Why Your LTC Community Should Be Focusing More on MDS

MDS (Minimum Dataset) is a requirement in long-term care homes, but many communities do not understand MDS well enough to use it to its full potential. In this article, we take a dive into MDS — what it is, how it improves quality of care, and how it connects to government funding for your community.

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What is RAI-MDS?

The Resident Assessment Instrument - Minimum Data Set (RAI-MDS) is a tool developed by interRAI to assess resident needs in long-term care settings. The tool allows care staff to collect the minimum amount of information they require about a resident’s strengths, limitations, and preferences to create an individualized care plan.

The tool has three components:

• ‍Minimum Dataset (MDS) that collects resident information in order to develop an individualized care plan
• Resident Assessment Protocols (RAPs) that guide the assessor through the best practices of care planning
• Resource Utilization Groups (RUGs) that predict the resources needed to care for the resident

Simply put, MDS is a type of resident assessment that covers a range of personal and health care needs. Canadian long-term care communities are required to complete MDS assessments. Typically, the MDS assessment is first conducted when a resident moves in and updated on a quarterly basis.

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Why are long-term care communities using MDS?

The purpose of interRAI’s Resident Assessment Instruments is to improve resident care worldwide. RAI-MDS creates a network of researchers and practitioners in over 35 countries who can share information with each other in a common language. The data they collect informs best care practices and policy-making. This level of collaboration helps to ensure that residents receive a consistent quality of care across different health care settings.

At a site level, the data collected through MDS triggers action to improve quality of care. The tool enables communities to compare their results to provincial, national, and international averages. When used to its full potential, MDS empowers teams to foster a culture of continuous improvement.

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RAI-MDS 2.0 and 3.0

RAI-MDS is used internationally, but regional versions have slight differences. The most-used regional versions are MDS 2.0 and MDS 3.0.

In the U.S.A, RAI-MDS 3.0 is the final updated version of MDS. In Canada, long-term care homes still use MDS 2.0, but it can be supplemented with interRAI’s Long Term Care Facility (LTCF) Assessment System 10.0.

MDS 3.0 and interRAI LTCF 10.0 both improved:

• Accuracy of the collected data
• Clarity of the tool and user experience
• Resident input by adding more resident interviews

If your community is located in Canada, your vendor for RAI-MDS 2.0 is the Canadian Institute for Health Information (CIHI).

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Why does MDS matter for recreation professionals?

RAI-MDS takes a holistic approach to care planning. The assessment questions are best answered with an interdisciplinary team that includes the resident, the resident’s family members, and care staff on all shifts, including recreation professionals.

Recreation professionals often know their residents best, so their knowledge is valuable for filling out the MDS assessment. Each community determines which staff will be involved in the assessment process, but the following sections of RAI-MDS 2.0 may be relevant to recreation professionals:

• Section E. Mood and Behaviour Patterns
• Section F. Psychological Well-Being
• Section N. Activity Pursuit Patterns
• N2: Average Time Involved in Activities
• Section P1b: Documenting Therapies (in communities with registered recreation therapists)

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Is MDS connected to funding?

In short, yes — MDS provides Resource Utilization Group (RUG) scores, which affect government funding.

Once a resident’s data has been entered and a care plan developed, RAI-MDS estimates the resources that the community will need to fulfill that resident’s care plan. The resident is assigned a RUG score based on the estimation. The score is impacted by factors like the complexity of the resident’s medical needs and the amount of therapy minutes they require.

Residents can then be grouped by similar resource use to predict the total amount of government funding that the community requires. The funding process follows strict guidelines that vary from province to province, but RUG scores allow communities to demonstrate their resource needs.

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How Can Welbi Help With MDS?

MDS must be completed before a care plan can be developed for a resident. One of the biggest challenges of MDS is making sure that data entry is done efficiently and accurately. MDS assessment questions typically cover observation of the resident within the last seven days. Recreation professionals may rely on memory to fill out MDS sections, which affects the accuracy of the resident’s information and the care plan’s ability to address the resident’s needs.

A resident experience platform like Welbi captures important resident information that can be used to fill out MDS section N: Activity Pursuit Patterns. Instead of relying on memory, recreation professionals can refer to attendance records from the last seven days for information about a resident’s activity preferences, their daily routine, and their hobbies and interests. This information can also be relevant to section E: Mood and Behaviour Patterns, as residents who withdraw from activities they previously enjoyed may be at risk of social isolation.

The information captured with a tool like Welbi can also be used for section F: Psychological Well-Being. For example, staff can take notes in Welbi on how residents interact with others, including contacts, friends, and family members. The attendance tracking also allows you to quickly get a sense of how often residents decline invites to programs or engage in self-directed activities - giving you insights into their psychological well-being.

Welbi can also calculate therapy minutes in communities with a registered recreation therapist. Therapy minutes refer to the amount of time that recreation therapists spend providing therapy to residents. Therapy minutes are covered in MDS section P1bf. In group recreation therapy programs, therapy minutes are calculated based on a ratio of eight residents for every one recreation therapist. Welbi performs this calculation automatically so all you have to do is input the minutes in the MDS.