Disposition of MDS Records
Some nursing homes have voiced their concerns about the validity of the MDS data they are currently collecting and transmitting. They recognize that the data may reflect a high number of errors, rejects, and resubmissions (which may be expected during this pre-regulation testing period). They have also questioned CMS’s intentions, if any, to use the MDS data currently being amassed. To address these concerns, CMS is providing its position on the disposition of MDS records:
CMS's final regulation, "Medicare and Medicaid; Resident Assessment in Long Term Care Facilities", will become effective on June 22, 1998. On this date, all nursing homes participating in the Medicare and/or Medicaid programs will be required to collect Minimum Data Set 2.0 (MDS) information and transmit it, electronically, to their State.
CMS encourages all nursing homes to work with their State to pilot the MDS system well before the June 22 implementation date. By encoding and transmitting MDS data to the State, nursing homes will have the opportunity to gain familiarity with the system requirements, to work out an internal process for assuring the accuracy of encoded and transmitted MDS data, and to identify corrections that need to be made to the process.
CMS does not plan to utilize any MDS data being collected and transmitted by nursing homes during this (pre-June 22) trial period, unless they are currently participating in the Medicare Case-Mix Demonstration Project. In addition, nursing homes in those States that have local/State requirements for submission of MDS data must continue to collect, store and transmit MDS data according to those State requirements.
Any MDS data submitted prior to June 22, 1998 may be deleted from the State system unless the nursing home is either part of the Medicare Case-Mix Demonstration or subject to a State-specific law requiring MDS data submission.
We recognize the intricacies and demands of the new MDS system. Therefore it is paramount that nursing homes, States, and CMS work together to test the process and solve identified problems in order to ensure a successful implementation in June.
QI's based on drug data
Reference files useful for calculating Quality Indicators that are based on Drug data collected in the (optional) Medication section. The primary focus is on data collected on the MDS+ version rather than the MDS 2.0 form.
See Downloads for January 1996 Drug Codes
Update to the ndc_0196.zip file that is described in more detail below. The only change is to the ndc_publ.dat file in the zip. In that file, between 50 and 100 drug codes had blank drug strengths replaced with valid values.
See Downloads for February 1996 Drug Codes
RUG-III VERSION 5.01
This version is for the original RUG-III model (RUG-III 1992). Only a 44 group model is provided. This version was previously used in CMS's Multistate Medicare Case Mix and Quality Demonstration Project in Kansas, Mississippi, and Texas for Medicare payment in participating facilities. Version 5.01 is no longer used for Medicare payment in any state. Version 5.01 may still be used in Medicaid payment systems in some states.
Version 5.01 Grouper Package:
See Downloads below to download a zipped file (ver501.zip, 237,583 bytes, 4+ MB expanded, WordPerfect 5.1 (DOS); ASCII text; and dBase formatted documents) containing all program and documentation files for RUG-III (M3PI) version 5.01. Contents include (1) a DOS "Grouper" program that will update RUG-III classifications in an MDS 2.0 submission file in standard CMS format; (2) a "manual calculator" module in the Grouper program that allows the user to enter the RUG-III MDS items on-screen and then view the resulting classification; (3) standard logic ("pseudcode") for the 44 group model; (4) test databases in standard CMS format with known RUG-III classifications; and (5) associated documentation. There is also a text file (readme.501) with a brief description of RUG-III (M3PI) version 5.01 including installation instructions.
RUG-III VERSION 5.11
The Grouper Program (M3PI) for RUGs 5.11 has been recently updated to version 5.11B. This minor change and will only affect facilities that directly use the Grouper program (M3PI) to perform RUGs classification. Facilities that use proprietary MDS software should be unaffected and no software or other changes should be required. If you use the 5.11 Grouper program for RUGs classification (either by manual entry into the M3PI Calculator screen or by the MDS file update process), please download and use the new 5.11B Grouper version. The new 5.11B Grouper allows use of the new Medicare reasons for assessment (item AA8b codes "7" and "8") implemented with the 1/30/98 Revision to MDS 2.0. Version 5.11 of the Grouper did not accommodate these new codes. There are no other changes with Version 5.11B of the Grouper, with all classification logic, methods, Case Mix Indices, etc. remaining unchanged from Version 5.11 of the Grouper.
Version 5.11B of the Grouper program is for an updated RUG-III model (RUG-III 1997 Update). Both 44 and 34 group models are provided. The 44 group model of this version is used in a preliminary Medicare payment system being demonstrated for Medicare facilities participating in CMS's Multistate Medicare Demonstration Project in several states (Kansas, Maine, Mississippi, New York, South Dakota, and Texas). The use of version 5.11B in each of these demonstration facilities will end with the new facility fiscal year beginning on or after July 1, 1998. With the start of each demonstration facility's new fiscal year (on or after July 1, 1998), the facility will switch from the Medicare Demonstration payment system to the national Medicare Prospective Payment System (PPS) and RUG-III Version 5.12B will then be used for Medicare payment. The 34 group model of Version 5.11B may also be used for Medicaid payment purposes in some States. The 44 group model is not recommended for Medicaid payment purposes.
Note that Version 5.11 replaced the prior Version 5.10. The 44 group model in Version 5.11 is exactly the same as in Version 5.10. Version 5.11 added a 34 group model not found in Version 5.10.
Version 5.11 Grouper Package:
See Downloads below for a zipped file (mdsv511b.zip, 458,338 bytes, 11+ MB expanded) containing all program and documentation files for RUG-III (M3PI) version 5.11B. Contents include (1) a DOS "Grouper" program that will update RUG-III classifications in an MDS 2.0 submission file in standard CMS format; (2) a "manual calculator" module in the Grouper program that allows the user to enter the RUG-III MDS items on-screen and then view the resulting classification; (3) standard logic ("pseudcode") for the 44 and 34 group models; (4) test databases in standard CMS format with known RUG-III classifications; and (5) associated documentation. There is also a text file (readme) with a brief description of RUG-III (M3PI) Grouper version 5.11B including installation instructions.
MDS 2.0 RAI
Announcement of the New September 2000 Update of the MDS 2.0 (posted 7/17/00)
A formal attestation statement certifying accuracy has been developed for all MDS forms (Assessment Forms, Tracking Forms, and the Correction Request Form). The September 2000 Update forms including this formal attestation statement and the appropriate, accompanying signature lines are available below and will be implemented on September 1, 2000. At that time, facilities must adopt all of the September 2000 Update forms. The implementation of the September 2000 Update forms will not require any changes to the MDS 2.0 data specifications or the data submitted in an MDS record.
Note that a Draft August 2000 Update of the MDS 2.0 had previously been posted here and targeted for August 1, 2000 implementation. This draft version has been removed and will not be implemented. Instead, the September 2000 Update will be implemented on September 1, 2000. There are only minor revision from the Draft August 2000 Update to the September 2000 Update, and these revisions are catalogued in the document mdsc0900.pdf provided below.
September 2000 Update to the MDS Resident Assessment form
September 2000 Update to the MDS Resident Assessment form includes the following files:
- The new September 2000 Update to the MDS form will be implemented on September 1, 2000. The form consists of one .pdf file (see Downloads below). This file contains the Basic Assessment Tracking Form, the MDS Facesheet, the Full Assessment Form, the Resident Assessment Protocol Summary, the Resident Assessment Protocol Trigger Legend, the Quarterly Assessment Form, the Optional Quarterly Assessment Form for RUG-III, the Optional Quarterly Assessment Form for RUG-III 1997 Update, the Discharge Tracking Form, the Reentry Tracking Form, the Correction Request Form, and the Medications Form (Section U).
- Correction Notice (8/29/2000) - The September 2000 Update to the MDS form was originally posted here in the .pdf file "mds0900.pdf". The RAP Trigger Legend forms that were included on pages 10 and 11 of this file were incomplete, with the dot symbols indicating RAP trigger items missing. Only these 2 pages were incorrect. The "mds0900.pdf'" file has therefore been replaced above with a new file named "mds0900b.pdf". The new "mds0900b.pdf" file includes corrected pages for the RAP Trigger Legend forms with the trigger symbols present. The new "mds0900b.pdf" file includes no other changes.
- Revisions made to the September 2000 Update form, compared to the 1/30/98 Version, are documented in a .pdf file (see Downloads below).
The implementation rules for the September 2000 Update form are provided in a .pdf file (see Downloads below).
Errata #1 for the September 2000 Update to the MDS Resident Assessment form (posted 7/20/2000):
All of the September 2000 Update MDS 2.0 forms are correct as originally posted. Only the document summarizing the changes made with the September 2000 Update form is in error, and there is only one typographical error in this document. The original document (file name mdsc0900.pdf) describing changes with the September 2000 Update form has been replaced above with a corrected document (file named mdsc900b.pdf). On page 3, the original document (mdsc0900.pdf) incorrectly stated that the attestation language had been changed (relative to the Draft August 2000 Update) from:
"…this information was collected in accordance with all Medicare and Medicaid requirements.."
"…this information was collected in accordance with appropriate Medicare and Medicaid requirements.." The actual language change from the Draft August 2000 Update to the September 2000 Update was from "all" to "applicable" (rather than to "appropriate"). This correction has been made in the document (named Revisions made to the September 2000 Update Form, see Downloads below).
MDS Resident Assessment form (v.1/30/98)
Includes the following files:
- A description of the Specifications of HCFA's MDS/RAI and Effective Dates can be found in Downloads below.
- A description of the Errata Sheet for MDS 2.0 (1/30/98) can be found in the Downloads below.
- The new MDS2.0 resident assessment form, version1/30/98, which must be used when the final rule is effective June 22, 1998. The form consists of two files: the first .pdf file mds20.pdf named MDS 2.0 resident assessment form, version 1/30/98 (see Downloads below) can be opened and read using Adobe Acrobat and the other .pdf file lays out the explanation for Section U entries (see Downloads below).
Includes 2 PageMaker 5.0 for Windows format documents (mds20a.pm5 and mds20b.pm5) containing the MDS 2.0 forms as found in HCFA's SOM 272 and Long Term Care Facility RAI User's Manual version 2.0, October 1995. See MDS Forms in the Downloads section.
Contains a list of changes and corrections found in form 10/94H. Available in rich text format. See Corrections Found in Form 10/94H in the Downloads Section.
Facility Guide for the Nursing Home Quality Indicators (QI's)
This guide was developed at the Center for Health Systems Research and Analysis (CHSRA) by the Nursing Home Quality Indicators Development Group (NHQIDG). The Group is associated with the University of Wisconsin-Madison. This guide is intended to be used for personal, educational, or other non-commercial purposes. (The manual is dated September 28, 1999.) See Downloads below to view the guide.