What changes in the MDS 3.0 should an Activity Director look for?

Q: What changes in the MDS 3.0 should an Activity Director look for?

A: The resident interview for Customary Routine and Activities affords the activity professional to directly interact with residents and patients to obtain their preferences. These preferences impact quality of life and should be more useful in designing resident-specific activities and care plans. Of particular note is the response, “Important, but can’t do or no choice (meaning the resident finds it important but feel he/she cannot do that at this time because of health or because of nursing home resources or scheduling),” which should allow activities and recreation therapy professionals to develop creative and meaningful activities

Nurses that participated in the RAND Study were polled about the revised sections and findings indicated that:

  • 81% rated the interview items as more useful for care planning
  • 80% found that the interview changed their impression of resident’s wants


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  2. Kim Grandal

    There are many changes the Activity Director/Activity Professional faces with the implementation of the MDS 3.0. Some include:

    •Section F now combines customary routine and activities. If the Activity Professional is completing all of section F, he/she must now learn about customary routines such as bathing, snacks, dressing and so on. This is a new area of assessment for the Activity Professional.

    •Although not the norm, if the Activity Professional is doing other interviews such as mood, cognition and pain-also new areas for the Activity Professional.

    •The Activity Professional, as well as the IDT will really need to communicate findings from resident interviews with the appropriate department. Communication will be key to formalizing the resident-centered care plan.

    •Care planning will be very different for the Activity Professional. Resident preferences will really be identified and the language should reflect that. Problem statement such as, “Mr. Smith has little time in activity”, are no longer relevant or useful.

    •Code 5 “can’t do or no choice” will really help the Activity Professional in formalizing care plan and addressing the resident’s recreational activity needs. Residents often have perceived barriers. A resident may feel he/she can longer participate in a favorite recreational activity related to pain, facility resources, health issues, time/energy and so on. Activity Professionals and CTRS’s are exclusively trained to assess and provide the necessary adaptation, modification and adaptive equipment needed to help the resident participate n their favorite activities to the highest extent possible. Leisure education will also play an important role in the coding of section F.

    •The triggers (CATs) for activities are completely different which will affect the CAAs and care planning for Activity Professionals.

    •Although the CAA process is the same, there are clearly defined CAA content areas that need to be documented. The Activity Professional must learn to be more thorough with the CAA documentation, truly identifying the underlying cause and contributing factors for the triggered activity CAA.

    •Activities may be triggered now by another section of the MDS, the Mood section. This will increase communication amongst the Social Worker and the Activity Professional.

  3. adele foreman

    Thanks Kim! I find that you are the “go to” source for current information and support for those of us in the field. My entire IDT team is overwhelmed by the additional time and paper work that this process involves. My concern is that we are not able to conduct our regular duties, and that our clients are not being served in the best way because of the time and staffing constraints. Can anyone else share their strategies for the day to day operations of their departments, activities programming and staffing and integrating the additional time required for the MDS 3.0 changes? Also, this past week I had 4 new “move ins” (culture change lingo for admissions), and 2 brief hospitalizations with re-admission. I am seriously falling behind on my regular documentation and review of Quarterly and Annual Careplans. I am a very conscientious clinician, and I am dreading the Peer Review that is just around the corner (conducted by our Corporate Registered Nurse Managers). I know that others are facing the same time challenges – please comment! Thanks and Good Luck everybody!

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  5. Linda Penner

    Good day
    I am seeking to find out if there will be refresher courses available for the MDS 3.0 in the Western New York or Buffalo area. I know how important it is to keep up to date and accurate with timely assessment and care for our population and our facilities.

    Thank you

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