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Nursing Homes Have a Year to Comply with New MDS 3.0 Assessment

MacKenzie Kimball, for HealthLeaders Media, November 2, 2009

The Centers for Medicare & Medicaid Services (CMS) released the much anticipated final Minimum Data Set, Version 3.0 (MDS 3.0), on Thursday, giving nursing homes approximately one year to prepare for implementation of this redesigned resident assessment instrument.

"The release of the final MDS 3.0 item set is very exciting news for the long-term care industry," says Diane Brown, a regulatory specialist, consultant, and Boot Camp instructor at HCPro. "Although the previous drafts gave us a good idea of what to expect, facilities could not do much in terms of preparation without the final version. Now, we can start preparing for the October 2010 implementation, which will be here before we know it."

In addition to the various item subsets for each MDS 3.0 assessment (e.g. admission, quarterly, annual, etc.), CMS released the following files:

  • MDS 3.0 Item Matrix – This document identifies the items required for each type of assessment along with how the item is used.
  • Data Technical Files – This file contains the following MDS 3.0 technical specification information:
    • MDS 3.0 Data Submission Specifications – Detailed data submission specifications for MDS 3.0.
    • RUG-IV SAS Package – Thoroughly tested SAS code for RUG- IV classification with documentation and test data.
    • RUG-III MDS 3.0 Mapping Specifications – This document presents logic that can be used to produce RUG-III classifications using assessment items contained on MDS 3.0.
    • MDS 3.0 Care Area Trigger (CAT) Specifications – For each Care Area, this document provides CAT specifications for the MDS 3.0 items used in triggering the Care Area, the conditions for triggering, and Visual Basic code for triggering. The CATs are replacing the MDS 2.0 Resident Assessment Protocols (RAP).

The release of the MDS 3.0 RAI User’s Manual, however, has been delayed. Rather than release the manual in its entirety, CMS is planning to release it in sections and anticipates that Chapters 1, 2, 3, 5, and 6 will be published in November, while Chapter 4 (Care Area Assessments (CAA) and Appendix C (CAA resources) will be released in December.

According to CMS, the manual, once published, will include “description and instructions for types of assessments and tracking documents, each MDS 3.0 item, the CAA, submission and correction of MDS 3.0 records, SNF and Swing Bed Prospective Payment System (PPS) policy for the MDS 3.0, and the RUG-IV classification system.”

"Once the RAI User’s Manual is released, we will have a better understanding of how to code the MDS 3.0," Brown says.

To view the final MDS 3.0 item set, visit the Resources page on MDSCentral.

For additional files, visit the CMS Web site.


MacKenzie Kimball is an associate editor in the long-term care market at HCPro. She writes PPS Alert for Long-term Care and manages MDSCentral.

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