Alterations to the MDS from 2.0 have the potential to significantly impact all direct care staff members. Following are some of the key changes that facilities should act upon as they transition to 3.0.

• Care Area Assessments (CAAs). CAAs replace Resident Area Protocols (RAPs) as the trigger for determining what areas must be addressed in a resident’s care plan. Unlike RAPs, which mandate specific assessment protocols, CAAs require that the facility select from existing “gold standard” assessment scales for these functional areas. Effectively, this places the burden back on facilities to select research-based, expert-endorsed clinical practice guidelines and align their policies accordingly. While the MDS manual lists certain care area resources, it is the facility’s responsibility to make an appropriate selection.
• Commonality of language.MDS 3.0 strives to reinforce the use of common terms to allow for a seamless vertical integration of assessments across the continuum of care, from an acute setting to therapy, home care, or hospice.
• Discharge assessment. Upon discharge every resident is required to undergo a full assessment to allow for tracking of outcomes when a resident returns to the community.
  For residents with frequent visits to an acute facility with an anticipated return, this requirement will be time consuming and thus require more resources.
• Participation in assessment and goal setting. All residents must be asked about their personal goals and care needed regarding their current admission and subsequent desire to return to the community.​