How Accurate is Your MDS Data?

A 2012 federal report raised questions about the accuracy of the Minimum Data Set (MDS) that skilled nursing settings are required to maintain for each of their residents.

A follow-up investigation by PointRight, a provider of predictive data analytics and decision-support services, confirmed the prevalence of accuracy issues. Seventy percent of the assessments submitted to PointRight’s MDS 3.0 database "had data integrity issues," according to Steven Littlehale, a gerontological clinical nurse specialist and the company’s chief clinical officer.

MDS 3.0 inaccuracies are not something to be taken lightly, writes Littlehale in McKnight’s Long-Term Care News. They impact reimbursement. They affect the quality measures reported to consumers by the Center for Medicare and Medicaid Services (CMS). And they present an imprecise picture of the individual resident.

"When you're holding the multi-paged assessment instrument, you are holding a person in your hands," he writes. "Their strengths and weaknesses, needs and preferences, hopes and desires are all captured in the MDS."

Responses to MDS Inaccuracies

What happens when Littlehale shares information about MDS 3.0 inaccuracies with skilled nursing providers? He gets 2 responses, which he characterizes as "shortsighted and perhaps a little naive."

• I have the most amazing MDS coordinator. That's probably true, but it's not enough to ensure good MDS data. "Just like it takes a village to raise a child, it takes a team and thoughtful systems to ensure that 100% of MDS assessments are accurate and corporate compliance requirements are met," says Littlehale. 

• My MDS software scrubs the data. That may not be as true as you think, says Littlehale. His firm studied data from 11 software vendors and 2 suppliers of MDS scrubbing services, after it passed through scrubbing modules. The “best” data sets had error rates of 62%. The “worst” error rate was 79%. 

MDS: Look under the Hood

Littlehale advises providers to "open up the hood and look at the engine" of their MDS 3.0 software. Ask yourself these questions, he says:

• Does your data-scrubbing module focus only on standard CMS coding and consistency checks and Resource Utilization Group (RUG) items? Or it is more robust? Does it emphasize clinical quality and risk management? 

• Does the system coach you to find that extra Activity of Daily Living (ADL) point? Is it fair and impartial? Does it challenge claims of acuity? 

• When you attend MDS training, is it solely focused on RUG items or does it include the entire MDS? 

"These questions should give you a sense of whether you have the systems in place to ensure accurate assessment and avoid the pitfalls associated with inaccurate data," writes Littlehale.