Following are details about the changes made to the various sections of the MDS:

• Section E (Behaviors): MDS 3.0 asks about the impact of behaviors on the resident and others. The items are designed to better inform staff, enhance assessment, and determine the effect of behaviors on quality-of-life and quality-of-care issues.
• Section F (Preferences for Customary and Routine Activities): This section includes resident input about daily preferences (such as clothes to wear, care of personal belongings, choice between bath and shower, snacks between meals, and bedtimes) and activity preferences (reading materials, music, animals/pets, favorite activities, desired access to outdoors, religious services/practices).
  In the national pilot study, 84 percent of residents were able to complete this section, and they commonly said that favorite activities, choices between bathing and showers, and doing things away from the facility were important but they can’t do them.
• Section G (Functional Status): Balance is to be assessed during transitions and walking and activities with an increased risk for falling.
• Section H (Bowel and Bladder): Catheter and ostomy now are not rated as continent, and fecal impaction is eliminated from the QI/QM.
• Section I (Diagnoses): This section includes two elements—diagnosis identification with a 30-day look-back and, after the diagnosis is made, the condition must be determined to be active or not.
• Section J (Health Conditions): “This is another area that is pretty exciting,” said Leible. “We do a chart review but also a direct interview with the resident. We look at how pain affects their function and if things such as not sleeping are related to pain. We have the opportunity to talk to residents to get their feedback and input.” This section also will enable facilities to collect much better falls data, according to Leible.
• Section K (Swallowing and Nutritional Status): Weight loss is now identified as on a physician-prescribed weight loss regimen or not on a prescribed regimen.
• Section M (Skin Conditions): Arterial and venous stasis ulcers are now separated from diabetic foot ulcers. This section also no longer stages venous stasis ulcers, and unstageable ulcers are assessed separately. Facilities will have an opportunity to note when a pressure ulcer is present at admission. National Pressure Ulcer Advisory Panel staging definitions are right on the page in this section.
• Section N (Medications): Anticoagulants are added.
• Section O (Special Treatments): MDS 3.0 combines MDS 2.0 Sections P, W, and part of T and includes a list of two columns of special treatments—one column to check if the person received the treatment when they were not a resident and the other for those received as a resident.
• Section P (Restraints): Separates restraints used in bed from those used in chair. Again, definitions are right on the instrument.
• Section Q (Participation in Assessment and Goal Setting): The changes in this section are designed to elicit residents’ goals and plans, including possibility for a return to the community.