Skilled Nursing & MDS Support for Long-Term Care Teams<br>

37 years of hands-on skilled nursing facility experience.

Stop the Documentation Scramble. Build Systems Over Sweat.

Leveraging 37 years of Long-Term Care nursing infrastructure to eliminate the frantic signature chase, secure total compliance, and protect clinical integrity—without burning out your team.

Book a Clinical Audit (Facility Consulting)

Join the Excellence Vault (MDS Nurse Membership)

Using her proprietary 6-Step MDS Auditing Method, Maria Messina evaluates facility-wide clinical systems to identify critical compliance gaps, documentation leakage, and structural vulnerabilities. By bridging the gap between bedside charting and accurate MDS coding, Maria helps nursing home leadership eliminate operational drift, minimize ADR risks, and build the sustainable, stress-free workflows clinical teams need to maintain total compliance integrity.

Who I Support

I work with skilled nursing facilities, MDS coordinators, directors of nursing, assistant DONs, administrators, and regional leaders who want stronger systems, fewer surprises on survey, and less stress around reimbursement.

MDS nurses who feel overwhelmed or alone in the role
DONs and administrators who want accurate reimbursement and clearer processes
Facilities that need support with PDPM, Medicaid, and quality measures
Teams that want education that respects their time and experience

What You Get with the Efficient MDS Resource Guide

The Efficient MDS Resource Guide is a practical starting point for teams who want more structure and support around their MDS process. It brings together tools and training that you can start using right away.

A clear overview of the MDS process in skilled nursing
Checklists to support accurate coding and documentation
Guidance that connects regulations to daily workflow
Ideas for teaching staff at the bedside and in huddles
A pathway into deeper support inside the membership

Ready for more support with your MDS work

Get the Efficient MDS Resource Guide

Services beyond Coaching:

Minimum Data Set (MDS) Assessment Oversight

Review OBRA and PPS MDS assessments for coding accuracy
Compare MDS data to quality measure (QM) flags to identify risk tied to inaccurate coding
Review ICD-10 coding and mapping to support PDPM and Medicaid reimbursement
Provide feedback and education to facility MDS staff and leaders

MDS Scrubber / Admission Review

Review traditional Medicare and other payor admissions within the first few days to identify missed coding opportunities
Verify that diagnoses, functional status, and services are captured accurately
Share clear, practical findings with MDS coordinators and leadership so changes are sustainable, not just one-time fixes

Education & Training for Long Term Care Teams

Education is most effective when it respects the realities of a busy nursing home. I offer targeted trainings that can be delivered live or virtually, tailored to your team.

MDS and Reimbursement Education

MDS fundamentals for new or transitioning staff
Intermediate and advanced MDS training for experienced coordinators
PDPM basics and practical application
Documentation tips that support accurate coding and reimbursement

Survey and Regulatory Support

Long term care survey regulations from a practical, day-to-day perspective
How MDS, care plans, and documentation connect to survey outcomes
Strategies to prepare staff for questions and expectations during survey

Interdisciplinary Team & Care Coordination
Clarifying roles and expectations within the IDT
Case management and care planning processes that help residents and staff
Building communication routines that support consistent resident outcomes

Leadership & Coaching Support

Technical knowledge is important, and so is the person doing the work. I offer coaching and support for nurse leaders and MDS staff who are carrying a lot.
Leadership support for DONs, ADONs, and MDS coordinators
Time management and organization for MDS and nurse leaders
Communication and conflict resolution skills for charge nurses and leadership teams
Space to process burnout, role strain, and change while staying grounded in regulations and resident care

Getting Started

Whether you need a focused review, ongoing support, or education for your team, we can shape services around your facility’s goals and constraints.

If you are not sure where to start, many facilities begin with the Efficient MDS Resource Guide and membership pathway to give their MDS staff structure, tools, and a place to bring questions.

I can help you so you can help them.

To schedule or discuss services:
Email maria.messina@skillednursingsupport.com or call 1-617-429-9903.