July Update: MDS 3.0 Implementation Timeline

CapeCodMermaid, RN · Jul 17, 2008

As always Talino, you provide up to the minute, useful information. Thanks.

Talino · Jul 18, 2008

According to the timeline above, the Final Report will be posted on July 25th. I guess the train arrived early ... http://www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp scroll down.

I still don't see the RAPs.

For quick reference, see the the summary of changes from the 2.0 to 3.0 and the rationale on pp 193-261 (browser's).

Rexie68 · Jul 19, 2008

keeping my fingers crossed that the raps won't be included in 3.0. i participated in a cms survey that asked our opinion on raps, and i strongly expressed my dislike for them. hopefully not seeing them now is a good omen for the future!! :typing

CapeCodMermaid, RN · Jul 19, 2008

OKAY so call me weird, but I always liked the raps. It's like being an attorney....sure the problem triggered based on the raw data, but for that particular resident is it a problem? If I did an MDS on myself I'd trigger for dehydration because I take a diuretic daily. Am I dehydrated? NO. Am I at risk? Hardly. Gotta love the thought process behind the raps and care plans.

Rexie68 · Jul 19, 2008

i just see the raps as unnecessary. i already know what needs care planned, and constantly typing in the whereabouts of the documentation (which never changes..."7 day assess, nn, caretracker" for my sections etc) seems quite redundant. i'd rather focus on making my careplans more personalized. i guess we all have our weirdness.......after all, we're mds peoples!

edhcinc · Aug 12, 2008

For those of you who DID participate in the March 2008 informal "survey/questionnaire" (by AHCA) about RAPs for MDS 3.0--THANK YOU!

We are FINALLY submitting our findings and recommendations to CMS. The final report will be posted and be available for all to read within the next week or so...will communicate the location via this listserv.

Preliminarily--most nurses DID NOT WANT TO CONTINUE doing the RAPS, as currently presented, for many reasons. Many nurses wanted to continue with "triggers" for MDS 3.0--as "reminders".

With MDS 3.0 right around the bend, and funding "short", it is highly unlikely that NEW RAPS will be prepared, though the OLD may still be included as a reference.

:spbox: As nurses, we must, however, recognize and appreciate the value of analyzing, or looking at, an individual's problem (or potential problem) as part of a process in a standardized way--using a multi-disciplinary approach using the RAPs, or more current clinical guidelines.

Sometimes we "know" our patients, but not THIS patient. We "miss the boat" about THIS patient's weight loss, because the dietitian picked up something in his/her assessment that was not considered in the care plan. Sometimes the plan contains components which have been proved to be ineffective in recent evidence-based research. And then we wonder why the care plan failed...

We can't forget that there is an "art" and a "science" behind nursing. It is our skill in using the science which can make the difference whether or not an individual patient's plan works, or doesn't.