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Feds develop new assessment tool for skilled nursing homes

Provides residents a voice in their care

Posted: September 10, 2010 2:56 p.m.
Updated: September 10, 2010 2:56 p.m.

SACRAMENTO -- A fundamental shift will take place in skilled nursing homes beginning in October following the
work of a California-based researcher and a team of investigators that has developed a new national assessment tool for nursing home residents.

The newly revised questionnaire, called MDS 3.0, or Minimum Data Set, Version 3.0, was developed for the federal Centers for Medicare & Medicaid Services (CMS) and represents a major change in data collection of residents.

Instead of just observing and determining what's best for the individual, residents will now be interviewed and asked about such things as their mood, pain levels, personal preferences and whether they want to be returned home or to another community-based setting.

Trained interviewers in skilled nursing facilities will ask residents some of the following new questions: How important is it to you to....

-- Choose what clothes you wear?
-- Choose between a tub bath, shower, bed bath or sponge bath?
-- Have snacks available between meals?
-- Choose your own bedtime?

The new 38-page standardized questionnaire was prepared by a team of researchers led by Debra Saliba, MD, the Anna & Harry Borun Chair in geriatrics at the David Geffen School of Medicine at UCLA and senior natural scientist at RAND, and by co-principal investigator Joan Buchanan, PhD, of Harvard Medical School.

The questionnaire was field-tested in 91 community nursing homes and veterans' health facilities in eight states. Approximately 4,500 residents participated in the interview process. Researchers hope that the improvements will produce a more efficient assessment and better quality information in less time, as well as better identifying resident needs to enhance resident-focused care planning.

"Multiple studies have shown that when we don't use direct, structured interviews, we too often underestimate residents' mood and pain and we are inaccurately guessing their preferences and cognitive ability," Saliba said. "If we don't ask in a specific, structured way, the resident suffers in silence."

"The interview is the gold-standard for assessing how people want to live their lives," said Jocelyn Montgomery, RN, director of clinical affairs for the California Association of Health Facilities (CAHF). "Now the voice of the resident will be front and center to help guide care."

Saliba will be the featured speaker at a CAHF Quality Symposium, which for the first time will bring together skilled nursing providers and long-term care medical doctors with the California Association of Long Term Care Medicine (CALTCM) to promote collaboration between acute care and long term care disciplines.

The symposium is also sponsored by the Health Services Advisory Group (HSAG), SCAN HealthPlan, the California Culture Change Coalition (CCCC) and the California Association of Physician Groups (CAPG). It will take place Sept. 27-28 in Newport Beach, Calif.

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