Section B – Hearing, Speech and Vision Changes

CMS released the MDS 3.0 version 1.18.11 item sets in December 2022. The item sets will be effective October 1, 2023. Additional information can be expected in the months prior to implementation.

Section B on the MDS is a component of the Standardized Patient Assessment Data Elements (SPADEs), which is utilized across post-acute care settings (PACs) including inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), skilled nursing facilities (SNFs), and home health agencies (HHAs).

Section B contains items of the Data Element for the Assessment of Impairments that includes information about resident hearing, speech, and vision abilities.

What You Can Expect to See

One of the changes is a new item - B1300. Health Literacy.  The question:

How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy? Enter Code

Disclaimer. This information is current as of February 23, 2023


About This Series

October 1, 2023 will bring a new MDS for us all to manage.  While there's still many details to finalize, the MDS Consultants team has gone through the known changes in Item Set version 1.18.11 to share with you these section-by-section primers.

Read the whole series to get prepared!

B1300. Health Literacy is scheduled only if:

  • A0310B = 01 (PPS Scheduled Assessment for a Medicare Part A Stay) or
  • A0310G = 1 (planned discharge) and A0310H = 1 (SNF Part A PPS Discharge Assessment).

What Do the Changes Mean?

Consider how your resident can answer B1300 and how their ability impacts planning for their successful discharge.

  • What barriers is the resident likely to encounter upon discharge from your care as it relates to understanding discharge instructions, such as language, hearing, and vision?
  • Are your discharged residents receiving written instructions in a language they understand, typed in a format they can see?
  • Are instructions verbally reviewed with the resident and/or their representative prior to discharge? Do additional accommodations need to be explored

According to the Final Specifications for SNF QRP (Quality Reporting Program) Quality Measures and Standardized Patient Assessment Data Elements (SPADEs) July 2019 p92:

“Similar to language barriers, low health literacy can interfere with communication between the provider and resident or patient and the ability for residents and patients or their caregivers to understand and follow treatment plans, including medication management. Poor health literacy is linked to lower levels of knowledge about health, worse health outcomes, receipt of fewer preventive services, higher medical costs, and higher rates of emergency department use.”

Recommendations from MDS Consultants

With these changes to the MDS, it is imperative to have a clear plan in place and policy that designates what staff are responsible for timely interviews, and an alternate plan if designated staff are not available.

Implementing an appropriate plan that takes individual Health Literacy into account - and mitigating barriers to Health Literacy in discharge planning from PAC - can reduce risk for emergency department use as well as potential rehospitalization.

Do not wait! The time to prepare is now.

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