As the October release of the Minimum Data Set 3.0 data specifications approaches, skilled nursing facilities across the nation become more and more concerned about the additional work this assessment tool seems to require. However, CMS officials and those involved with the development of the MDS 3.0 stand behind the claim that it will actually be easier and less time-consuming than the currently used MDS 2.0.
"Having been a part of the MDS 3.0 development team, I really believe that it shouldn't take any more time than the MDS 2.0," says Rena Shephard, RN, president of RRS Healthcare Consulting Services and founding chair and executive editor of the American Association of Nurse Assessment Coordinators. "In fact, during the demonstration study, nurses timed how long it took to complete the MDS 3.0 and MDS 2.0 for the same residents, and it took them less time to do the MDS 3.0."
However, given the length, required resident interviews, and other features of the MDS 3.0, many SNFs are skeptical that this seemingly cumbersome assessment will actually take less time. Fortunately for SNFs, things are not always as they seem.
"When people downloaded and printed the MDS 3.0 draft item set from the CMS Web site, many were shocked at how long it was. However, the draft item set is very deceptive," Shephard says. "Compared to the MDS 2.0, the font on MDS 3.0 draft item set is a lot bigger, there is a lot more white space, and the physical layout is different. This makes it appear to be much longer than the MDS 2.0 when, in actuality, it isn't."
SNFs should also understand that the MDS 3.0 draft item set includes every MDS item that could appear on any MDS assessment or tracking form. "You would never complete every single item included in the draft for one assessment," Shephard says.
Even some items that will be included on full MDS 3.0 assessment form will not be completed every time. For example, there will be a screening process under the MDS 3.0 to determine if a resident is able to complete the interviews for mental status, mood, pain, and daily preferences. If he or she is not capable of completing the interviews, the staff assessment would be completed instead. A facility would never complete both the interview section and the staff assessment section.
Although completing the MDS 3.0 may actually require less time and effort than the MDS 2.0, adapting to the new assessment tool will be a time-consuming task for many SNFs.
"Change, in general, often is chaotic and it may take facilities a little while to develop policies and procedure that work with the MDS 3.0," Shephard says. "I really encourage facilities to begin training staff early on the interview items and thinking about the policies, procedures, and other things that will have to be changed once the MDS 3.0 is implemented."
So, will all the initial work be worth it? Shephard seems to think so.
"As with any new system, we will fumble with the MDS 3.0 at first," Shephard says. "But once everyone becomes comfortable with it, facilities should see how much of an improvement it is and they, along with their residents, will reap the benefits of a better assessment and an easier and faster assessment process."