Finding Gertrude: The resident's voice in Minimum Data Set 3.0

Area of Science:

• Gerontology
• Health Services Research
• Nursing Home Quality

Background:

• The Minimum Data Set 3.0 (MDS 3.0) mandates resident interviews for assessing subjective states like pain, mood, and cognition.
• Resident self-report is crucial for accurate clinical assessments in nursing homes.
• The actual practice of conducting these interviews by nursing home staff remains largely unexamined.

Purpose of the Study:

• To determine the frequency of resident interview attempts for clinical assessments under MDS 3.0.
• To identify resident characteristics associated with the likelihood of being interviewed.
• To explore facility characteristics that correlate with higher interview attempt rates.

Main Methods:

• Analysis of MDS 3.0 annual assessments for over 750,000 residents across 15,000 nursing homes (2011-2012).
• Utilized the Online Survey, Certification, and Reporting (OSCAR) database for facility-level data.
• Employed hierarchical generalized linear models to assess associations between resident/facility factors and interview attempt rates for cognition, mood, and pain.

Main Results:

• Over 83% of long-stay residents had all three clinical self-report items attempted.
• Attempt rates for mood, cognition, and pain were 88%, 89%, and 92%, respectively.
• Residents without dementia, cognitive impairment, delirium, or a prognosis of ≤6 months were more likely to be interviewed. Smaller, chain-affiliated nursing homes with fewer Medicare residents and lower nurse staffing ratios showed higher attempt rates.

Conclusions:

• Nursing home residents demonstrate a high participation rate in interviews regarding their clinical states.
• Specific resident profiles require further investigation to enhance interview participation.
• Facility resources and characteristics significantly influence the likelihood of conducting resident interviews.