NHQI Spotlights and Announcements

Updates

October 23, 2023

The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.v2.October.20.2023” is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The errata document contains revisions to the MDS 3.0 RAI Manual version (v)1.18.11R to provide clarity and additional guidance in Section D and Chapter 6 to support item D0100, Should Resident Mood Interview be Conducted? serving as a gateway item for the Resident Mood Interview (PHQ-2 to 9^©) and D0500, Staff Assessment of Resident Mood (PHQ-9-OV^©). Minor revisions also included are corrections to language in Section Q to provide proper guidance on Care Area Assessment (CAA) requirements, corrections to language in Chapter 2 to provide proper guidance on combining Omnibus Budget Reconciliation Act (OBRA) discharge assessments, an updated Internet Quality Improvement & Evaluation System (iQIES) warning error message in Chapter 5, updated screenshots in Section A and Section O, and an updated MDS Item Matrix. The errata document also includes all issues from previous MDS 3.0 RAI Manual v1.18.11R errata releases.

Changed manual pages are marked with the footer “October 2023 (R).”

The errata document begins with a table that lists all identified revisions and the pages to which they have been applied. Following the table are the actual corrected replacement pages for insertion into the printed manual.

October 20, 2023

UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v6

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. Changes in this version (listed below) align the item sets with the Errata V3.01.3 for MDS Data Specifications V3.01.1 (FINAL) posted September 21, 2023, on the Minimum Data Set (MDS) 3.0 Technical Information page. For a full list of changes to the final posted item sets since v1, see the Item Set Change Table Supplement that accompanies the posting. The MDS Item Sets v1.18.11 were effective beginning October 01, 2023.

M0300G1 on NPE                       Replaced erroneous skip pattern <Skip to N2005, Medication Intervention> with the correct one: <Skip to N0415, High-Risk Drug Classes: Use and Indication>.

O0300A on NP and NQ              Corrected transposition of verbs in skip patterns (changed <Skip> to <Continue> in choice 0 and <Continue> to <Skip> in choice 1).

O0400 on NC and NQ                 Removed completion language <Complete only when A0310B = 1 (complete O0400D2 when required by state)>.

O0400 on NP and SP                  Removed completion language <Complete only when A0310B = 1>.

O0420 on NC, NP, and NQ           Removed completion language <Complete only when A0310B = 1>.

September 20, 2023

MDS 3.0 QM User’s Manual Version 16.0– Now Available

The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual is now available. This document serves as an update to the specifications used to calculate quality measures that are included in the NHQI effective October 1, 2023.

For more information, please visit the NHQI Quality Measures website.

September 08, 2023

The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.September.8.2023” is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The errata document contains revisions to pages in Chapter 4 of the MDS 3.0 RAI Manual version (v)1.18.11R that better align the Care Area Assessments (CAAs) with the Care Area Trigger (CAT) specifications, as well as a revision to Section D that corrects the Coding Instructions guidance for item D0160. Total Severity Score.

Changed manual pages are marked with the footer “October 2023 (R).”

The errata document begins with a table that lists all identified revisions and the pages to which they have been applied. Following the table are the actual corrected replacement pages for insertion into the printed manual.

August 24, 2023

UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v5

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. All item sets have been replaced with revised versions. The list below highlights all substantive changes or corrections since the final versions were first posted on April 3rd. Additionally, a number of other items (not listed) have had small changes to their formatting. This will be the final version of the MDS Item Sets v1.18.11 that will be effective beginning October 01, 2023.

A1005 on IPA                               Corrected erroneous lettering of final subitem (changed A1005Z [wrong] to A1005Y [correct]).

A1200 on NC and NQ                 Corrected erroneous numbering scheme for responses (changed from 0-4 [wrong]) to 1-5 [correct]).

A2121 on NQ                               Corrected typo (<Referenc>) in choice 0.

B1300 on NPE                              Changed completion language to remove <Complete only if A0310G = 1>.

D0100 on NPE                              Changed completion language to remove <If A0130G=2 Skip to D0700. Otherwise.>

D0100 on NPE                              Corrected incorrect skip pattern in choice 0.

D0100 on IPA                               Removed erroneous skip pattern language.

D0150B on NQ                             Removed <or appearing> from item language.

D0700 on NPE                              Changed completion language to remove <Complete only if A0310G = 1>.

D0700 on ND                               Added completion language <Complete only if A0310G = 1>.

GG0130, Column 3, on NPE      Changed completion language to remove <and A2105 is not = 04>.

GG0170, Column 3, on NPE      Changed completion language to remove <and A2105 is not = 04>.

GG0170, Column 3, on SD         Corrected capitalization in item title from <stay> to <Stay> (on first page of two).

I0020 on IPA                                Corrected numbering of final option from 99 to 13.

J0530 on SD                                 Removed erroneous option 0 and corrected typo (<activites>) in question that the resident is being asked.

J0600 on NP                                 Corrected label for boxes from <Enter Code> to <Enter Rating>.

J1400 on NP                                 Corrected typo (inserted missing closing parenthesis at end of item text).

M0300 on SP                               Added missing item title to heading at top of page.

M0300C on NPE                          Corrected typo (removed period at end of item).

M1040 on NC                              Corrected typo in label in the gray area above subitem A (made <Problems> plural).

O0300A on NP and NQ              Corrected transposition of verbs in skip patterns (changed <Skip> to <Continue> in choice 0 and <Continue> to <Skip> in choice 1).

O0400 on NC and NQ                 Changed completion language to add <complete O0400D2 when required by state)>.

O0500 on IPA, NP, and SP         Removed extra box at left (items O0500D–O0500J had eight boxes for only seven items in the list) and realigned boxes on left with items on right.

X1100E on SD    Restored this subitem, which was missing in previous version.

August 22, 2023

NOW AVAILABLE: Final MDS 3.0 RAI User’s Manual version 1.18.11

The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.18.11 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.18.11 will be effective beginning October 01, 2023.

This version of the MDS 3.0 RAI Manual contains substantial revisions related to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which requires that standardized assessment items be collected across post-acute care (PAC) settings. Standardized data will enable cross-setting data collection, outcome comparison, exchangeability of data, and comparison of quality within and across PAC settings. Additionally, the language of the manual has been updated throughout to be gender neutral. Guidance and examples in numerous chapters and appendices have been revised for clarification and to reflect current regulations and best practices. Due to the scope of the revisions, CMS will not issue Replacement Pages for v1.18.11; those wishing to continue using a physical copy of the manual are encouraged to print the new version.

A document listing all changes from the MDS 3.0 RAI Manual v1.18.11 draft version to the final version is available for reference in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page.

August 22, 2023

New Minimum Data Set (MDS) 3.0 Frequency Report Website

Effective August 21, 2023, MDS 3.0 Frequency data will be available from a new location on the data.cms.gov website (https://data.cms.gov/quality-of-care/minimum-data-set-frequency). This new website replaces the previous MDS 3.0 Frequency Report webpage which was decommissioned on August 1, 2023.

Users will find very similar information on this new website to that which was provided on the historical MDS 3.0 Frequency Report webpage, including an overview of the data that are accessible from the website, explanatory text that identifies the methodology for calculation of those data, and the item response frequency data. Enhanced functionality on the new website allows users to view the Frequency data online, including filtering functionality of the data to meet the user’s needs. This new website also allows users to download and save the Frequency data in Comma Separated Value (CSV) or CSV for Excel files by calendar quarter. The downloadable files contain MDS 3.0 Frequency data for all states and the Nation by the calendar quarter report period. Downloadable CSV files will be available for all calendar quarters beginning with Calendar Year (CY) 2020 (Q1, 2020) through Q2, 2023. As each new calendar quarter begins, data for the prior calendar quarter will be made available on the website. For example, Q3, 2023 data will be available for download approximately mid-late October, 2023.

The CSV files contain the following data elements:

•            Geographical Location – this column identifies the State or National location for which the MDS 3.0 Frequency data are reported.

•            Report Date – this column identifies the Calendar Quarter and Year for which the MDS 3.0 Frequency data are reported (e.g., Q1, 2022).

•            MDS Item Question/Description – this column identifies the item ID and section description as displayed on the MDS assessment instrument, followed by the item specific description for which the data are reported. Example: A0800: Identification Information – Gender.

•            MDS Item Response – this column contains item responses that correspond to the assessment item. Each response for an item is listed on a separate row so that counts and percentages are displayed for each response by geographic location.

•            Percent – this column contains the percent of responses for each item, geographical location, and reporting quarter.

•            Total Residents – this column identifies the number of times each response was answered for an item grouped at a state and national level for the reporting quarter.

With this migration to the new webpage, active MDS items for which the frequency counts are calculated for the report periods above are included in the CSV files and retired items have been removed.  As new items are added to the MDS assessment instrument, they will be included in the downloadable files if the item/response value are appropriate for the MDS 3.0 Frequency calculations.

iQIES Service Center

If you have any questions regarding this information, please contact the QIES/iQIES Service Center by phone at (800) 339-9313 or send an email.

August 15, 2023

UPDATED: Optional State Assessment (OSA) Item Set and OSA Manual

The Optional State Assessment (OSA) Item Set and OSA Manual have been updated, and the updated versions are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. Some items, listed below, have been corrected, and a number of other items have had small changes to their formatting. Screenshots in the manual have been updated, where needed, to reflect these changes.

The OSA is not a Federally required assessment; rather, it may be required in some States for payment purposes. Each State determines whether the OSA is required and if so, when the assessment must be completed. For questions regarding completion of the OSA, please contact your State Survey Agency.

The following corrections were made:

A0700        The word <patient> was changed to <recipient>.

C0300A      Erroneous numbering (1–4) was changed to the correct numbering (0–3). 

C0500         The wording of the instruction was changed from <Enter Code> to <Enter Score>.

O0100   The label above subitem Z was corrected from <Other> to <None of the above>.

August 14, 2023

Final MDS 3.0 RAI User’s Manual Version 1.18.11

Earlier today, messaging was posted on several CMS pages announcing the “Final” version of the MDS 3.0 RAI User’s Manual version 1.18.11. This messaging and the associated file was posted in error and is not the Final version the MDS 3.0 RAI User’s Manual version 1.18.11. CMS expects to post the final version before the end of August.

August 3, 2023

Decommissioning of the Minimum Data Set (MDS) 3.0 Frequency Report Website

Effective August 1, 2023, the MDS 3.0 Frequency Report webpage (https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Minimum-Data-Set-3-0-Public-Reports/Minimum-Data-Set-3-0-Frequency-Report) is no longer supported and has been decommissioned.  A replacement webpage where users can access the MDS 3.0 Frequency report data will be made available in the near future.  Additional information about the new webpage will be forthcoming.

Any questions regarding this information should be directed to the iQIES Service Center via email at iqies@cms.hhs.gov or by phone at (800) 339-9313.

July7, 2023

UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v4

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The Interim Payment Assessment (IPA), Nursing Home Prospective Payment System (PPS) (NP), and Swing Bed PPS (SP) Item Sets have been replaced with revised versions; the remaining item sets remain unchanged from the last posted version. The MDS Item Sets v1.18.11 will be effective beginning October 1, 2023.

The Item set edits are noted below.

IPA item set

O0500 contained an additional response box which was removed

A1005 response option Z. was changed to response option Y.

NP item set

O0500 contained an additional response box which was removed

SP item set

O0500 contained an additional response box which was removed

June 23, 2023

UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v3

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The Nursing Home Comprehensive (NC) and Nursing Home Quarterly (NQ)Item Sets have been replaced with revised versions; the remaining item sets remain unchanged from the last posted version. The MDS Item Sets v1.18.11 will be effective beginning October 1, 2023.

The change that was made involved A1200. Marital Status.  It was noted that the item response code numbering was changed in error on the NC and NQ item sets only. This has been corrected.

June 7, 2023

UPDATED: Final MDS 3.0 Item Sets version 1.18.11

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual webpage. The Nursing Home Prospective Payment System (PPS) (NP), Nursing Home Part A PPS Discharge (NPE), and Swing Bed Discharge (SD) Item Sets have been replaced with revised versions; the remaining item sets remain unchanged from the last posted version. The MDS Item Sets v1.18.11 will be effective beginning October 1, 2023.

The item set edits are noted below and on the revised MDS 3.0 Item Set Change History v1.18.11v2.pdf. These edits are also reflected in the Final MDS Data Submission Specifications V3.01.0 posted on the Minimum Data Set (MDS) 3.0 Technical Information webpage.

NPE item set

B1300: Completion language removed

D0100: Part of the completion language was removed

D0700: Completion language removed

ND item set

D0700: Completion language added

SD item set

X1100E: added to item set

May 15, 2023

REGISTRATION OPEN: The SNF MDS 3.0 RAI v1.18.11 Guidance Training Program

The Centers for Medicare & Medicaid Services (CMS) is offering a virtual training program that provides instruction on the updated guidance for the Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) v1.18.11 Manual and Item Set. This training consists of a series of recorded presentations intended to be reviewed prior to a live virtual event. Registration is only required for the live virtual training event.

For more information and to register for the event, please visit the SNF Quality Reporting Program (QRP) Training page.

April 24, 2023

NOW AVAILABLE: OSA Item Set and OSA Manual

The Optional State Assessment (OSA) Item Set, OSA Manual, and OSA Change History table are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The OSA is not a Federally required assessment; rather, it may be required in some States for payment purposes. Each State determines whether the OSA is required and if so, when the assessment must be completed. For questions regarding completion of the OSA, please contact your State Survey Agency.

April 3, 2023

NOW AVAILABLE: Final MDS 3.0 Item Sets version 1.18.11

The final Minimum Data Set (MDS) 3.0 Item Sets version v1.18.11 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.18.11 will be effective beginning October 1, 2023.

April 3, 2023

NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.18.11

The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.18.11 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.18.11 will be effective beginning October 1, 2023.

This version of the MDS 3.0 RAI Manual contains substantial revisions related to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which requires that standardized assessment items be collected across post-acute care (PAC) settings. Standardized data will enable cross-setting data collection, outcome comparison, exchangeability of data, and comparison of quality within and across PAC settings. Additionally, the language of the manual has been updated throughout to be gender neutral. Guidance and examples in numerous chapters and appendices have been revised for clarification and to reflect current regulations and best practices. Due to the scope of the revisions, the Centers for Medicare & Medicaid Services (CMS) will not issue Replacement Pages for v1.18.11; those wishing to continue using a physical copy of the manual are encouraged to print the new version.