MDS Alert

The MDS plays a lead role in the new Quality Indicator Survey process. The Centers for Medicare & Medicaid Services is testing the QIS in a five-state demonstration and has plans to roll it out in Florida statewide. In the demonstration, the QIS is the survey of record where it's performed instead of the traditional survey. In the QIS, surveyors prepare offsite by requesting and downloading MDSs performed on a facility's residents within 180 days prior to the survey. The surveyors run the MDSs through an algorithm to identify quality concerns, reported CMS official Cynthia Graunke, in a presentation, "Quality Indicator Survey -- The Survey of the Future," at the 2007 American Health Care Lawyers' Long-Term Care and the Law conference in Orlando. The revamped survey process focuses more surveyor attention on facilities with problems, Graunke relayed.

Check out the March 2007 RAI user's manual update. The latest update makes some minor but significant changes. For example, CMS revised the definition of "Any Scheduled Toileting Plan" for coding H3a by adding the words "A plan for bowel and/or bladder elimination whereby staff members at scheduled times each day either take the resident to the toilet room, or give the resident a urinal, or remind the resident to go to the toilet. Includes bowel habit training and/or prompted voiding."

The update also deletes the words "or biological (e.g., contrast material)" from the following sentence for coding P1ac: "Includes any drug or biological (e.g., contrast material) given by intravenous push or drip through a central or peripheral port." Review all the changes at www.cms.hhs.gov/NursingHomeQualityInits/downloads/MDS20Update200703.pdf.