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ABSTRACT
The Minimum Data Set (MDS) is a tool used by nursing homes for resident assessment and care planning, indicating facility quality and the extent of residents' care needs. The process by which the MDS is completed by facilities has not been empirically studied. Understanding common strategies and practices for completing the MDS helps further comprehend the validity of the MDS and its relevance for focusing on residents and implementing clinical nursing interventions. This article reports on the responses to a survey questionnaire addressing this process by a sample of nursing homes in Ohio. The MDS assessment was found to be an intensive activity requiring the commitment of multiple staff members. Most facilities employed at least one full-time coordinator for this task. The importance of training was noted by a number of facilities, and the Resident Assessment Instrument manual was highlighted as one of the most valued resources for completing this assessment.
The Omnibus Budget Reconciliation Act (OBRA) of 1987 instituted many changes in the nursing home industry. One of the most sweeping reforms called for the development of a single tool to be used nationwide for the assessment of residents. This tool, the Minimum Data Set (MDS) for resident assessment and care (Morris et al., 1990), has come to provide the basis for resident care planning, indicators of facility quality, resource utilization groups (RUGs) indicative of the extent of care needed by individual residents and in the facility as a whole, and prospective reimbursement to facilities through Medicare and Medicaid. The completion of this assessment tool is typically coordinated by a staff nurse, although many other staff members may provide input. Because one tool does so much in nursing homes, one might expect there would be much agreement as to how the tool is implemented; however, little empirical evidence exists regarding how nursing facilities actually conduct the process of MDS assessments and submissions in nursing facilities. This study characterizes the MDS process in a sample of nursing facilities in Ohio, with an emphasis on understanding the level, kind, and amount of effort facilities devote to this aspect of facility administration and resident care. In addition, important differences are noted among facilities that have and have not been cited for deficiencies in the assessment...