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60 Essential Forms for Long-Term Care Documentation PPS Alert for Long-Term Care

The proposed MDS 3.0 assesses signs and symptoms of delirium in item C11 and acute onset mental status change in C12 based on the confusion assessment method (CAM), which "is a validated delirium assessment that replaces the MDS 2.0 delirium items [B5, indicators of delirium-periodic disordered thinking/awareness and B6, change in cognitive status]," explained Debra Saliba, MD, MPH, during a CMS special open door forum to review the proposed clinical content changes for the revised draft MDS 3.0.

The goal of CAM is to improve delirium screening. "In some studies, the reliability of the MDS 2.0 delirium items has been worse than chance. In addition, independent evaluation shows significant underdetection of delirium with unstructured observation," she said. "CAM is increasingly recognized as a valid approach to identifying delirium. It has improved sensitivity and specificity for detecting delirium in frail older adults in hospitals and in postacute care settings."