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MDS 3.0 – Becoming a Reality October 1, 2010 Presented to:

MDS 3.0 – Becoming a Reality October 1, 2010 Presented to: MDS 3.0 National Train the Trainer Conference April 12-15, 2010 Baltimore, MD Thomas Dudley, MS, RN Centers for Medicare & Medicaid Services Office of Clinical Standards and Quality Quality Improvement and Health Assessment Group

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MDS 3.0 – Becoming a Reality October 1, 2010 Presented to:

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  1. MDS 3.0 – Becoming a Reality October 1, 2010 Presented to: MDS 3.0 National Train the Trainer Conference April 12-15, 2010 Baltimore, MD Thomas Dudley, MS, RN Centers for Medicare & Medicaid Services Office of Clinical Standards and Quality Quality Improvement and Health Assessment Group Division of Chronic and Post Acute Care

  2. Let’s Address a Couple of Things Before We Get Started • An updated version of the instrument and manual will be published on the MDS 3.0 page of www.cms.gov in late May or early June. • The taped version of this training conference will be published on www.cms.gov in late May or early June.

  3. Let’s Address a Couple of Things Before We Get Started (cont.) • Comments and questions can be submitted to MDS30Comments@cms.hhs.gov. • The transition to MDS 3.0 is a TEAM effort and together WE will successfully make it through the change.

  4. Let’s Address a Couple of Things Before We Get Started (cont.) • Yes, the new MDS 3.0 instrument will be challenging at first, but keep in mind that MDS 2.0 was challenging at first. Change is hard, but change is good! • “Perfect” doesn’t exist, we strive for perfection, but inevitably there will be hiccups. We all need to be patient as we work through the change together.

  5. Topics to be Covered • History of MDS • Why the Change to MDS 3.0? • MDS 3.0 Timeline • MDS 3.0 Training – Now and Beyond • Quality Measures and Public Reporting

  6. Why MDS? Simple answer: Because the law says so Omnibus Budget Reconciliation Act of 1987 is the Statutory & Regulatory Basis for the RAI To provide a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capabilities To help staff identify health problems Balanced Budget Act (BBA) of 1997 Established the Skilled Nursing Facility (SNF) prospective payment system (PPS).

  7. History Lesson • October 1988 – Development of the RAI Began (HCFA established contracts with RTI, the Hebrew Rehabilitation Center for Aged, Brown University & the University of Michigan) • October 1990 – Effective date for the RAI • April 1995 – MDS 2.0 • April 1995 – Present – Instrument has remained relatively static

  8. Official Uses for MDS • Care Planning - December 1990 • Survey and Certification - December 1990 • Payment/Electronic Submission - June 22, 1998 • Nursing Home Quality Initiative/Public Reporting - November 2002 and the QIO Scope of Work

  9. The true intent of MDS is…. To make CMS happy? NO To give NH providers something to do? NO To give surveyors something to do? NO To make sure providers are paid properly? YES To make sure NH Residents are receiving appropriate care? ABSOLUTELY YES To provide NH providers with a tool to assess the status of their Residents in order to appropriately develop plans of care to optimize quality of life? ABSOLUTELY YES

  10. Why MDS 3.0? • Why not? • MDS 2.0 is outdated • MDS 2.0 isn’t consistent with current clinical practices • MDS 2.0 has limited value to NH’s outside of it being a required assessment

  11. Timeline

  12. Timeline

  13. Official MDS Information and Training Materials SNF/LTC ODF www.cms.gov/OpenDoorForums/25_ODF_SNFLTC.asp MDS 3.0 Website www.cms.gov/NursingHomeQualityInits/25_NHQIMDS30.asp

  14. MDS Web-Based Training Available ~May-June 2010 To be available online 24/7, 365 days/year Exactly the same content that was available at the National Train-the-Trainer Conference

  15. Nursing Home Quality Measures Will include Post Acute and Chronic Care Measures New measures will replace existing measures (or at a minimum modify the existing measures based on the MDS 3.0 Instrument) 18 Candidate measures submitted to NQF Ultimately the measures will be published on Nursing Home Compare

  16. Measures for Possible Retirement

  17. Candidate Measures Submitted to NQF

  18. Candidate Measures Submitted to NQF

  19. Candidate Measures Submitted to NQF

  20. Candidate Measures Submitted to NQF

  21. Just the Facts… • Yes, October 1, 2010 is the implementation date. • Yes, this applies to everyone. • Yes, all of us will survive the change to MDS 3.0.

  22. What’s Next? • Additional QMs • Modifications to the MDS instrument to keep pace with changes in clinical practices • MDS 4.0, Continuity Assessment Record and Evaluation Instrument (CARE), or EHRs?

  23. Questions?

  24. Thank you and enjoy your stay in Baltimore. • General Comments or Suggestions can be submitted to: • MDS30Comments@cms.hhs.gov • Or • Specific Questions can be submitted directly to me: • thomas.dudley@cms.hhs.gov

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