1. MDS 3.0 Overview Presented to: The National Consumer Voice for Quality Long Term Care NCCNHR Annual Meeting and Conference: Quality Care October 23, 2009 Washington DC Mary Pratt, RN, MSN Director, Division of Chronic and Post Acute Care

2. Review the MDS 3.0 Timeline Features of MDS 3.0 Overview of the plans for MDS 3.0 Training New Quality Measure Development

3. January / February 2010 – -- Publish final MDS 3.0 Data Specifications (including RUGs and CAA triggers. (QM/QI specifications to be released at a later date) -- Publish MDS 3.0 Item Sets (includes Admission, Quarterly, Swing Bed, PPS, Discharge MDS and tracking records) -- Publish MDS 3.0 Long-Term Care Facility Resident Assessment Instrument User’s Manual (Revision to be Published May 2010) March 2010 – NQF Call for Quality Measures (MDS 3.0) April 12-15, 2010 – MDS 3.0 National Train the Trainer Conference October 1, 2010 – MDS 3.0 Implementation December 2010 – NQF Endorsement of Quality Measures (3.0)

4. Uses Standardized Assessments Tools Gives Resident Voice Increases Clinical Relevance Increases Accuracy Increases Clarity Provides Care Area Assessments

5. December 2009 – MDS 3.0 Overview Summer 2010 – Impact on surveyors Coding and assessment requirements Anticipate hosting three MDS 3.0 satellite broadcasts or webcasts:

6. MDS 3.0 Train-the-Trainer Baltimore, MD March 15 - 19, 2010 CMS CO, RO, and State RAI Coordinators MDS National Conferences (2) Baltimore, MD During the week of April 12, 2010 Provider groups, stakeholders & professional associations

7.  MDS Conferences  SNF/LTC ODF (www.cms.hhs.gov/OpenDoorForums/25_ODF_SNFLTC.asp)www.cms.hhs.gov/OpenDoorForums/25_ODF_SNFLTC.asp  Medicare Learning Network (www.cms.hhs.gov/MLNGenInfo/)www.cms.hhs.gov/MLNGenInfo/  MDS 3.0 Website (www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp)www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp

8. To be available online 24/7, 365 days/year Structured by section supported by key topics Overview Key terms relevant to the section Conducting the assessment Coding instructions Coding practice (for selected sections) Available through the Medicare Learning Network (MLN)

9. Conduct via telephone and web conference To include opportunity to ask questions of MDS subject matter experts

10. Based on questions documented at the MDS conferences and web conferences Available through the MLN

11. Nursing Home Quality Measures Will include Post Acute and Chronic Care Measures New measures will replace existing measures (or at a minimum modify the existing measures based on the MDS 3.0 Instrument) 18 Candidate measures submitted to NQF Ultimately the measures will be published on Nursing Home Compare

12. October 2009 TEP to review proposed new measures based on MDS 3.0 January 2010 NQF call for measures. Sept 2010 Last day for MDS 2.0 data collection (Sept 30) October 2010 MDS 3.0 data collection begins. Decembe r 2010 NQF endorsement of new post acute and chronic measures. January 2011 End of first quarter MDS 3.0 data submission Last quarterly posting of MDS 2.0 data on NHC April 2011 MDS 2.0 QM Data will no longer be “current” based on existing quarterly NHC update cycle. Jan/Apr2 2012 MDS 3.0 Data posted on NHC

13. Disposition of Existing Measures MDS 2.0 Quality Measures Transitioning to MDS 3.0 PACChronic Percent of Residents Who Were Assessed and Given Influenza Vaccination XX Percent of Residents with Pain XX Percent of Residents Who Were Assessed and Given Pneumococcal Vaccination XX Percent of Short-Stay Residents with Pressure Ulcers That Are New or Have Not Improved X

14. Disposition of Existing Measures MDS 2.0 Quality Measures Transitioning to MDS 3.0 PACChronic Percent of Long-Stay Residents Who Have Become More Depressed or Anxious X Percent of Long-Stay, Low-Risk Residents Who Lose Control of their Bowels or Bladder X Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder X Percent of Long-Stay Residents Who Were Physically Restrained X Percent of Long-Stay, High-Risk Residents with Pressure Ulcers X Percent of Long-Stay Residents with a Urinary Tract Infection X Percent of Long-Stay Residents Who Lose Too Much Weight X

15. Measures for Possible Retirement MDS 2.0 Quality Measures Recommended for Retirement/Replacement PACChronicPotential Replacement Delirium X Delirium (new PAC measure) Mobility decline X ‘Ambulation’ (PAC and Chronic) Pressure ulcers (low risk) X Bedfast X

16. Summary Table of 18 Measures Submitted to NQF for Endorsement PACChronic Five-Star Item Percent of Residents with PainXXX Delirium (replacement measure)XX Percent of Short-Stay Residents with Pressure Ulcers That Are New or Have Not Improved XX Percent of Residents Who Were Assessed and Given Pneumococcal Vaccination XX

17. Summary Table of 18 Measures Submitted to NQF for Endorsement PACChronic Five-Star Item Percent of Residents Who Were Assessed and Given Influenza Vaccination XX ADL decline (replacement measure)XX Mobility decline (replacement w/ focus on ambulation) XX Percent of Long-Stay, High-Risk Residents with Pressure Ulcers XX

18. Summary Table of 18 Measures Submitted to NQF for Endorsement PACChronic Five-Star Item Percent of Long-Stay Residents Who Were Physically Restrained XX Percent of Long-Stay Residents Who Have/Had a Catheter Inserted and Left in Their Bladder XX Percent of Long-Stay Residents with a Urinary Tract Infection XX

19. Summary Table of 18 Measures Submitted to NQF for Endorsement PACChronic Five-Star Item Percent of Long-Stay, Low-Risk Residents Who Lose Control of their Bowels or Bladder X Percent of Long-Stay Residents Who Lose Too Much Weight X Percent of Long-Stay Residents Who Have Become More Depressed or Anxious X

20. Comments can be submitted to: MDS30Comments@cms.hhs.gov