Estimated or researched times to complete MDS 2.0 vs MDS 3.0

andy3k · Jun 15, 2011

I am sorry that I do not have any documented studies or times but I do have this much ...

Carol Maher, a gold standard MDS 3.0 nurse, helped with the testing and timing of MDS 3.0. The CMS claim that it is faster to complete an MDS 3.0 assessment than an MDS 2.0 assessment is not really true, according to Carol. The gold standard nurses only tested the time for the Comprehensive Assessment (not quarterly, discharge, etc.) and it was done without including CAAs. When I spoke to her last year, she believed that MDS 3.0 would take providers longer to complete than MDS 2.0. Carol and Sheri Kennedy, another gold standard MDS 3.0 nurse I spoke with, agreed separately that despite the skip patterns that are built in, the workload is increased from MDS 2.0 due to the clinical interviews, additional tracking forms, and additional assessments that are new with MDS 3.0 (especially the discharge assessment).

susanthomas1954 · Jun 15, 2011

Our personal experience is that the 2.0 full assmt with RAPs took 2.5 hours average. The 3.0 takes just over 3 hours as if you could sit that long with no interruptions. Our company does not allow any autopopulation other than demographics, so it takes a little longer. They used to allow it with 2.0, so all you had to do was enter changes in the qutrlys. The main time WASTER is the discharge assmt. The tracking form took about 45 seconds to complete. Now it takes at least 20 minutes even if you dash through pain, etc. It has nothing to do with care planning or reimbursement, and is so unreliable as to be useless for QI's. The problem is that we have so many dc's that we are buried with those and can't actually get enough time for care plans and CAA's.

edhcinc · Jun 17, 2011

Hi.

The MDS 3.0 used during the RAND research and pilot study was very different than what we have now. It had less data items, easy to complete and understand ADLs, lookback on most items was 5 days (it takes almost 25% more time if the lookback is 7 days), special treatments/programs had a 14 day lookback (regardless of setting) and other variations. Nurses received extensive training by psychology professionals on interviewing techniques. The study had no mention of scheduling/completion "hassles" because the nurse completed the entire MDS in most cases.

SO YES--the originally tested draft MDS 3.0 (full--no RAPs/CAAs) took less time than the MDS 2.0 did. The RAND report can be found at

http://www.cms.gov/NursingHomeQualityInits/Downloads/MDS30FinalReport.pdf

The RAND study appendixes can be found at:

https://www.cms.gov/NursingHomeQualityInits/downloads/MDS30FinalReportAppendix.pdf

Then CMS added and changed particular data items and added multiple new payment assessment types. Most (if not all) of the additional and changed data items were in response to MEDPAC recommendations for "more accurate" MC PPS reimbursement. The discharge "assessment" type was added to try to capture discharge status for potential QMs and upcoming P4P initiatives (but falls short, as the resident status is NOT the status AT DISCHARGE--it includes the same lookbacks and is not useful to any receiving facility). Oh yes--On/Off hospice requires a significant change comprehensive assessment even if one was completed 4 days ago, all orders and CP were changed to reflect the resident's terminal status and care, and included that hospice would begin when family returned from vacation to sign the hospice option form. Despite skip patterns, there are more data items on the current MDS 3.0 than the MDS 2.0.

We all know the outcome--more data items, more assessments, more complicated scheduling, less time for planning and providing care and less time to complete an "accurate" assessment. :uhoh3:

The times mentioned are about what my many colleagues have reported (and does include some "hassle" time)--but does not include the time spent by other professionals.