Warning: Don't assume that your IT (technical/computer/network) staff is backing up your data or that the data is being backed up correctly. It is a good idea to periodically test backups (see below) to ensure successful data recovery.
Nursing facilities (NFs) are responsible for ensuring that their Minimum Data Set (MDS) data is backed up. Unexpected problems can occur that could cause the loss of electronic MDS data. The most frequent issue is hard drive failure (the hard drive is the device inside the computer where data is stored). A natural disaster such as fire, flood or tornado may damage software or hardware. Human error can also cause data to be deleted or overwritten. Backing up the MDS data will ensure that MDS assessments are retrievable and not lost.
Developing a Backup Plan
Consider the following as you develop a backup plan.
- Software — There are a variety of free and purchased backup software products available, depending on your needs. Your MDS software vendor may be prepared to assist you with backups. Most operating systems, including Microsoft Windows, include a simple backup program. In Microsoft Windows, click on "Start," "Programs," "Accessories," "System tools" and "Backup" to gain access to MS Backup. MS Backup includes online instructions.
- Media — Use a reliable media product such as a ZIP drive, tape drive, CD writer or off-site FTP storage. Software that creates automatic backups on the user's hard drive is helpful, but it is not a substitute for a comprehensive backup strategy. Do not back up data to another location on the same computer, as this data will also be lost if the hard drive fails.
- National repository — If MDS data is lost, and the facility—s backup strategy fails, the Centers for Medicare and Medicaid Services (CMS) or a CMS contractor can, for a fee, return any data that a NF has submitted that has been accepted into the MDS national repository. Rejected MDS, and MDS that have not yet been submitted, cannot be returned by CMS. To get a NF—s data from the CMS national repository, request a Data Restore Request form from the state MDS Automation coordinator. Complete the Data Restore Request form and mail it to the state MDS Automation Coordinator, who will sign the form and send the request to CMS. Then CMS will e-mail you an invoice to be paid before the request is processed.
Information Technology (IT) Policies and Practices
NFs determine their own IT policies and practices, with the assistance of their IT staff and software vendor. The nursing facility administrator is responsible for ensuring that IT policies are developed and implemented at their NF. The following are offered as examples of desirable policies and practices:
- Backup schedule — Institute a regular procedure of backing up MDS data to another computer or media via a secure network or a reliable portable media device. Store the backup in a secure remote location. It is a typical practice to back up data daily on an incremental basis and to conduct a total replacement backup on a weekly basis that is stored off-site. There is nothing wrong with backing up all your data every day. The question you have to ask is: How much data am I willing to lose?
- File naming conventions — Develop a file naming convention that will make it easy to identify files over a long period of time. For instance, you may want to list the year, month, day and computer name from which the data was saved. Always create a unique name for each backup.
- Equipment moves — Develop a procedure to create a retrievable copy of data before moving equipment.
- Periodically test backups — Occasionally retrieve backed-up data to be sure the data is not corrupted and that the mechanism used to conduct backups is, in fact, backing up the data properly. Monthly is best but semi-annually is the minimum suggested frequency. Again, how much data are you willing to lose?
- Back up people, too — If you have a computer network and only one staff person with administrator access or knowledge of the backup process, then that person needs to cross-train someone else on backups. If the one person with access and knowledge leaves employment, you might have a difficult time accessing your current data or backup data.
- Develop standards for use of off-site storage — Off-site storage minimizes the chance for total destruction of electronic records.
- Stick to a schedule — If you don't have consistency, you don't really have backup. Set a schedule and stick to it.