Q: Our facility has several residents with severe advanced dementia who are essentially nonverbal and family contact is inconsistent at times. How does CMS address the resident interviews conducted under the MDS 3.0 when the resident is unable to answer and a family member or responsible party cannot be reached?
Diane: The MDS 3.0 will specify alternate methods for capturing information when a resident is incapable of completing the interviews. For example, the latest MDS 3.0 Draft Item Set indicates that if a resident was unable to complete the Brief Interview for Mental Status (BIMS), the Staff Assessment for Mental Status should be completed instead. Most of the alternative methods for collecting information rely on the observational skills of the clinical team, which is similar to how assessments were completed under the MDS 2.0.
The Interview for Daily and Activity Preferences (Section F of the MDS 3.0 Draft Item Set) requires a slightly different approach than the other resident interviews. If a resident is unable to complete this interview, nursing home staff should attempt to contact a family member to complete the interview. If three or more items in the Interview for Daily and Activity Preferences cannot be completed by the resident or family, the Staff Assessment of Daily and Activity Preferences should be completed.
It is important to note that nursing home staff must attempt to conduct the MDS 3.0 interviews with all residents, or in the case of the Interview for Daily and Activity Preferences, all residents who are able to communicate.