MDS 3.0 Section Q Referral Process

Important Notice

Local contact agencies for nursing facility residents who express a desire to relocate to a community resident through the Minimum Data Set 3.0 Section Q:

MDS 3.0 Resources

  • Minutes from the national MDS 3.0 teleconferences contain links to useful information regarding implementation of MDS 3.0.
  • Minimum Data Set (MDS) 3.0 Section Q: Referral to the Community-Responsibilities and Local Contact Agencies Information (Information Letter No. 11-57/Provider letter No. 11-20)
  • Relocation Contractor Staff Access to Nursing Facility Residents and Clinical Records and Access by Nursing Facility Residents to Other Representatives of Community-based Organizations (Information Letter No. 11-38)

Changes to Relocation and Referral Processes under MDS 3.0

The Centers for Medicare & Medicaid Services (CMS) recently revised the Minimum Data Set (MDS) 2.0; MDS 3.0 became effective Oct. 1, 2010. MDS 3.0 is a very different document both in substance and in philosophy. It approaches the nursing facility resident assessment from a more person-centered planning perspective in which residents are required to take a more active role in determining their individual service plan.

One of the major changes to MDS 3.0 is Section Q, or the "relocation/referral" section. The original Section Q was minimalistic and dependent on others to respond to the question. The MDS 3.0 Section Q is more robust and actively engages residents to determine their goals in pursuing going back to a community residence or remaining in a nursing facility setting.

The "new Q" asks s resident "Do you want to talk to someone about the possibility of leaving this facility and returning to live and receive services in the community? If the resident answers "yes" a referral will be made to a third-party, independent community organization (local contact agency) to provide them information and potential assistance in relocating.

Nursing facilities are required to make the referral to the local contact agency and to ensure that there was a follow-up response. All people in Medicaid-certified nursing facilities, regardless of their payment source, must respond to Section Q and have a referral made on their behalf if they respond affirmatively to Section Q: Q0500B.

Texas has an established process that provides outreach, education, facilitation and case management for people who have expressed a desire to relocate. This coverage is available for people who are eligible for Medicaid. Please reach out to the managed care organization service coordinator, Program Support Unit staff or the Local Intellectual and Developmental Disability Authority service coordinator assigned to your resident.

The state has established an "options counseling" system for people who are not eligible for Medicaid or who are in a spend-down mode. These options counselors are part of the Aging and Disability Resource Centers (ADRCs) system and provide statewide coverage. Please visit the page HERE to locate the ADRC that covers your facility.

Texas is a national leader with nursing facility relocation through its Money Follows the Person program. The new MDS 3.0 Section Q supports the U.S. Supreme Court's Olmstead decision (June 1999) and Texas' own Promoting Independence Initiative and Promoting Independence Plan. An individual's stated goal to relocate back to the community is one of choice and no one is required nor forced into this decision. For those who want to relocate, the state, the nursing facility, the local contact agency, the managed care organization (if appropriate) and the home health agency must work collaboratively to make the choice viable.

Additional information will be forthcoming in regarding how to help make the culture change among the nursing facility staff to support the new MDS 3.0 Section Q.

Aging and Disability Resource Centers

Search for your local ADRC.

Form 1579, Referral for Relocation Services

Managed care organization service coordinators, Program Support Unit staff, or Local Intellectual and Developmental Disability Authority service coordinators will need to complete Form 1579, Referral for Relocation Services.