MDS 2023 Countdown Wrap-Up


CMS released the first MDS draft item set (v1.18.11) in September 2022, which generated many questions for the long-term care community.

Over the past several months, we at MDS Consultants have broken down some of the major changes with MDS 3.0 v1.18.11 that become effective on October 1, 2023.

What Is Changing

Highlights of the upcoming changes include:


Both the final item sets and the draft MDS 3.0 v1.18.11 User’s Manual were released in April 2023. The updated User's Manual includes updates to section intent, coding instructions, definitions, and tips – and totals nearly 400 more pages than the previous manual. The Final MDS 3.0 v1.18.11 User’s Manual will be released in August 2023, followed by updates to the Quality Measures later in the year.

Disclaimer. This information is current as of April 28, 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!

The OSA (Optional State Assessment) has also recently been released (along with the OSA manual) for states to utilize.



The MDS updates/changes also include Standardized Patient Assessment Elements (SPADEs). The Impact Act of 2014:

"requires the submission of standardized data by Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs). Standardized data are to be collected by the commonly used assessment instruments.…”
IMPACT Act Standardized Patient Assessment Data Elements | CMS

SPADEs include five categories:

  1. Cognitive function
  2. Special services, treatments, and interventions
  3. Medical conditions and comorbidities
  4. Impairments
  5. Social Determinants of Health

The information will be collected and shared among the LTCHs, Skilled Nursing Facilities, Home Health Agencies, and Inpatient Rehabilitation Facilities.

Recommendations from MDS Consultants

We can all agree that the MDS 3.0 updates/changes still have one main focus- the resident’s voice. The resident’s interview answers and data collection are the core of the assessment items within the RAI process.

  • Assemble your IDT (Interdisciplinary Team) members included in the RAI (Resident Assessment Instrument) process
  • Review the final item sets with the draft RAI manual
  • Re-evaluate facility policies and data collection forms
  • Train IDT members and staff on upcoming changes/updates
  • Be attentive to CMS MDS 3.0 v1.18.11 updates/changes/trainings

Do not wait! The time to prepare is now.

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