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MDS 3.0

Taking an in-depth look at falls and injuries

By Pam West

Falls are a serious problem in long-term care, with 45 to 70 percent of the 1.7 million U.S. nursing home residents falling each year. Of these residents, 30 to 40 percent will fall two or more times and 11 percent will experience a serious injury from the fall.1,2

What's new in MDS 3.0?

MDS 3.0 takes a more in-depth look at falls and injuries than MDS 2.0 did. The new MDS will review fall history under Section J and identify the number of falls a resident has had in the past six months as well as the severity of any injuries from the falls. MDS 3.0 also expands Section G0300 with input from physical therapists and other fall experts, who suggested adding balance items designed to guide in identifying parts of gait and transition that relate to fall risk.

Falls are a leading cause of injury, morbidity and mortality in nursing home residents. They can result in serious injury, especially hip fractures. A previous fall is one of the most important predictors of risk for future falls, and residents who have a history of falls can develop a fear of falling that may limit their activity and negatively impact quality of life.3

According to the MDS 3.0, a fall is an "unintentional change in position coming to rest on the ground, floor, or next lower surface i.e., bed, chair, or bedside mat). The fall may be witnessed, reported by the resident or an observer or identified when a resident is found on the floor or ground. Falls include any fall, no matter whether it occurred at home, while out in the community, in an acute hospital or a nursing home. Falls are not a result of an overwhelming external force (e.g., a resident pushes another resident). An intercepted fall occurs when the resident would have fallen if he or she had not caught him/herself or had not been intercepted by another person this is still considered a fall."3

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