Answer: The Minimum Data Set 3.0 (MDS) and Care Area Assessments (CAA’s) are assessment
tools designed to direct the plan of care for residents. Understanding the process, its intent, and the
regulatory requirements, is essential for an administrator.

The requirement and its intent read:

§483.20 Resident Assessment

The facility must conduct initially and periodically a comprehensive, accurate, standardized
reproducible assessment of each resident’s functional capacity.

Intent §483.20

To provide the facility with ongoing assessment information necessary to develop a care plan, to provide the appropriate care and services for each resident, and to modify the care plan and care/services based on the resident’s status. The facility is expected to use the resident observation and communication as the primary source of information when completing the RAI. In addition to direct observation and communication with the resident, the facility should use a variety of other sources, including communication with licensed and non-licensed staff members on all shifts and may include discussions with the resident’s physician, family members, or outside consultants and review of the resident’s record.

Nicky’s perspective: The MDS, CAAs and utilization guidelines, are the State specified Resident Assessment Instrument approved for assessment. Missouri has no additional requirements beyond the Federal regulations. They are to be utilized to direct an interdisciplinary team approach for resident assessment and subsequent care. This team approach is necessary in order for the assessment to serve its main function: directing care. The RAI process will identify key areas where a resident is doing well, maintaining, or declining and defines a resident’s acuity level. These areas are then “care planned” in order to direct the care for a resident. The more involvement you can get from the resident, family members, physicians, direct care givers, etc…, the more likely you are to get an accurate representation of a resident. The RAI process and everything it entails effects many areas of nursing homes: Resident care, Five-Star Reporting, Quality Measures (QM), and Reimbursement are key areas that are driven by the RAI Process. A new administrator may want to spend a few hours a couple days a week with your MDS Coordinator(s) and have them walk you through the assessment process. This will help you get an over-all perspective of the process; get comfortable with it so that you know and have a full understanding of how the RAI process works and how it effects the operations of a Skilled Nursing Facility.