Introduction to MDS

What are RAI and MDS?

The Centers for Medicare and Medicaid Services (CMS), an agency under the U.S. Department of Health and Human Services (HHS), designed the Resident Assessment Instrument (RAI), which consists of three components:

  1. Minimum Data Set (MDS)
  2. Resident Assessment Protocols (RAPs) in MDS 2.0 or Care Area Assessments (CAAs) in MDS 3.0
  3. Utilization Guidelines

The RAI helps nursing facility staff look at residents holistically, gather information about the resident's strengths and needs, develop an individualized plan of care, implement the care plan, and evaluate the care plan. Resident data recorded on the MDS are used for federal Medicare and state Medicaid reimbursement systems. The MDS is used to monitor quality of care provided to nursing facility residents through the Quality Monitoring and Quality Indicator reports and the survey process. State and federal nursing home rating/comparison systems use the MDS as part of their formula. Although the RAI is the overarching tool, the RAI and data collection process is commonly referred to as "the MDS."

Texas MDS statistics

(All numbers are approximate)

  • 1,240 Texas nursing facilities and 60 swing bed facilities are open during any one year
  • More than 95,000 residents reside in nursing facilities at any specific point in time
  • Number of long-term and rehab residents staying in nursing facilities:
    • 227,000 in 2012
    • 221,000 in 2011
    • 213,000 in 2010
    • 203,000 in 2009
    • 202,000 in 2008
    • 196,000 in 2007
    • 193,000 in 2006
  • Approximately half of each yearly total were residents with admissions submitted in that year.

Overall, Texas collects a million unique MDS assessments per year, not including inactivated (deleted) assessments, older versions of corrected assessments or assessments that are rejected due to error.

More basic information about MDS can be found in Chapter 1 of the CMS Long-Term Care Resident Assessment Instrument User's Manual, found on the CMS website. Reference the MDS 2.0 RAI Manual, effective December 2002, or the MDS 3.0 RAI Manual, effective Oct. 1, 2010.