All Dietitians need to know how to complete MDS in a long term care facility. Here you will an easy guide for Dietitians completing MDS: The Minimum Data Set. MDS is not complicated and it should be a very quick process for you to complete if you have the right plan in place.
Keep reading to find out more!
What is the MDS: Minimum Data Set Used For?
MDS also known as the Minimum Data Set is a requirement for Provincial Standards as well as State Audits.
It’s important that the information is up to date, and as a Dietitian, chances are that you are in charge of Sections K and V.
If you don’t know, this is something that is very important you ask right from the start what is required of you for the MDS.
Ask your Administrator or Director of Nursing/Care, they will tell you what you need to do.
MDS’s are due quarterly, they go through the residents individual care plan. This covers everything from the days of their bath, how they like their hearing aids put in, to likes/dislikes in their diet.
The purpose is someone should be able to look at the resident’s care plan and know exactly how to care for them even if they haven’t met them.
During Standards/Audits they will go through the resident’s care plans with a fine tooth comb to make sure they are accurate and up to date.
If you are like most facilities, then you as the Dietitian are responsible for keeping up with MDS quarterly care plans, Section K and V.
This is where Canada versus the United States will be slightly different, but how you acquire the information is quite similar. The information may just be in a different place.
If you have a new resident, you need to complete their MDS within 14 days of admission. If it is a quarterly assessment, you should ask your facilities Educator or Director if they have a calendar that you can have with the due dates.
At quarterly assessments, you do not need to complete a full nutrition assessment. You just need to review your patients nutrition state to ensure that you don’t need to update any of the information below.
Terms to Know For Dietitians Completing MDS
ARD – Assessment Reference Date, this is the time period you will be evaluating the resident. Typically you will assess the resident after this date. Make sure that you know the date that your assessment must be completed by. A nurse will sign off on the MDS and it will be closed after this, meaning you won’t be able to do your section anymore. They’ll likely have to complete it and won’t be too happy considering they did your job for you.
Significant Weight Change – 5% change up or down in 30 days, 10% up or down in 180 days.
Mechanically Altered Diet – Any diet texture that is different than a Regular/Standard diet. If your resident is on Minced, Pureed, etc. then this is a yes.
Therapeutic Diet – We see these less and less in LTC/NH, but they still exist. This is where you would put if they are on any diet that has exceptions to a Regular/Standard diet. Low Salt, Controlled Carbohydrate (I don’t recommend using this diet…), Vegetarian, etc…
I won’t go through the parenteral/enteral because as a Dietitian you should know what these are.
What is the Dietitians Role in MDS?
The Dietitian Needs to Assess:
Perform a Mealtime Observation.
You need to assess whether there is any changes needed to be made to their nutrition care plan. A mealtime observation allows you to assess any difficulties, intake levels, assistance levels, chewing/swallowing issues.
If you need a free meal observation screen form, you can find one by clicking here.
It’s highly unlikely that your facility will measure a patients height annually. I continue to use the patients height that I recorded on their initial nutrition assessment, unless there has been a visible change.
Weights are always a contentious topic in long term care. You can read this article if you want some great advice on how to get weights done in your facility!
You will want to have the patient’s most recent weight, if you don’t have that, you should discuss what your facility wants you to do. Some Dietitians will put a dash, ‘-‘, through, others will ask you to use a previous weight.
I always have serious concerns when a facility asks you to use a previous weight, as this is not honest practice. Be honest about your preference, but be reasonable.
There will be a section about whether a significant weight change has occurred or not. You will always follow this formula:
5% loss or gain within the previous 30 days.
10% loss or gain within the previous 180 days.
There are no other numbers that you will use to assess a significant change.
This is a straight forward calculation.
Artificial Nutrition and Feeding Tube
This section is very straight forward. If your patient receives any type of Enteral or Parenteral Nutrition, whether it’s only partial or full, check yes.
Mechanically Altered Diet
This item will vary based on the type of diets that your facility offers. If your facility offers a ‘soft texture diet’, this is NOT a mechanically altered diet. That is a frequent question that I get asked.
A soft texture diet is serving a patient items that are soft. The kitchen does not alter the texture of the food in most facilities.
A mechanically altered diet is any type of food delivered to a patient that has been altered by either a cook manipulating it, or a machine. For example: Minced, total minced, pureed, blenderized.
Fill this section out if you have prescribed any type of therapeutic diet. This can be for example: low salt, controlled carbohydrate, renal friendly, and more.
Closing Thoughts on Guide for Dietitians Completing MDS
MDS can seem intimidating at first, but once you get the hang of it, it’ll be smooth sailing and quick!
You should have a calendar with all of your MDS dates, and add new patients to it as they are admitted. If you have an ongoing calendar monthly of all the patients that need to be done, you can keep yourself organized!
If you’re looking for a Dietitian calendar to keep up with MDS, meetings, etc. Check this one out.
If you want to know exactly what you will be audited on for a Provincial Audit or State Survey, you can find the perfect guide specifically for Dietitians by clicking here.
If you want a broad overview of all things to do with MDS, even outside of the Dietitians role, click here to find out more!
Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.