OVERVIEW OF FINAL RULE

The long awaited Final Rule for the regulations implementing the Resident Assessment Instrument,  MDS 2.0, was published on December 23, 1997. An portion of this rule is provided on this page.

The full text has more detailed explanations regarding the process and the penalties for non compliance with the electronic submission requirements. 

Much of the document is "old hat" by now. The effective date of the regulations are March 23, 1998 except for the sections for:

1. State MDS collection and database requirements - Section 483.20(f)

2. Automated data processing requirement – Section 483.315(h)

The automated data processing requirement requiring facilities to encode and electronically submit assessment data to the state was effective June 22, 1998.

III. Provisions of the Final Rule

In summary, in this final rule, adopted without change, the provisions of the proposed rule with the exception of the following.

• We are adding greater specificity to the proposed requirement that each facility establish a data base of resident assessment information and transmit MDS data to the State at least monthly 

(Sec. 483.20(f)).  

• We are adding a new requirement that each State establish a data base of resident assessment information received from facilities, using a system to manage and analyze data that is developed or approved by us, and transmit that information to us at least monthly

(Sec. 483.315(h)).

• We are adding a definition of ``significant change'' in a resident's physical or mental condition to clarify when a facility must conduct a comprehensive assessment of a resident 

(Sec. 483.20(b)(2)).

• Instead of including the entire content of the MDS, the utilization guidelines for resident assessment instruments, common definitions, resident assessment protocols and instructions in the regulations text or in an appendix to the text, we are providing descriptions of the RAI, the MDS, and RAPs. We are providing a description of the assessment areas included in the MDS (Sec. 483.315(e)), and a description of the domains addressed in the RAPs (Sec. 483.315(f)), both of which must be included in the RAI specified by a State 

(Sec. 483.20(b)(1)).

• To address concerns about confidentiality of resident data, we are providing that a facility and a State may not release resident-identifiable information to the public, and may not release the information to an agent or contractor without certain safeguards 

(Secs. 483.120(f)(5) and 483.315(j)).

• In this final rule, we are not adopting the proposed technical revisions to part 456 concerning inspection of care reviews of SNFs and ICFs. We will include these revisions in another document.