In summary, the MDS is a paper and pencil assessment form that summarizes data from a variety of sources, may be completed by person who are not knowledgeable about the resident, and is eventually encoded and transmitted electronically to State and Federal governments. MDS forms are used for a variety of purposes:
- Comprehensive assessment and care planning;
- Medicare, and, in some States, Medicaid payments;
- Construction of quality indicators used in the survey process and as a source of public information; and
- Construction of quality measures used as a source of public information.
MDS data inaccuracies can have implications for accurately assessing nursing home residents' needs and developing appropriate care plans, paying appropriate Medicare and Medicaid nursing home payment rates, adequately and appropriately monitoring quality of care, and reporting useful and accurate information about nursing home quality. Deriving administrative data requirements from clinically relevant information collected and recorded at the point of care would significantly reduce the burden providers presently experience in completing the MDS and likely improve the accuracy of data needed to support administrative requirements (e.g., payment, quality monitoring, and public reporting requirements). Most importantly, introducing electronic medical records and information systems to long-term care would support important enhancements to quality of care when automated alerts, decision support can be built into point of care systems. As emphasized earlier, uniform descriptions of clinical data are essential to the success of any such initiative.