RAC-MTA - December 15, 2020

MDS accuracy is no joking matter, but who can resist a good dietary-related pun? I decided I would take a whisk and go for it.

While nutrition has always played a key roll in the care planning process, the resident’s nutritional status carries a lot more weight since the October 2019 launch of the Patient-Driven Payment Model (PDPM), which tied payment directly to the residents’ characteristics. It is time that the NACs and dietary professionals strap on their aprons and work together to serve up some accuracy with these four key ingredients of successful collaboration.


Swallowing disorders

When it comes to possible swallowing disorders, it is key that dietary and nursing staff, and likely therapy, work together to monitor for signs and symptoms. A resident’s ability to swallow may be affected by a functional decline or a disease process, such as Parkinson’s disease. Residents with swallowing problems may be at higher risk for choking, aspiration, malnutrition, dehydration, and aspiration pneumonia. Crucially, MDS item K0100 reflects possible signs and symptoms of a swallowing disorder; the resident does not need to have a physician-diagnosed swallowing problem to meet its criteria. Item K0100 is coded if the sign or symptom occurred during the 7-day look-back period, even if it only occurred once. And, since documentation must appear in the medical record to support the MDS coding, it is essential that the staff present during meals document any observed issue.