Reliability Estimates for The Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS)

TLDR

The Minimum Data Set (MDS) is a core assessment tool for all 1.5 million U.S. nursing‑home residents, and a proposed HCFA rule will mandate its computerization and submission to state and federal agencies, creating a national database. This article seeks to evaluate the reliability of MDS items. The authors tested item reliability in 13 nursing homes across five states.

Abstract

The MDS is a core set of items, definitions, and response categories used to assess all of the nation's 1.5 million nursing home residents who reside in facilities participating in the Medicare or Medicaid programs. Further, the Health Care Financing Administration (HCFA) has proposed a rule that would require facilities to computerize MDS data and submit it to state and federal agencies, paving the way for a national database. This article describes the process of testing the reliability of the MDS items in 13 nursing homes in five states. The results demonstrate that MDS data gathered in a research effort attain reliabilities that make such data useful. MDS items met a standard for excellent reliability (i.e., intraclass correlation of .7 or higher) in key areas of functional status, such as cognition, ADLs, continence, and diagnoses. Sixty-three percent of the items achieved reliability coefficients of .6 or higher. Eighty-nine percent of the items in the MDS achieved .4 or higher.