MDS Rules

Nursing Facility Requirements

The Centers for Medicare and Medicaid Services (CMS) requires certified nursing facilities to complete and transmit Minimum Data Set (MDS) assessments for all nursing facility residents. Reference the Code of Federal Regulations (CFR), Title 42, Chapter IV, Part 483.20.

The state of Texas requires nursing facilities to complete and transmit MDS assessments for all residents, including private pay residents. §Reference the Texas Administrative Code - Nursing Facility Requirements for Licensure and Medicaid Certification, Title 26, Part 1, Chapter 554, Subchapter I, Section 554.801.

According to state code, all MDS assessments and tracking forms are transmitted to the MDS central repository following the schedule, format and procedures documented in the CMS Long Term Care Resident Assessment Instrument (RAI) User's Manual. Reference the MDS 2.0 RAI Manual, effective December 2002, or the MDS 3.0 RAI Manual, effective Oct. 1, 2010.


Privacy and confidentiality are strictly maintained with regard to MDS. The Texas Health and Human Services Commission currently has a data use agreement in place with CMS that allows Regulatory Services to collect and review MDS data, Provider Claims Services to use MDS for Medicaid reimbursement, and Quality Assurance and Improvement to use MDS for the Long Term Care Quality Reporting System. Anyone outside of the areas covered by the data use agreement cannot be given MDS data that uniquely identify individuals or facilities. They can be given aggregate, deidentified MDS data (totals, averages, etc.).