MDS Alert

Reader Questions:

Understand Exactly How the MDS is Used

Question: I’m new to the minimum data set (MDS) and am wondering just how important of a document it is. My higher-ups say it’s the main way our facility is paid. I thought that it is mostly a tool for documenting a resident’s condition? Doesn’t their medical record cover that well enough already?

New Jersey Subscriber

Answer: The MDS was designed to collect and showcase comprehensive medical and functional information for individual residents, but also as a means of evaluating reimbursement, and collecting data that constitutes a big-picture look at the state of people living in and receiving care from nursing homes.

Reimbursement is determined by more than just the MDS, notes Jane Belt, MS, RN, QCP, RAC-MT, RAC-MTA, MDS consultant, in Columbus, Ohio.

The RAI Manual explains that the MDS has several crucial functions.

It is the foundation of:

  • the development of an individualized care plan;
  • the Medicare Prospective Payment System;
  • Medicaid reimbursement programs;
  • quality monitoring activities, such as the quality measure reports;
  • the data-driven survey and certification process;
  • the quality measures used for public reporting; and
  • research and policy development.

Various stakeholders use the MDS in such wide-ranging ways that accuracy is absolutely paramount. The templates that constitute the MDS are important for ensuring that the same types of data are assessed and documented for each resident across the country.