Q: What are the concerns or consequences of dashing items on the MDS?

A: Except for items using a dash-filled value to indicate an event has not yet occurred, i.e. the Medicare stay end date, a dash shows an item was not assessed. 

Almost all MDS 3.0 items allow a dash (—) value to be entered, and this most often occurs when a resident is discharged before the item could be assessed. Even though there will be times when dashes are unavoidable, the Centers for Medicare & Medicaid Services expects the use of dashes to be rare.

You and other members of your interdisciplinary team should always strive to thoroughly assess all residents to ensure an accurate assessment. Dashing MDS items can lead to ineffective care planning and financial repercussions. 

Resident interviews in MDS sections C and D are a great example. These interviews must be conducted during the assessment reference period. If they aren’t, the interviews must be dashed. Had the interviews been conducted and reported according to RAI requirements, PDPM reimbursement for a Medicare beneficiary could have been increased if the resident exhibited cognitive impairment and/or indicators of depression. 

Additionally, be wary of unnecessarily dashing items used for SNF QRP data, including items in Section GG. Not only can a lack of information in this section lead to PDPM reimbursement concerns, but trends in dash use also can negatively affect the Annual Payment Update. For a given data submission period, submitted MDS assessments must meet the APU minimum data completion threshold of no less than 80% of MDS assessments having 100% completion of the required SNF QRP data elements.