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CMS releases new MDS 3.0 draft

MDS 3.0 Update, May 18, 2009

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CMS released an updated MDS 3.0 Draft Item Set on May 7 and the new version includes significant changes from previous drafts and the MDS 2.0. CMS plans to release the final MDS 3.0 in October of this year and implement the new assessment system on October 1, 2010.

Although items may be added, revised, or dropped before the final MDS 3.0 is released, the updated MDS 3.0 draft gives providers a good indication of what the final version will include.

Some key changes featured in the updated MDS 3.0 draft include:

• The MDS 2.0 two-column coding format for ADL self-performance and support provided, which was omitted from the previous draft, is included in the updated version.
• Changes to section T. The updated MDS 3.0 draft revises the manner in which therapy services are reported. The updated draft includes a section to report the start and end dates of therapy, which will allow an Other Medicare Required Assessment (OMRA) to be done sooner.
• The requirement that the Brief Interview for Mental Status, Resident Mood Interview (PHQ-9), Interview for Daily Preference, Interview for Activity Preference, and Pain Assessment Interview be conducted the day before, day of, or day after the assessment reference date is omitted from the updated MDS 3.0 draft.
• The look-back period for active diseases was reduced from 30 days to 7 days.
• The updated MDS 3.0 draft clearly states the reverse staging of pressure ulcers should not be used.
• Section N, Medication, of the updated MDS 3.0 draft includes a section for insulin.
• The revision to the look-back period under RUG-IV, which will exclude certain preadmission services from RUG calculation, necessitates changes to the way these services are reported on the MDS. Section O of the updated MDS 3.0 draft includes a two-column format indicating which special treatments and procedures provided in the 14-day look-back period were administered “while not a resident” and “while a resident.” The services provided “while a resident” will be used in RUG calculation and care planning, while the services provided “while not a resident” will only be used in care planning.
• The updated MDS 3.0 draft includes a section for the Care Area Trigger (CAT) Summary (Section V). CATs will replace Resident Assessment Protocols (RAP) as the new tools for organizing MDS information about a resident’s health problems and functional status.

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