Why AI Should Support the MDS Coordinator — Not Replace Them
Artificial intelligence is rapidly reshaping healthcare and long-term care operations. Facilities are already using it to review documentation, identify trends, streamline workflows, summarize records, and flag potential reimbursement opportunities. But as the conversation around automation accelerates, healthcare leaders need to recognize an important truth: AI can serve as a tool to strengthen the MDS process, but it should not replace the MDS Coordinator.
The MDS Coordinator role is one of the most clinically complex, interdisciplinary integrating, and strategically important positions in a skilled nursing facility. The MDS Coordinator does much more than data collection.
MDS Coordinators must continually make clinical decisions that require:
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- Interpreting complex resident conditions
- Identifying changes in status
- Evaluating supporting documentation
- Coordinating interdisciplinary input
- Understanding regulatory requirements
- Determining reimbursement implications
- Recognizing quality measure impacts
- Connecting assessment findings to resident care planning
AI can identify words and patterns within a medical record, but cannot independently determine whether documentation truly supports the resident’s usual performance, whether a decline is clinically significant, or whether multiple pieces of conflicting information require additional investigation.
MDS Requires Clinical Judgment — Not Pattern Recognition Alone
AI functions largely through pattern identification and prediction. While that can be incredibly valuable, MDS coding frequently requires interpretation of nuanced clinical situations. Consider the following Section GG scenario:
Therapy documents the resident required supervision with transfers. Nursing documentation shows extensive assistance on night shift due to fatigue and weakness. CNA documentation varies throughout the assessment window.
The question becomes:
What represents the resident’s usual performance?
That answer frequently requires interdisciplinary discussion, investigation, and professional judgment.
A seasoned MDS Coordinator understands the need to determine:
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- Was there a temporary fluctuation?
- Was the resident affected by medications?
- Did the resident experience a clinical change?
- Which documentation most accurately reflects usual function?
- Does the record support the coding decision?
AI is useful to summarize data points. The MDS Coordinator determines what those data points actually mean.
Residents Are Not Algorithms
Long-term care residents rarely fit into perfect categories. They decline unexpectedly, families raise concerns, behaviors change, documentation conflicts, and conditions can evolve quickly.
Experienced MDS Coordinators often identify issues before they become larger problems:
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- “Something does not look right.”
- “This documentation doesn’t match the resident I know.”
- “We may be missing a change in condition.”
- “I think we need to involve the physician or therapy team.”
Clinical insight comes from experience, relationships, observation, and human judgment. While there is a place for AI as a tool and resource, AI does not walk the halls. AI does not attend care conferences.
AI does not notice subtle resident changes. AI does not build trust with staff and families.
The MDS Coordinator Is a Clinical Leader
The MDS department has a tremendous impact on care and operations, serving as a translator between clinical care, finance, compliance and operations.
Strong MDS Coordinators impact:
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- Reimbursement accuracy
- Quality Measures
- Five-Star outcomes
- Survey preparedness
- Care planning
- QAPI initiatives
- Documentation practices
- Interdisciplinary communication
- Resident outcomes
How can AI make great MDS Coordinators even stronger?
AI can provide value by:
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- Organizing large volumes of information
- Assisting with workflow efficiencies
- Identifying trends and patterns
- Supporting audits and education
- Reducing administrative burden
- Highlighting potential documentation gaps
These functions can help MDS Coordinators spend less time searching for information and more time doing what matters most: using clinical expertise to improve care, guide teams, and ensure accurate resident assessment. While AI should not replace the MDS Coordinator — it should give them better tools, better visibility, and more time to make an impact in each resident’s clinical story.
Next Steps:
Engage Proactive for access to MDS support to drive clinical reimbursement and quality measure success! Complete MDS resource options include new MDS Orientation, Mentorship via a designated consultant, scheduled auditing and monitoring with performance enhancement activities and progress tracking, medical review assistance and interim coverage—we provide the information and resources your MDS department needs to succeed! Contact us to schedule a conversation.
Written By:
Sarah Becker, RN, RAC-CT, DNS-CT, QCP
Director of Clinical Reimbursement
Proactive LTC Consulting