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The Nursing Home Minimum Data Set Assessment Instrument: Manifest Functions and Unintended Consequences--Past, Present, and Future

2009/06/16 by A. N. Rahman, R. A. Applebaum, Robert Applebaum · 100 citations
Health Professions · Medicine · Nursing · Psychology · Social Sciences · #Business #Computer science #Data collection #Data quality #Dementia and Cognitive Impairment Research #Geriatric Care and Nursing Homes #Health care #Health disparities and outcomes #Marketing #Medicaid #Medicine #Minimum Data Set #Nursing #Nursing homes #Political science #Psychology #Quality (philosophy) #Quality management #Service (business) #Set (abstract data type) #Staffing #Unintended consequences

paper · pdf · doi:10.1093/geront/gnp066

published in The Gerontologist 49(6), 727-735 (Oxford University Press)

openalex publication_date 2009/06/16 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/25

Abstract

The Minimum Data Set (MDS) is a uniform instrument used in nursing homes to assess residents. In January 2008, the Centers for Medicare and Medicaid Services published a draft of a new MDS-version 3.0. This article traces the instrument's development and the design decisions that shaped it, discusses the MDS's manifest functions-data collection intended to drive quality improvement and the unintended consequences of its use-paper compliance and diminished attention to resident quality of life, and examines the revised version to gauge its success in meeting the instrument's objectives. Although results of the national evaluation of MDS 3.0 are promising, the revisions, especially those pertaining to quality-of-life assessment and the use of resident interviews and standardized assessment procedures, raise questions for future consideration. Additionally, past research suggests that the MDS's impact on quality-of-care improvement will be limited unless efforts are directed toward resolving the industry's persistent struggles with staffing, survey effectiveness, and the development of feasible care processes. MDS 3.0 seems most likely to achieve its potential if it operates within a multifaceted quality improvement framework.

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