MDS Alert

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CMS' recent memo, "The Use of Dashes in Completing the MDS 3.0 Assessment: Potential Impact to Beneficiaries and Nursing Home Facilities," includes the following information from the current MDS 3.0 manual:

Chapter 2: "For unplanned discharges, the facility should complete the Discharge assessment to the best of its abilities. The use of the dash, "-", is appropriate when the staff are unable to determine the response to an item, including the interview items. In some cases, the facility may have already completed some items of the assessment and should record those responses or may be in the process of completing an assessment. The facility may combine the Discharge assessment with another assessment(s) when requirements for all assessments are met."

Chapter 3: "Almost all MDS 3.0 items allow a dash (-) value to be entered and submitted to the MDS QIES ASAP system.

A dash value indicates that an item was not assessed. This most often occurs when a resident is discharged before the item could be assessed.

Dash values allow a partial assessment to be submitted when an assessment is required for payment purposes.

There are five date items (A2400C, M0300B3, O0400A6, O0400B6, and O0400C6) that use a dash-filled value to indicate that the event has not yet occurred. For example, if there is an ongoing Medicare stay, then the end date for that Medicare stay (A2400C) has not occurred, therefore, this item would be dash-filled.

The few items that do not allow dash values include identification items in Section A (e.g., reasons for assessment, resident name, assessment reference date) and ICD-9 diagnosis codes (Item I8000)."

"To determine whether a specific item allows a dash value or not, refer to the MDS 3.0 Data Submission Specifications at: http://www.cms.gov/NursingHomeQualityInits/30_NHQIMDS30TechnicalInformation.asp."

Source: Printed verbatim from the CMS memo at www.cms.gov/NursingHomeQualityInits/Downloads/MDS30TheUseOfDashes.pdf.