How Long Should an MDS Assessment Take? Benchmarks and Optimization Strategies

Ask any MDS Coordinator how long an assessment takes, and you'll get widely varying answers—anywhere from 45 minutes to 4+ hours. This variability isn't random. It reflects differences in processes, technology, staffing, and documentation practices.

Understanding realistic time benchmarks—and the factors that affect them—is essential for staffing, scheduling, and identifying opportunities for improvement.

MDS Assessment Time Benchmarks

Based on industry surveys and operational data, here are realistic time ranges for different assessment types:

Assessment Type	Below Average	Average	Above Average
5-Day PPS	3-4 hours	2-3 hours	45-90 min
14-Day PPS	2-3 hours	1-2 hours	30-60 min
Quarterly	2-3 hours	1-2 hours	30-60 min
Annual	3-4 hours	2-3 hours	60-90 min
Significant Change	3-4 hours	2-3 hours	60-90 min
Discharge	1-2 hours	45-90 min	20-45 min

Factors That Increase Assessment Time

If your assessments consistently take longer than benchmarks, look for these common culprits:

1. Poor Documentation Accessibility

MDS Coordinators spend significant time hunting for information across multiple systems:

• EMR clinical notes scattered across departments
• Paper documentation not yet entered
• Hospital records in separate system or faxed pages
• Therapy evaluations in third-party software
• Physician orders in yet another location

When documentation isn't consolidated, you're spending time searching instead of assessing.

2. Insufficient Real-Time Documentation

When CNAs and nurses document late or incompletely, MDS Coordinators must:

• Interview staff to reconstruct what happened
• Review incomplete records multiple times
• Make follow-up requests for missing information
• Delay assessments waiting for documentation

3. Inefficient MDS Software

Legacy MDS software often requires excessive navigation:

• Multiple screens for related items
• Manual lookups for coding guidance
• Slow system performance
• Lack of pre-population from prior assessments
• No integration with clinical documentation

4. Lack of Standardized Processes

Without consistent processes, coordinators reinvent workflows for each assessment:

• No standard checklist for documentation gathering
• Inconsistent IDT meeting schedules
• Unclear responsibilities across disciplines
• No templates for common scenarios

5. Frequent Interruptions

MDS Coordinators are often interrupted for other tasks:

• Floor nursing responsibilities
• Care plan meetings
• Family questions
• Survey preparation
• Admission processing

Each interruption adds time to restart and re-focus on the assessment.

Strategies to Reduce Assessment Time

Top-performing facilities use these approaches to cut assessment time significantly:

1. Batch Documentation Review

Instead of reviewing documentation for each MDS item individually, review all documentation first and extract information for multiple sections simultaneously.

• Read through nursing notes once, noting relevant items for Sections C, E, G, H, I, J, K, etc.
• Review therapy evals once for Section GG, O, and care planning
• Extract diagnoses and medications in a single pass

2. Implement Pre-Assessment Checklists

Before starting any assessment, verify all needed documentation is available:

• Hospital discharge summary and H&P
• Therapy evaluations and progress notes
• Nursing assessments and flow sheets
• CNA ADL documentation for look-back period
• Physician orders and progress notes
• Labs and imaging reports

Missing documentation should be gathered before starting—not discovered mid-assessment.

3. Establish Documentation Standards

Work with nursing leadership to ensure documentation supports MDS completion:

• Require shift documentation within one hour of shift end
• Use structured ADL documentation that maps to MDS coding
• Train CNAs on what information MDS requires
• Implement documentation audits with feedback loops

4. Schedule Protected MDS Time

Block calendar time specifically for assessment completion:

• Designate MDS office space away from floor interruptions
• Block 2-3 hour windows for complex assessments
• Communicate MDS schedule to other staff
• Use do-not-disturb signals during focused work

5. Use Technology

Modern tools can dramatically reduce manual effort:

• AI-powered clinical note analysis
• Automated pre-population of stable items
• Integrated access to all clinical documentation
• Built-in coding guidance and validation
• PDPM optimization alerts

Time Allocation Within an Assessment

Understanding where time goes helps identify improvement opportunities. Here's typical time allocation for a 5-Day PPS assessment:

Activity	Inefficient	Efficient
Gathering documentation	45-60 min	10-15 min
Reviewing clinical notes	60-90 min	15-20 min
Completing MDS items	45-60 min	15-30 min
IDT coordination	30-45 min	10-15 min
Validation and review	15-30 min	5-10 min
Total	3-4+ hours	55-90 min

Notice that the biggest time savings come from documentation gathering and clinical note review—not faster data entry. This is where process improvement and technology have the most impact.

Staffing Implications

Assessment time directly affects staffing requirements. Here's how to calculate MDS Coordinator capacity:

Monthly Assessment Volume

For a typical 100-bed SNF with 25% Medicare census:

• Medicare admissions: 15-20/month
• 5-Day assessments: 15-20
• 14-Day assessments: 10-15
• Quarterly assessments: 25-30
• Annual assessments: 8-10
• Discharge assessments: 15-20
• Total: 75-115 assessments/month

Time Required

At 2-3 hours per assessment average, that's 150-345 hours of MDS work monthly—nearly 2 FTEs just for assessment completion, not including care planning, meetings, and other duties.

Reducing average assessment time to 1 hour cuts required time to 75-115 hours—essentially cutting MDS staffing needs in half.

Quality vs. Speed

A common concern: will faster assessments mean lower accuracy? The data suggests no—if time is reduced through better processes rather than shortcuts.

Speed Through Efficiency, Not Shortcuts

Facilities that achieve faster times do so by:

• Eliminating documentation search time
• Using technology to extract information automatically
• Standardizing processes to reduce re-work
• Improving real-time documentation by other staff

They're not skipping steps—they're eliminating waste.

Accuracy Indicators

Monitor these metrics to ensure speed doesn't compromise quality:

• ADR (Additional Documentation Request) rate
• MDS error rates on validation reports
• PDPM revenue per patient day vs. benchmark
• QM (Quality Measure) accuracy
• Audit findings related to MDS

Building a Continuous Improvement Process

Time optimization should be ongoing, not a one-time project:

Track Time by Assessment Type

Have coordinators log actual time spent on each assessment. After a month, you'll have data to identify:

• Which assessment types take longest
• Which activities consume the most time
• Variation between coordinators
• Improvement opportunities

Identify Bottlenecks

Look for patterns:

• Are specific sections consistently slow?
• Is documentation from certain departments always late?
• Are specific days or times worse than others?
• Do interruptions cluster around certain activities?

Implement and Measure Changes

When you implement improvements, measure the impact:

• Time before vs. after the change
• Accuracy metrics before vs. after
• Coordinator satisfaction and feedback
• Sustainability over time

Summary

MDS assessment time is highly variable, but top-performing facilities consistently complete assessments in under 90 minutes—without sacrificing accuracy. They achieve this through:

• Better documentation accessibility and quality
• Standardized pre-assessment processes
• Protected time for focused work
• Modern technology that reduces manual effort
• Continuous measurement and improvement

If your assessments consistently take 3+ hours, there's significant opportunity to reduce time while improving accuracy. The key is systematic process improvement, not working faster.

Additional Resources

• Complete Guide to MDS 3.0 Section GG
• PDPM Reimbursement: 5 Common Classification Mistakes
• MDS Genie™ - AI-Powered MDS Assessment Software