MDS Information

This page contains information for nursing home providers and other parties interested in the Minimum Data Set (MDS). This site will contain information related to MDS educational opportunities, links to federal websites, manuals, resources available and other items of significant interest. Please check back frequently for new information.

Visit MDS 3.0 Training for online educational activities provided by CMS (Centers for Medicare and Medicaid Services). You can also check MDS Resources for more information.

MDS History/Background

The MDS is a powerful tool nursing homes (NHs) and non-critical access hospital swing beds (SBs) facilities use for standardized residents/patients assessments and for facilitating their care management. It is a core set of screening, clinical, and functional status elements which form the foundation of a comprehensive assessment for all residents of nursing homes and patients of swing bed facilities certified to participate in Medicare or Medicaid. The MDS standardize communication about residents/patients within facilities, between facilities, and between facilities and outside agencies.

The primary purpose for the MDS as an assessment tool is to identify resident/patient care problems which should be addressed in an individualized care plan. In addition, data collected from MDS assessments is used for Medicare reimbursement and for monitoring the quality of care provided to nursing home residents and swing bed facility patients. Its content has implications for residents, families, providers, researchers, and policy makers. (Adapted from CMS website and CMS Resident Assessment Instrument (RAI) Manual, page 1-5).

Who Needs a MDS?

OBRA (Omnibus Budget Reconciliation Act of 1987) regulations require Medicare and/or Medicaid certified nursing homes to conduct initial and periodic assessments for all their residents. The requirements are applicable regardless of age, diagnosis, length of stay payment source or payer source.

MDS assessments are also required for Medicare payment (Prospective Payment System [PPS]) purposes under Medicare Part A. MDS requirements are not applicable to individuals residing in non-certified units of long-term care facilities or licensed-only facilities.

MDS Data Backup Plan

Facilities are responsible for ensuring their local MDS data is backed up. A number of unexpected problems can occur with electronic data. For example, a hard drive may fail or files can be overwritten or deleted. A natural disaster such as fire, flood or tornado may damage software/hardware. Backing up the MDS data will ensure the MDS assessments are safe and retrievable.

State of Alabama Related MDS Information

1. HIV/STD: Alabama does not allow collection of HIV/STD information. The following ICD codes will be blocked if submitted on a MDS:

Code 042.00 Human Immunodeficiency Virus (HIV) disease
Code 054.10 Genital Herpes
Code 079.53 Human Immunodeficiency Virus, type 2 (HIV-2)
Code 090.00 Congenital Syphilis
Code 098.00 Gonococcal Infection
Code 099.00 Other Venereal Disease (VD)
Code 099.50 Other Chlamydia Trachomatis VD
Code 099.80 Other Specified VD
Code 099.90 Venereal Disease, Unspecified
Code 795.71 Nonspecific Serologic evidence of HIV
Code V08 Asymptomatic Human Immunodeficiency Virus (HIV) infection status

2. Alabama is a flat rate per diem state for Medicaid reimbursement.

3. Section S: Alabama does not have a Section S requirement.

4. Section K: K0510 and K0710 Alabama does not require completion of column 1 for items K0510C and K0510D or K0710A and K0710B (See RAI Manual, Section K0510 and K0710, October 1, 2018).

If you have additional coding questions regarding the MDS/RAI, email the Alabama State RAI Coordinator at [email protected].