How to Read MDS Assessments

Episode 191
Categories: Resources

Unlock the secrets of healthcare assessments! Ever wondered what MDS assessments really mean for your loved one in a nursing home? Discover simple tips on how to read MDS assessments, empowering families to make informed decisions about their loved one’s care. In this week’s episode, nursing home abuse attorney Rob Schenk discusses practical insights to help you decode and understand the impact of MDS assessments on your family member’s well-being.

How to Read MDS Assessments?

Schenk: Hey out there. Welcome back, everybody. My name is Rob. I’m going to be your host for this episode of the nursing home abuse podcast. And I guess in a word, we are back. I know it’s been a few years since I’ve put out an episode of the nursing home abuse podcast. I think the last time I recorded an episode was in maybe 2019.

So I had recorded a whole, at least a year’s worth of. of episodes in the pandemic hit. And I got married, had a child. So it’s, I’ve did a lot of life in between the last episode and this one, so very happy to be back for those of you that are new to the podcast, I just want to give a brief explanation of kind of what the nursing home abuse podcast is about who it’s for and what I’ve learned over the past couple of years about who’s actually listening or watching this thing.

The goal of this podcast is for someone who has a family member in a nursing home that may have a specific question, whether that is what is a care plan? My loved one has been diagnosed with sepsis. What is that? Why does my loved one keep getting UTIs? So questions that someone that has a loved one in a nursing home would have.

I wanted to have episodes specifically related to those issues. those topics. And so that’s what we did. And we’ve had plenty of episodes about pressure injuries, UTIs, falls the nursing home industry as a whole. But I guess my intention was never to build an audience. In other words, I just wanted somebody, if they had a question about UTIs, if they Googled that, if this podcast came up, they would listen to the podcast.

Learn something and then move on. Like it was never a, my intent to like, grow this thing, which is obviously my intent came to fruition because I didn’t grow this thing. But the idea was that I didn’t care about, continuity between episodes to episodes, like doing things that would make the content entertaining to anyone other than someone coming in and listening for that specific topic.

And over the course of the past few years, I’ve gotten emails from ombudsman and lawyers who do listen to the show regularly. There’s not that many of them. There’s not that many of them. But I learned that my audience wasn’t just one off family members Of nursing home residents. It was actually other types of people tuning in to learn just like me.

Cause that’s one of the, we’ll get to that in a second. One of the other reasons why I have this podcast so I can learn some stuff, but a lot of that, it wasn’t just those people. That’s what’s going to drive how I want to do the podcast moving forward. I guess we can say that we’re in a second season, in other words.

So I’m going to have some things that I’m going to do episode to episode to make the episodes a little bit, not necessarily funner, but a little bit more levity. And. A little bit more. Something that something for everybody. If you are, you actually are listening week to the episodes.

I’m also going to have because of this fact that I’m opening up the podcast. To, to topics beyond just those would, that would be specifically interesting to somebody that has a loved one in a nursing home with a specific problem. I actually want to start talking to attorneys. And what I mean by that is I want, I’m going to have, I’m going to start having episodes that deal directly with.

Nursing home abuse cases, because I think that’s at least that’s interesting to me. It is tangentially probably interesting to the family member of a nursing home resident, but for those that are in the audience that are actually our attorneys that practice in this line of work, I want to start having episodes specifically dealing with that.

As of right now I, this podcast obviously is plaintiff related. It’s from the perspective of the nursing home resident, as opposed to the actual facility itself. But I’m not opposed to having attorneys representing the nursing home industry, come on the podcast to talk about specific topics as well.

But that’s that’s the change. Like it’s not now, it’s not just about a specific topic week to week without with without giving a little bit of something for somebody that listens every week. And also the topics are going to expand out to not just industry specific things but the, from the legal aspect of bringing these types of claims.

So that’s what I hope to do over the next 10, episodes. We are going back to a weekly knock on wood. We’re going to go back to a weekly schedule before we had been. every other week. Now I’m trying to get us to every week. So that way there’s 20 to 30 minutes of content for you. Every single week as we go forward the only other thing I would mention is that if you’re, if you begin listening to this podcast, you’re coming back and listening again, and you have ideas for content.

If there’s something that you want me to address. If there’s a particular guest that you want me to have on to talk about something, please let me know. You can, I’m not really tech savvy. You can hit me up on tick tock or leave a comment. If you’re watching this on YouTube. You can email me any, which way you want to get in contact with me with ideas for content or ideas for guests, please let me know.

It’s not like I’m getting a ton of mail. I’ll get it. I promise. And I’ll read it and we’ll try to make these things work. But don’t hold your breath. I can say this, that I send out probably, or my or my podcast manager sends out Erica. She sends out probably for every 300. emails soliciting somebody to come on here and talk about something in their area expertise, I might get one response.

So if you do give me an idea for a guest, I can’t guarantee you they’re going to want to come on this podcast. Cause like I said I’m screaming from the rooftops, please somebody come in here and talk to me. And most of the time nobody does. I guess that’s that’s it.

I promise I won’t. I won’t meander like that again. I just want to make sure that as far as this episode goes, if you’re coming back, you understand what the purpose of this podcast is, what you can expect moving forward in the future. And with that, we’re going to go ahead and get into a couple of the I guess new features of the podcast.

The first is going to be, I want to try to do a quiz. So this is for, All of you nursing home regulation junkies out there, whether you’re an ombudsman, a nurse, an attorney every week I want to highlight a particular regulation with a question and a very difficulty. These aren’t going to be softballs.

They’re not going to all be softballs and they’re not going to all be extremely tedious, but they will revolve. Exclusively around the federal OBRA regulations of nursing homes. So I want to go ahead and get into that, into the first question of the week, for lack of a better word, the nursing home regulation question of the week.

What is the MDS Assessment?

The MDS meaning minimum data set is essentially a comprehensive assessment, although it can be less than comprehensive, but it’s a comprehensive assessment that the nursing home has to do at regular intervals. And what makes this special is that it’s, it has to follow a certain structure that the federal government sets out.

So there is typically going to be, a series of assessments, a series of categories of assessments based on the the different categories. In other words, vision, things like that, that the nursing home must go through step by step and It’s extremely comprehensive. I’m talking head to toe.

How to obtain the MDS Assessment?

So every category it the nursing home must answer a specific set of questions. And that’s, and that’s the reason why I want to have this episode is because if you’re out there and your loved one is in a nursing home you have the right to see the chart. And sometimes when you request a chart and you get the chart, it’s You can’t make heads or tails of it like you don’t know what’s important.

Why is the MDS Assessment important?

What’s not important. A lot of it’s important, but you don’t know what’s what. And so why this episode is important is because if you do have the chart in front of you, you’re going to see the MDS assessment and the reason why you’re going to see the MDS assessment is because it’s required.

So depending on how long your loved one has been in that nursing home, there’s, there could be, one or two, there could be dozens. Because like I said, it’s required at certain intervals and that’s a topic that we’ll get into later today. We just want to talk about once you have the MDS in front of you, what does it mean?

How to read the MDS Assessment?

What are some of the important things to your loved one. So I want to do that. Now. I want to just take us through section by section. What the section in from a 40, 000 foot view means. And what are some of the important kernels that you can draw from that? So when you have the MDS in front of you you’re going to see that it’s separated by categories to the alphabet.

MDS Section A: Identification Information

The first section, which is section a, which is what we’re looking at right now. And obviously if you’re. Watching this. It’s going to be a lot more beneficial for you. But if you’re listening to it, I hope that you can still get something from it.

We’re going to the best we can. So that such that, if you’re listening on the radio, you’re going to get something from it. So when you’re talking about Section A is typically just demographic information. It’s information that is used for the nursing home getting paid. Essentially, it’s telling the government, Hey, this is the type of assessment we’re doing, whether it’s One, for the purposes of OBRA, meaning that it’s literally a clinical assessment or if it’s basically just to tell the government this is how much we should get paid.

So that’s what section a is doing. There’s not a lot of real information in terms of what’s going on with your loved one, with the actual resident. I will say though, that when you’re looking at section a, an important part of it is going to be a three one zero a. A three one zero, which is the type of assessment.

So typically in order to get the most information out of the MDS, it’s relevant to you. You’re going to want to look at the MDS assessments that are admission assessments or annual assessments or significant change in status assessments. Admission annual or significant change in status. These are comprehensive assessments, meaning that the, they’re gonna have the most information about your loved one in them.

The other ones may not have as much information as you would wanna see. So if you have in front of you the different types, what you’re looking for is one that’s either admission, annual, or significant change in status, because that’s gonna have the most information. So as we scroll. 

MDS Section B: Hearing, Speech, and Vision

So section B is hearing speech and vision. It’s going to deal with your loved one’s ability to communicate with the nursing home staff. and your loved one’s ability to actually respond and understand what the nursing home staff is actually saying. So you’re going to see that a lot of this is, a lot of this information is easy to understand.

In other words, like some documents first of all, if you had a physician’s order, you couldn’t even read the writing much less understand what it means here. It’s very intuitive. Is your loved one in a persistent vegetative state? Yes or no? You’re going to be able to see in this one how the nursing home is.

diagnosing or for a better word, assessing how your loved one communicates and how they hear when they’re communicated to. So that’s the purpose of this section B. A couple of things that I would point out to you is in other words, if you’re wanting to understand and get the most out of it is B 700.

Does your love, is your loved one able to express themselves? Because sometimes. You think your loved one is able to express themselves and that’s because you’ve known them your whole life. It’s important to understand how the nursing home Understands what your loved one is saying or how they’re communicating.

So B 700 is important. So if you see that, it says rarely or never understood, but you understand them every time you go and talk to them, there, there might be a disconnect, but it might be based on the fact that your loved one. So that’s a, that’s also an asterisk footnote. That’s why it’s important for you to be involved in the care planning process and be involved in your loved one’s life there in the nursing home, because nobody knows your loved one as good as you do.

MDS Section C: Cognitive Patterns

So coming down to C is about cognitive patterns. So in this part of the assessment, this is actually one of the parts of the assessment where there actually literally has to be somebody in the staff putting hands on your loved one. And this is the cognitive patterns section. So what this is about is the nursing home will come and do what’s called a brief interview mental status.

It’s a test. We call it a BIMS test. Some words are spoken to your loved one. They’re asked to say them back. And depending on that interaction, they’re given a BIMS score, meaning they’re given a score. which will tell you what their level of cognitive impairment is. So depending on what that score is, they might view your loved one as being, not cognitively impaired all the way to severely cognitively impaired.

I often have People call me and I’ll say, does your loved one have any any cognitive issues, Alzheimer’s, dementia, and they’ll say they’re saying that my mom has dementia, but I don’t think so. This is the section that’s going to tell you what the nursing home thinks about any. potential cognitive impairment that your loved one has.

And that’s at C 500. There’s a BIM summary score that’s going to tell you what the score is. And based on that score, you’re going to know if the nursing home thinks that your loved one has cognitive impairments or not. So that’s section C cognitive impairments. 

MDS Section D: Mood

So D section deals with mood. So the nursing home has to assess essentially the level of, you would say, possibly depression, possibly anxiety that your loved one has.

So some of the questions that get asked might be have you been feeling down or depressed in the last seven or eight days? Have you had trouble concentrating or have you had feelings of of depression? of wanting to hurt yourself. For example, these are the questions that get asked in section D for mood.

To the extent that your loved one can answer these questions to the extent that you’re understanding how the nursing home thinks you have your loved one in this capacity, that would be important to know. So this is, this whole section, again, it’s easy to understand. Did your loved one feel tired to have a little energy in the past seven days?

It’ll say frequency and whether or not that’s the case. So you don’t have to be a nurse. or a doctor to understand this document, but it’s important for you to read it so that you keep up with what’s going on with your loved one and what you think the nursing home thinks is what’s going on with your loved one.

MDS Section E800: Rejection of Care – Presence & Frequency

So section E basically deals with a lot with what we would call noncompliance. So in other words, Is your loved one refusing care? Is your loved one being aggressive or combative when it comes to the nursing home staff?

More information on what an MDS Assessment entails can be found through the UCSF Pepper Center and a helpful explanation on

Section E is what’s going to, is where that’s going to be documented. That’s where this assessment is coming from. The one of the main things I’ll point out to you is E800 of the MDS assessment, E800. is the section called rejection of care, presence and frequency, meaning did your loved one reject care, whether that’s, they didn’t want to be turned to repositioned.

They didn’t want to take a shower. They didn’t want to go to activities. Did they reject care and how often that did that happen? So often in cases, what will happen is I’ll have a nursing home accusing my client of rejecting care. Turning repositioning, for example, and that’s why they developed the pressure entry.

But I’ll go to section e 800 and it’ll say, no, they didn’t behave. They didn’t exhibit that behavior at all during the look back period. And so there will be, there’ll be Conflict between what the nursing home is saying, what they actually documented. But as for you for your loved one, that’s in the nursing home, that’s where that’s located.

And if it says that they’re rejecting care, then you want to get involved because sometimes when the resident rejects care, it’s not just because they don’t want to, it’s not as though they’re oriented. and they know what’s going on, they just don’t want it. Often it’s some type of underlying pain issue, medical issue, perhaps a dignity issue.

So if it is, if there is rejection of care and it’s marked here in eight one eight in eight hundred address it with the nursing home staff talk to the D. O. N. Hey. If they are rejecting care, what are we doing to make sure that there are alternatives to that care so that they ultimately, at the end of the day, they have their needs taken care of?

So E 800 is an important part of the MDS Section E. 


MDS Section F: Preferences for Customary Routine and Activities

Section F deals with, typically what your loved one usually does, what the routine is. This part of the assessment is where, what type of music do you like? What time do you like to get up? What kind of snacks do you like? More or less the type of person that you are.

Gets put into this one. And the reason why this one is important, the reason why you should get involved in this is because typically when a resident is admitted to a nursing home, they’re bringing their life with them. If they were a police officer, it might be that, they’re in in, they have cognitive impairments.

It might be that in their mind, they’re going, they’re walking the beat. And so it might be, okay, they were a policeman and that’s good for us to know, because that might. affect the interventions that we’re going to give to your loved one. So really taking part in this section F, the customary routine and activities would be very important.

MDS Section G: Functional Status

Section G section G and section GG deal with the functional status and the functional ability of your loved one to perform what we would call activities of daily living. How much help does your loved one need to comb his or her hair to walk to the bathroom, to get outta bed, to take a bath?

These type of things where your physical body is needed to do things. So this assessment gets a little bit in the woods and it’s not beyond durability as a lay person. to understand section G or section GG, believe me, but there is a little bit more to it because there’s a lot of numbers and you’ve got to look up what the numbers mean, but essentially section G and section GG is going to tell you what the nursing home thinks about how much help, both in literally how much does your loved one participate in the activity and how much physical, How many people are required to help them?

For example bed mobility is one. Meaning, how does your loved one move around in bed? Can they do it themselves? If they can’t do it themselves, how much help do they need? Do they just need a rail, like a setup bar, a quarter rail, or do they need one person or do they need two people literally to help move around and in bed.

Learn how to address bedsores in nursing homes with our bedsores lawyer’s expertise.

And so to the extent that you want to know about that it’s in section G. So anything related to the activities of daily living and how much help your loved one needs with the activity of daily living is in section G and section GG. 

MDS Section H: Bladder and Bowel

So section H is typically pretty important because it deals with bladder and bowel if your loved one is incontinent or So all that information related to bowel and bladder is in section H. So oftentimes what happens is somebody will go into the nursing home and they’ll be incontinent. And maybe if they don’t have a catheter, they get put in briefs and they stay in briefs forever, which is typically not a good thing unless there’s no other options.

And people will call me and be like, my loved one is incontinent. She’s always in a diaper, blah, blah, blah. The nursing home typically, if the standard of care requires it should Put your loved one through what’s called a toileting program, whether that is a urinary toileting program or a bowel toileting program, meaning Do they, should it be a situation where they’re just, there’s a routine monitoring, like we’re going to come and check for her diaper every two hours, or maybe it could be queuing like, Hey, listen, now’s the time that we do this.

And then you develop a program. There are different ways that you can try to eliminate the incontinence of a resident, whether it’s urinary or bowel. And if your loved one is on that type of program, it’s going to be in section H, the bowel, the bladder and bowel. Typically the regulations are going to want the nursing home to at least have a trial of a toileting program.

And again, that’s going to be in section H. If you have concerns about UTIs, recurrent UTIs, if you have concerns about your loved one sitting in an adult brief, just go to section H and see whether or not a trial has been done in the past. And if it hasn’t approached the DUN about it. Okay, so section I is the next section.

MDS Section I: Active Diagnoses

Section I just deals with active diagnosis, meaning there’s like literally a list of different diagnoses from anemia on down to cerebral palsy. To what else? We got diabetes. Where everything that your loved one has gets, gets a check mark and it gets put into their documents, basically, their care plan.

So again, oftentimes, even though we do the best we can with our loved ones in terms of being a caregiver and then we make the decision to put them in a nursing home we don’t know everything. So it could, you could be where. Perhaps the nursing home has said that your grandmother has I don’t know hypertension.

And you never knew that. And so this could be a conversation starter with the DUN. Hey, why is hypertension marked on active diagnosis and section? I’ve never known her to have hypertension and they might say, Oh, that’s a mistake. Or they might say you need to learn because she’s on the medication, et cetera.

So this is where you can. I guess cross check what the nursing home is doing because you might think that your loved one has one of these active diagnosis and they don’t put it and vice versa. But that’s where the Diagnosis information for your loved one gets put in section I section J 

MDS Section J: Health Conditions

Section J is about health conditions, meaning it, this gets into pain management, it gets into pain assessment, it gets into essentially Some sort some specific issues of health that your loved one might have.

For example, shortness of breath, but mostly it has to do with pain management. So if you have any questions about pain management, section J is gonna be where it is. Another issue that I have is I have, oftentimes people will call me and they won’t realize that their loved one is on hospice care or palliative care, which in Georgia hospice care and palliative care typically means that there’s a terminal illness.

That is that is the prognosis is six months or less. I know that’s not a bright line rule, but typically that’s what that means. And the people and the loved ones will call me and they’ll say, no, there’s nothing wrong with my loved one and he’s gonna live forever. They don’t realize that they’ve been diagnosed as having a terminal illness and they have less than six months to live.

Where you’re going to find that information on the MDS assessment is section J 1400. So that’s J 1, 4, 0, 0. And they, the nursing home has to answer a question. Yes or no, does the resident have a condition or chronic disease that may result in a life expectancy of less than six months? So that is a yes or no question that gets responded to or gets answered on the MDS assessment.

I’m at section J. J 1400 is called Prognosis. So again, that’s what this is. One of the one of the key portions. If my loved one is in a nursing home is do they think that they have that my loved one has a condition in which they’re going to likely pass away in six months or less? That would be something that I would want to know.

MDS Section K: Swallowing/Nutritional Status

Section K is deals with swallowing and nutrition. Typically this is where weight goes. The nursing home has to, typically the center of care will be to weigh. Your loved one at a regular interval. And that’s where this information goes. Also, if your loved one either gains weight too quickly or loses weight too quickly and there, there are, percentages of body weight lost or gained that would red flag this.

But that’s also where this goes. So if during this assessment process, your loved one has lost a certain amount of weight in a certain amount of time, then this, and if that gets checked, then there are going to be some things that get triggered down the line to Put interventions in place, but this is all about, does your, is your loved one able to, is your loved one?

Can your loved one swallow food? Does your loved one need a tube? That kind of stuff that goes into section K. 

Seek guidance on malnutrition issues from our Georgia nursing home malnutrition lawyer.

MDS Section M: Skin Conditions

Section M is relatively important, at least in my line of work, because oftentimes it’s unfortunate, but many of my clients have pressure injuries, but section M deals with skin conditions, and it doesn’t have to necessarily be pressure injuries, but a majority of section M deals with skin conditions.

Did your loved one enter the nursing home with a pressure injury? Do they currently have one? How many? What stages it. All that information gets put into section M. Again, one of the main things that I would look at, because sometimes the nursing homes, they And again, sometimes if this, if an MDS is inaccurate, it’s not, doesn’t necessarily mean it’s nefarious.

It’s, these are human people doing this work. This document is 50 pages. They’re looking at hundreds of pages of chart when they’re doing this. So there’s going to be inaccuracies, but tip but what I would look for is there are sections in section M that will say, was this pressure injury present at admission?

So that’s what I would look for too. When you’re looking at section M, was it present on admission? The next thing I would look at on section M is what are they doing about it? So if your loved one is at risk for pressure injury, then section M is going to be where it’ll tell you, here are all the interventions or intervention categories that are in place.

That were the nursing home is using to try to prevent future pressure injuries or treat the one that she had here. Here she has now. So you’ll see that in section M 1200 you have skin and ulcer treatment. So there’s pressure reducing device for chair. They may or may not click that pressure reducing device for bed.

Gain insights into wound care with our explanation of the Bates-Jensen Wound Assessment Scale.

They may not click that. Turning repositioning program, et cetera, et cetera. So there’s a list of interventions that if they’re actually being done, they would be checked off here. So if your loved one has a pressure injury and you’re, excuse me, and you’re looking at the MDS for the first time, zero in on section M and then zero in on section M 1200, and that’s going to tell you what they’re doing.

MDS Section N: Medications

Section N deals with medications. Meaning that is your loved one on any type of psychotropic medication is your love. Does your loved one need insulin? These type of things. Section N as in Nancy is where medications go. Section O is going to be where medications go. Special treatments and procedures go.

For example, if your loved one is getting chemotherapy if your loved one is getting dialysis, these special typically outpatient type of things if they’re receiving any of these, this is where this gets assessed and marked. Also where therapy goes, section O sorry, if you’re watching this, I’m breezing through it.

MDS Section O: Special Treatments, Procedures, and Programs

Section O is where if your loved one needs speech language, pathology, occupational therapy, physical therapy, section O is where that goes. So it, a lot of times I get calls. There are certain rules about how long Medicare will pay for certain therapy. What you’re entitled to under Medicare, these types of things.

Go to section O and it will tell you how much therapy was deemed as necessary and whether or not your loved one is through with therapy. That’ll answer these questions. Section P deals with restraints. So typically restraints, whether they’re physical restraints, chemical restraints, They’re not allowed they’re only going to be allowed under really specific reasons.

So if you do see that there that and again on section P, there’s a list of restraints, bed rail, trunk restraint, limb restraint, et cetera. So if you see one of these clicked, then that should be a massive red flag for you. Something’s going on. I’m not saying that it’s wrong. Because typically a physician is going to have to prescribe that restraint, but if one of these is checked off in Section P, one of these restraints, you need to get to the bottom of that really quickly because, it, it has, it’s, it should be a very rare occurrence that there is a restraint.

MDS Section Q: Participation in Assessment and Goal Setting

So Section Q Section Q typically has to do with the level of involvement that your loved one has in this comprehensive assessment process. So typically you’re going to find that if your loved one is has severe dementia, they’re probably not participating. And so this section is going to be marked as no.

There’s questions in here about, do you expect to go back back home after nursing home, that kind of after you’re staying in the nursing home, et cetera, et cetera. And that kind of thing, typically how the resident is viewing their stay at the nursing home and what their future plans are.

If they can actually have that conversation. There’s several letters are skipped. 

MDS Section V: Care Area Assessment (CAA) Summary

Then we get to section V, which for us has no, there’s not going to be really value in this. All section V does is tell you that. Which let me back up. So section V is telling you about whether or not there’s a care area assessment.

And I don’t want to get into that in this episode, because we’re just talking about, the down and dirty, quick and nitty gritty of reading an MDS assessment if you’re a lay person, but. If somebody, if a resident gets admitted, so for example, in section M for skin condition, if they have a pressure injury and they, in the nursing home checks that off, then what’s going to happen is that a care area assessment is going to be checked.

And what that means is that the MDS drives the care planning process, the MDS, the information on that MDS. MDS after the assessment, and you have the MDS that’s supposed to essentially be the data that drives what the interventions are. For your loved one, the interventions being on the care plan. So the federal government has provided a series of questions and a series of further information that’s needed.

If one of those areas, care areas is flagged. So again, if it’s a pressure injury, then there’s going to be a care area assessment that has to be done, which again, influences how the care plan is done. But. For our purposes today, we don’t really need to get into that section X is just is not for our purposes.

MDS Section Z: Assessment Administration

And then finally, getting down to section Z Z 400. So to me, this is where the rubber meets the road. Everybody that conducts a portion of the MDS assessment, you’re going to, you might see one name, you might see several names. I hope that you see several names because that means that different departments are participating in the MDS assessment.

So you might have dietary doing the dietary portion. You might have physical therapy doing the other portion, et cetera, et cetera. But you’re going to see names, you’re going to see first names and last names. to me. That’s important. You want to know who’s taking care of your loved one. So jot those names down and be like, Hey, can I talk to, Jane Smith?

She’s the one that did the skin condition assessment. And it’s possible that this person only looked at the chart. I hope not. But it is possible that they looked at your loved one. You can be like, Hey, why did you say this or this? And if you can’t do that, then you bring that up with a deal when, Hey, Jane Smith on the new MDS assessment set X, Y, or Z.

Read further details on the MDS 3.0 Public Reports.

The MDS assessment actually has to be under the regs coordinated by a registered nurse. Now, in my experience, that can mean a lot of things. Where everything from the nurse does everything or nurses do everything to the nurse does nothing and only signs off on the MDS assessment and the MDS assessment is done itself by LPNs.

But the individual signing their name to that Z500 is the nurse that is saying this is accurate. Everything in the 50 pages of assessment is accurate under penalty of perjury, which is really interesting to me. But at any rate at least with Section Z of the MDS assessment, you’re going to get names of the individuals who conducted the MDS assessment and the various sections.

It’s going to tell you, Jane Smith did Section M, N, and O. John Smith did Sections A, B, and C, et cetera, et cetera. And so at least you’ll know who took part in the assessment of your loved one. So that was a lot. If I hope that wasn’t too in depth, I wanted that to be an overview. Again, it’s not medical advice, not legal advice, but if you have an MDS in your hands.

These are the things that I would be looking at. Of course the MDS has a lot more information, but like I said, this is just a 40, 000 foot view of, to me, typically what’s going to be important from resident to resident. It’s not intended for you to be a medical provider. It’s not this episode is not intended for you to insert, your medical judgment over the medical judgment of the nurses and the physician.

Read further details on the MDS 3.0 Public Reports.

It’s simply for you to understand and this is how the nursing home is viewing your loved one. This is how the nursing home sees your loved one’s clinical condition. And this gives you an opportunity to say, I never knew that my loved one had this, or this, or I never knew that my loved one had this diagnosis and you can start that conversation.

But typically the conversations we have, whether it’s during care plan meetings or just during visits that we have with nursing home staff. I’m not saying that we’re at a disadvantage, but it’s the more that you know, and the more that you know that they know, I think is a powerful thing. So if you have that MDS assessment and you read through it it’s only going to be better for you to start these conversations, to have these conversations and having these conversations might lead to better interventions that might lead to better outcomes for your loved one. 

If you have questions or concerns about the care of a loved one in a nursing home, it’s important to speak up. Getting and understanding the MDS Assessment can help you make sure they’re getting the right care.

If you need help or aren’t sure what to do next, consider talking to an attorney who knows about nursing home care. They can guide you and help protect your loved one’s rights.