This section discusses the key points for ensuring a systematic and timely approach for completing education for:

  • Initial implementation of the Courseware

  • Remedial training as needed for identified competency issues

  • Ongoing refresher training (CMS updates)

  • For new employees

  • For employees who have changed positions


Initial Implementation

  • Although it is possible to implement the Courseware without using the Curriculum Management system, AIS strongly recommends setting up and using the Curriculum Management system as soon as possible. This will allow for a smoother implementation, and will also make compliance and completion monitoring much simpler and easier.

  • Following the kick-off meeting, all employees who are identified as educators/trainers should begin accessing the Courseware. Ideally, they would complete the course work prior to the organization-wide roll-out. Since these employees are typically Subject Matter Experts (SMEs) for the RAI and RUG IV, they are expected to complete the Courseware within 2 or 3 weeks.

  • Weekly calls during the roll-out period are recommended to address concerns about connectivity, time management, course completion, etc. By addressing issues weekly, organizations will ensure a more successful roll-out and more field staff in compliance.

  • The recommended schedule for the facility and region team is based on a 90-day implementation. The alternate schedule is based on a 30-day or 6-week implementation. The time can be adjusted based on company/region/facility requirements, and may also change if each learner’s required courses are customized.

  • Employees follow the schedule based on the course content identified by their job title and/or their determined competency in the core material.

  • AIS recommends requiring less core content in the first week, while users become familiar with the eTraining.

  • Frequent communication to managers regarding course completion and compliance will ensure a smoother roll out. Weekly communication using Curriculum Management is a quick and efficient method of communication. Managers can then follow up with learners to ensure adequate time is being allocated to allow them to take the education.


Remedial Training

When Remedial Training is Required

Remedial training is typically for a specific section or sections of the MDS or a module in the Courseware. There are several reasons an organization may want the learner to complete remedial training and retesting. The most common reasons are listed below.

  • Failed Test Modules:
    The Courseware is set up to allow the learner to take the module post-test three times. A learner who fails the test three times will be “locked out” of the system and will require approval for additional retakes. The test can be reset by the Help Desk Account holder. The process for determining whether the learner is ready to retake the test will depend on the organization’s policy or process.

  • Issues Identified by Audit Process
    Many organizations complete routine audits (with either external or internal auditors) of MDS coding, assessment timing, and RUG issues as part of their quality improvement process. In addition, issues are often identified in a monthly billing review.

  • Issues Identified by Data Analytics
    If your organization uses a data analytics program, either as part of your MDS software or another product, the analytics will identify issues with your MDS coding or timing of assessments.

  • Issues Identified by Review of Dashboard and/or Reports
    By reviewing the results of the tests, you can identify any sections or groups of questions that are frequently answered incorrectly by a group of learners. If the questions have tags related to the high-risk areas of RUGs, Regulatory, QI/QM, or CAAs, remedial training on the applicable sections may be indicated.


Process For Remedial Training

  • Identify and group the issues related to MDS sections and/or timing and completion of assessments. These issues can often be grouped by the sections or assessments, or grouped by RUGs/Reimbursement, Quality/Care, Regulatory, and Care Planning.

Verify test scores and number of takes
Use the Courseware’s Results of Evaluation to identify the problematic sections, and use Responses – Individual Learner to identify the specific areas of concern.

Verify the time spent in the module
this is very important. Learners who have not spent enough time reviewing the module or with the audio/closed caption explanations will find it difficult to demonstrate competency.


  • Provide the remedial training:

Review the problematic sections/areas of concern and provide focused mentoring or education on areas that were not understood (not the entire MDS or RUG IV process).

Supplement the education based on test scores and discussion with the learner. This is the optimal time for a Blended Learning approach; Educator/Mentor-led training can take place either on site, via Webinar, via conference call, or via partnering with another employee with known competency in the area in question.


  • Retakes: Once the education has taken place, the learner can take the applicable test modules again to demonstrate competency. This step is recommended, but will be specific to each organization based on their policy or process.


Refresher Training

  • When needed, CMS typically issues an RAI update following posting of the Fiscal Year Final Rule in July (which would then become effective October 1). The AIS team reviews the changes and updates the course content as needed for an October 1 release. In addition, all of the tests are reviewed and refreshed no later than January 1.

  • AIS notifies the corporate contact once the test refresh has been completed.

  • Most organizations determine a frequency for refresher training. AIS recommends refresher training annually.

  • If the changes that occur with the annual October 1 CMS update are significant, AIS recommends that all affected staff take the refresher training.


New Hires

All Applicable New Hires

  • It is recommended that the Courseware be incorporated into the orientation plan for applicable new hires. A Blended Learning approach has been demonstrated to be the most effective method of orienting new hires.

  • By using the Learning Matrix spreadsheet (see Appendix C), a schedule can be created for new hires, allowing learners, educators, and managers to track compliance.

New Hires Who Are MDS Coordinators

Note: Some companies required employees to successfully complete the assigned modules before being allowed to complete their section of the MDS.

  • Methods for MDS Coordinators who are new to MDS:

These new hires could learn section by section: complete a section module, pass the test, complete that section of the MDS using the case study, review with the mentor, and then complete that section of the MDS with a resident prior to entering the section into the software.

Alternately, these new hires could complete the RAI modules, review the case study with the mentor, then complete a full MDS on a resident for review prior to entering the assessment into the software.

  • Methods for MDS Coordinators who are new to the company but have experience in MDS:

These new hires could: complete all course content related to RAI, pass the tests, review the case study with the mentor, and then complete OBRA MDS assessments and enter into the software; then complete all course content in RUG IV module and pass the test, and then complete PPS assessments.

Alternately, these new hires could follow the recommended schedule for completion of course content while being allowed to complete MDS assessments.


Position Changes

  • Depending on previous experience with the organization and with the RAI process, the employee would either follow the standard method for newly hired MDS Coordinators who are new to MDS, or newly hired MDS Coordinators who have experience with MDS.

  • If the employee has recently successfully completed all course content, a review of the case study with the mentor would be beneficial before the employee completes an MDS and enters into the software.