MDS 3.0 Overview Presented to: The National Consumer Voice for

MDS 3.0 Overview Presented to: The National Consumer Voice for Quality Long Term Care NCCNHR Annual Meeting and Conference: Quality Care October 23, 2009 Washington DC Mary Pratt, RN, MSN Director, Division of Chronic and Post Acute Care

Review the MDS 3.0 Timeline Features of MDS 3.0 Overview of the plans for MDS 3.0 Training New Quality Measure Development

January / February 2010 – -- Publish final MDS 3.0 Data Specifications (including RUGs and CAA triggers. (QM/QI specifications to be released at a later date) -- Publish MDS 3.0 Item Sets (includes Admission, Quarterly, Swing Bed, PPS, Discharge MDS and tracking records) -- Publish MDS 3.0 Long-Term Care Facility Resident Assessment Instrument User’s Manual (Revision to be Published May 2010) March 2010 – NQF Call for Quality Measures (MDS 3.0) April 12-15, 2010 – MDS 3.0 National Train the Trainer Conference October 1, 2010 – MDS 3.0 Implementation December 2010 – NQF Endorsement of Quality Measures (3.0)

Uses Standardized Assessments Tools Gives Resident Voice Increases Clinical Relevance Increases Accuracy Increases Clarity Provides Care Area Assessments

Anticipate hosting three MDS 3.0 satellite broadcasts or webcasts: December 2009 – MDS 3.0 Overview Summer 2010 – Impact on surveyors Coding and assessment requirements

MDS 3.0 Train-the-Trainer Baltimore, MD March 15 - 19, 2010 CMS CO, RO, and State RAI Coordinators MDS National Conferences (2) Baltimore, MD During the week of April 12, 2010 Provider groups, stakeholders & professional associations

MDS Conferences SNF/LTC ODF ( www.cms.hhs.gov/OpenDoorForums/25 ODF SNFLTC.asp) Medicare Learning Network MDS 3.0 Website (www.cms.hhs.gov/MLNGenInfo/) ( www.cms.hhs.gov/NursingHomeQualityInits/25 NHQIMDS30.asp)

To be available online 24/7, 365 days/year Structured by section supported by key topics Overview Key terms relevant to the section Conducting the assessment Coding instructions Coding practice (for selected sections) Available through the Medicare Learning Network (MLN)

Conduct via telephone and web conference To include opportunity to ask questions of MDS subject matter experts

Based on questions documented at the MDS conferences and web conferences Available through the MLN

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

Disposition of Existing Measures MDS 2.0 Quality Measures Transitioning to MDS 3.0 Percent of Residents Who Were Assessed and Given Influenza Vaccination Percent of Residents with Pain Percent of Residents Who Were Assessed and Given Pneumococcal Vaccination Percent of Short-Stay Residents with Pressure Ulcers That Are New or Have Not Improved PAC Chronic X X X X X X X

Disposition of Existing Measures MDS 2.0 Quality Measures Transitioning to MDS 3.0 PAC Percent of Long-Stay Residents Who Have Become More Depressed or Anxious Percent of Long-Stay, Low-Risk Residents Who Lose Control of their Bowels or Bladder Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder Percent of Long-Stay Residents Who Were Physically Restrained Percent of Long-Stay, High-Risk Residents with Pressure Ulcers Percent of Long-Stay Residents with a Urinary Tract Infection Percent of Long-Stay Residents Who Lose Too Much Weight Chronic X X X X X X X

Measures for Possible Retirement MDS 2.0 Quality Measures Recommended for Retirement/Replacement PAC Chronic Potential Replacement Delirium Mobility decline Pressure ulcers (low risk) Bedfast X X X X Delirium (new PAC measure) ‘Ambulation’ (PAC and Chronic)

Summary Table of 18 Measures Submitted to NQF for Endorsement PAC Chronic Five-Star Item Percent of Residents with Pain X X X Delirium (replacement measure) X X Percent of Short-Stay Residents with Pressure Ulcers That Are New or Have Not Improved X X Percent of Residents Who Were Assessed and Given Pneumococcal Vaccination X X

Summary Table of 18 Measures Submitted to NQF for Endorsement Percent of Residents Who Were Assessed and Given Influenza Vaccination PAC Chronic X X Five-Star Item ADL decline (replacement measure) X X Mobility decline (replacement w/ focus on ambulation) X X Percent of Long-Stay, High-Risk Residents with Pressure Ulcers X X

Summary Table of 18 Measures Submitted to NQF for Endorsement Chronic Five-Star Item Percent of Long-Stay Residents Who Were Physically Restrained X X Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder X X Percent of Long-Stay Residents with a Urinary Tract Infection X X PAC

Summary Table of 18 Measures Submitted to NQF for Endorsement PAC Chronic Percent of Long-Stay, Low-Risk Residents Who Lose Control of their Bowels or Bladder X Percent of Long-Stay Residents Who Lose Too Much Weight X Percent of Long-Stay Residents Who Have Become More Depressed or Anxious X Five-Star Item

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