DLC Information
- Alerts
- Hotline Numbers
- Health Care Oversight
- Community Services Programs
- Customer Support
- Maine Registry of Certified Nursing Assistants (CNA Registry)
- Medical Facilities Unit
- Maine Medical use of Marijuana
- Minimum Data Set (MDS)
- Rural Health and Primary Care
- Sentinel Event Program
Other DLC Links
Licensing and Certification
State House Station #11
41 Anthony Avenue
Augusta Maine 04333
Telephone:
1-800-791-4080 or
(207)287-9300
TDD Number:
Maine relay 711
Section V: Care Area Assessment (CAA) Summary
Section V Intent:
The MDS does not constitute a comprehensive assessment. Rather, it is a preliminary assessment to identify potential resident problems, strengths, and preferences. Care Areas are triggered by MDS item responses that indicate the need for additional assessment based on problem identification, known as “triggered care areas,” which form a critical link between the MDS and decisions about care planning.
There are 20 CAAs in Version 3.0 of the RAI, which includes the addition of “Pain” and “Return to the Community Referral.” These CAAs cover the majority of care areas known to be problematic for nursing home residents. The Care Area Assessment (CAA) process provides guidance on how to focus on key issues identified during a comprehensive MDS assessment and directs facility staff and health professionals to evaluate triggered care areas.
(CMS’s Resident Assessment Instrument (RAI) Manual, Chapter 3)
Select a topic to view or close the training information.
RAI Manual for MDS 3.0
The RAI Manual is CMS's official guide to MDS 3.0. This manual contains six chapters plus appendices. Chapter 3 includes step-by-step instructions for completing each section of the MDS 3.0. Since Chapter 3 Section V relates to Care Area Assessment (CAA) Summary the letter V comes before all page numbers in this section. The RAI Manual could take between 3 to 10 minutes to download.
Directions: When you follow the link below, you will open the MDS 3.0 RAI Manual page on the U.S.
Department of Health and Human Service, Centers for Medicare and Medicaid Services (CMS) site. Once you are on this page, scroll to the download section. Select the MDS 3.0 RAI Manual.
MDS 3.0 Forms (Resident Assessment & Care Screening All Item Listing)
Directions: When you follow the link below, you will open the MDS 3.0 Technical Information page on the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) site. Once you are on this page, scroll to the download section. Sometimes you may find two releases of the Item Subsets in the download section; you will need to pay attention to the dates to get the right one to meet your needs. Select MDS 3.0 Item Subsets to download the files.
MDS 3.0 Coding Training Section
Instructor Guides
This link will take you to PDF files of PowerPoint Slides with Instructor Notes used in CMS Training of Trainers in the summer of 2010. You can go through this training material at your own pace. You may find it helpful to have a copy of the MDS 3.0 forms when you review this information. Please refer to the RAI Manual and CMS Transmittals of Changes.
Presentation Slides
This link will take you to the CMS Power Point Slides developed for Training of Trainers for Section V. This PowerPoint includes only the slides; it does not include trainer notes or audio of the training.
Supplemental Training Handouts
There are no training aids related to Section V: Care Area Assessment (CAA) Summary.
Training Videos
There are no training videos for Section V: Care Area Assessment (CAA) Summary.
For more training videos, this link will take you to a list of MDS 3.0 videos on YouTube; it is filtered by date. Beginning at the top, you can view the most videos that have been uploaded on the subject of MDS 3.0. Please note that several of the videos have been uploaded by CMSHHSGOV. While there are many videos on this YouTube channel, the videos posted by CMS would be most recommended by the State of Maine as this is the primary source of guidance on the MDS 3.0 from CMS.
Some things, such as interview techniques have not changed since the implementation of MDS 3.0 in 2011, other sections may not have current information.
CAAs and CATs
Certain responses to questions in the MDS 3.0 will point to conditions, symptoms and other areas of concern that need further assessment in order to help the facility develop a comprehensive individualized care plan. These responses will “trigger” (Care Area Trigger, CAT) the need to complete a Care Area Assessment (CAA). Chapter 4 of the RAI Manual covers the Care Area Assessment (CAA) Process and Care Planning.
Directions: When you follow the link below, you will open the MDS 3.0 RAI Manual page located on the U.S. Department of Health and Human Service, Centers for Medicaid and Medicare Services (CMS) site. Once you are on this page, scroll to the download section. Select the MDS 3.0 RAI Manual. See Chapter 4 in the MDS 3.0 RAI Manual.
Link to CAAs and CATs material
Responses to the following Items in Section V: Care Area Assessment (CAA) Summary may trigger the facility to conduct a Care Area Assessment.
- V0100D (CAA 1 – Delirium) [Effective prior to 10/1/2015]
- V0100E (CAA 8 – Mood State)
- V0100F (CAA 8 – Mood State)
Additional, compound responses to the following sections of the MDS 3.0 can trigger a Care Area Assessment directly related to Section V: Care Area Assessment Summary
- A0310A (CAA 1 – Delirium) [Effective prior to 10/1/2015]
- A0310A (CAA 8 – Mood State) [Effective prior to 10/1/2015]
- C0500 (CAA 1 – Delirium) [Effective prior to 10/1/2015]
- D0300 (CAA 8 – Mood State)
- D0600 (CAA 8 – Mood State)
Case Mix
Long Term Care facilities receive reimbursement through two government programs: Medicare and MaineCare. Both programs reimburse Long Term Care facilities based on measures of the intensity of care and services required for each resident. Case Mix refers to the aggregate level of services and care needed by all the residents of a Long Term Care facility.
Medicare reimbursement is based on a category-based classification system called Resource Utilization Group IV (RUG-IV). Certain responses on the MDS 3.0 determine assignment of a resident to a RUG-IV group. Medicare reimbursement guidelines are the same all across the country.
Medicaid reimbursement rules and guidelines differ from state to state. Currently Maine's Medicaid program (called MaineCare) uses a Case Mix system that differs from the Medicare system.
CMS does not require the completion of C0600 and C0700. However, the State of Maine does require these items to be completed in order to calculate Case Mix payment.
Link to MDS 3.0 Item Subset (10/01/2018)
