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MDS 3.0 History Importance The MDS is a potentially powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs). Its content has implications for residents, families, providers, researchers, and policymakers, all of whom have expressed concerns about the reliability, validity, and relevance of MDS 2.0. Some argue that because MDS 2.0 fails to include items that rely on direct resident interview, it fails to obtain critical information and effectively disenfranchises many residents from the assessment process. In addition, many users and government agencies have expressed concerns that the structure, length, and data collection burden of the MDS 2.0 exacerbate problems with data quality and validity when the MDS is collected by actual NH staff. Other stakeholders contend that items used in other care settings should be included to improve communication across providers. Improving the reliability, accuracy, and usefulness of the MDS has profound implications for NH care and public policy. Enhanced accuracy supports the primary legislative intent that MDS be a tool to improve clinical assessment and supports the credibility of programs that rely on MDS. In addition, most agree that the potential of the MDS to improve resident care can be realized only if providers do not view the MDS as an onerous data collection burden. Goals The goals of the MDS 3.0 revision were to introduce advances in assessment measures, increase the clinical relevance of items, improve the accuracy and validity of the tool, and increase the resident's voice by introducing more resident interview items. Providers, consumers, and other technical experts in NH care requested that MDS 3.0 revisions focus on improving the tool's clinical utility, clarity, and accuracy. CMS also wanted to shorten the tool while maintaining the ability to use MDS data for quality indicators, quality measures, and payment (resource utilization groups-III [RUGs-III] classification). In addition to improving the content and structure of the MDS, the RAND/Harvard team effort also aimed to improve user satisfaction. User attitudes are key determinants of quality improvement implementation. Negative user attitudes toward the MDS are often cited as a reason that NHs have not fully implemented it in targeted care planning. Key Findings for MDS 3.0 - Improved Resident Input
- Improved Accuracy and Reliability
- Increased Efficiency
- Improved Staff Satisfaction and Perception of Clinical Utility
Improvements incorporated in MDS 3.0 produce a more efficient assessment instrument: better quality information was obtained in less time. Such gains should improve identification of resident needs and enhance resident-focused care planning. In addition, inclusion of items recognized in other care settings is likely to enhance communication among providers. These significant gains reflect the cumulative effect of changes across the tool, including: - use of more valid items,
- direct inclusion of resident reports,
- improved clarity of retained items,
- deletion of poorly performing items, form redesign, and
- briefer assessment periods for clinical items.
Draft MDS 3.0 Data Specifications and Data Item Set A draft version of the MDS 3.0 Item Set is now posted. The final version is scheduled for publication in October 2009. Please Note: This is a DRAFT version of the data set and should not be used for any training purposes. The FINAL version of the item set, data specifications and RAI manual are scheduled for publication on this page in October 2009. Publishing the final versions of each of these documents in October 2009 will provide all stakeholders approximately one year to complete all tasks associated with the implementation of MDS 3.0. Questions regarding the data specifications should be directed to MDS30Comments@cms.hhs.gov. The information listed below under the "Downloads" section is subject to change. CMS will communicate any changes to these materials on this page as well as through Open Door Forums hosted by CMS.
Page Last Modified: 05/06/2009 8:57:02 AM
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