The Matrix
- Vanessa Tyscka, RN, BSN, MBA, RAC-CT
- Oct 13, 2021
- 4 min read
It's easy to forget to keep this survey required form up-to-date. But what if you could use it as a survey preparedness tool and even use it to make your QMs better? Then it might seem like a useful tool instead of a burden.
The Matrix, formerly call the 802, is one of the first things that surveyors require when they walk into a skilled nursing facility for a survey. They have access to the QM reports and they definitely have a lot of information already gathered before the enter the building. But giving them the updated and accurate Matrix will make their job easier and hopefully will help you have a smooth survey as well. Let's take a look into some best practices and common errors when filling out the Matrix.
One of the most common errors I have seen over the years is no one is assigned ownership. It's easy to depend on our software systems to generate a Matrix, but don't fall into that trap! The software will only pull information from the MDS and other forms within your software and that information can be up to 3 months old. The designee(s) should have good knowledge about the residents and have access to physician orders and pertinent reports to help them fill out the Matrix. If your facility is small one person should be assigned, larger facilities might consider breaking it down by unit and assigning to a Unit Manager or MDS Coordinator.
Accuracy is the next item that a lot of facilities stumble on when filling out the Matrix. They might be looking at the form a couple times a month or even weekly, but the information filled out on the form is not up-to-date or accurate. If you're not updating the Matrix as orders change, chances are you have inaccurate data recorded. This holds true for majority of the items that are tracked on the Matrix. New med for anxiety? Newly acquired pressure ulcer? Resident developed pneumonia? Resident had a fall? Any of these things can happen after the most recent MDS is complete and need to be manually added to the Matrix. Or vice versa, maybe the pressure ulcer healed, a resident has a successful GDR, that infection is no longer active. The Matrix also needs to be updated to remove these events as well.
In addition to the Matrix, Surveyors will also ask for the 672 form within 24 hours of entry. This more detailed form can be initiated by most software systems, but will need a thorough review and update prior to submitting to the survey team. The 672 is used to give surveyors an accurate picture of the census and conditions of the resident population in your facility. Again, ensuring that this form is accurate is critical to getting survey started on the right foot. Showing errors on the Matrix/672 tells surveyors that you don't really know what's going on with your residents.
So how do you keep all this information up-to-date and accurate? As mentioned earlier, assigning someone who knows the residents and has access to orders, reports, care plans, and communicates regularly with the resident, family and staff members will have the best knowledge. This can often times be a Unit Manager, ADON, or the MDS Coordinator.
5 Tips for Keeping an up-to-date Matrix
Be familiar with the items that are being tracked on the Matrix
Review Physician Orders on a daily or weekly basis and update as needed
Set reminders to review items that may need to be removed (resolved infections, last fall)
Utilize reports to cross check information (wound reports, psychoactive medication reports, weight reports, fall reports, wound reports, etc.)
Keep these items in mind at each meeting (quality of care, fall committee, etc. to ensure you have all pertinent date recorded)
Think about this way, if a surveyor can use this tool to pick apart a facility and see where there are deficiencies, we should be able to as well! We really do have an advantage to be able to review any areas of concern and implement appropriate interventions prior to any survey.
How to improve QMs
A lot of times the requirements we must comply with seem like busy work doesn't always feel useful. But if you use the Matrix as a QA tool it can really improve your QMs and hopefully the quality of life your residents and direct care givers. Do a thorough chart review of the residents that have the most items flagged first. Ensure the accuracy of the information coded. Discuss with the team and determine if there are any interventions that can be implemented to resolve the areas of concern. This doesn't have to be 'extra' work - many times we have meetings to cover this stuff we just don't use this time efficiently.
Many facilities still use their QM reports for their QAPI process and while the QM reports do provide a good benchmark, they are based off old data. If your facility doesn't have time, a good consultant can also perform this task on an as-needed basis and give recommendations. Best practice would be to review about 1/3 of the resident population each month so that every resident is reviewed on a quarterly basis. Utilizing the Matrix form to improve performance will keep your facility ahead of the curve, improve your QMs and can yield better survey results!
MDS Solutions HQ Do you want to take your facility to the next level? Let MDS Solutions HQ show you where your opportunities are. Whether it’s improved quality of care, better survey outcomes or if revenue is your focus it all begins with the MDS. I specialize in training MDS nurses in the RAI process, training floor nurses to document skilled need, educating revenue capture through the PDPM process, analyzing and creating action plans for QM and 5 star success.
Contact me at:
MDSSolutionsHQ@gmail.com or 404-309-3013
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