DPG11 Healthy Aging (HA)

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  • 1.  MDS Weight Review Windows

    Posted 07-21-2025 11:14 AM

    Hi! 

    We are having discussions between our RDNs and one of our RNACs about which weights should be used for 1-month and 6-month MDS windows. 

    The RAI has the most recent weight used within the last 30 days.

    It states for admissions, to use 7-day look back windows at the 1-month and 6-month reviews and for long-term residents to use the weight closest to the 30-day mark.

    Our questions about what everyone else is doing:

    • Do you use the date of the most recent weight and the weight closest to 30- and 180-days from the date of that weight?
    • Do you use the 7-day MDS lookback/observation window at the 1- and 6-month marks for comparison to your most recent weight?
    • Do you use weights that are slightly older than 1- or 6-months if it is the weight closest to the 30- and 180-day marks?

    We are looking forward to hearing what everyone else is doing!



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    Brittany Knick MS, RDN, LDN
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  • 2.  RE: MDS Weight Review Windows

    Posted 07-23-2025 07:05 AM

    Hi Brittany, 

    My understanding is that for current weight for MDS you should be using the most recent weight that has been obtained within the last 30 days and if no weight has been obtained within the last 30 days (or since their most recent admission/readmission) you should be entering a dash for the weight section per the RAI Manual. 

    For the lookback period, you should not be using weights older than 30 or 180 days. I believe the RAI Manual says to use a weight obtained on the 30 or 180 day mark or the first weight obtained after that date.

    Hope that helps!

    Jeremy Kinman, RDN, CSG, LD, CSNC



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    Jeremy Kinman
    Lancaster OH
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  • 3.  RE: MDS Weight Review Windows

    Posted 07-23-2025 07:23 AM

    Thanks, Jeremy! 

    We are not using weights older than 30 or 180 days. 

    I think the largest clarification needed is whether the 30 or 180 days is being looked at from the ARD date or whether that is from the last weight obtained (the one within the 30-days preceding the ARD date). Clinically, we would look back from the weight we are using to assess weight change, but is this what you also do for the 30- and 180-day weights or do the 30- and 180-day marks get based off the ARD date regardless of the weight we are using (in the last 30 days) in the MDS?



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    Brittany Knick MS, RDN, LDN, CNSC
    Diabetes Educator
    ChristianaCare
    Newark, DE
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  • 4.  RE: MDS Weight Review Windows

    Posted 07-23-2025 08:13 AM

    Brittany, 

    I agree with you that, clinically, I would use the closest weight to 7/30/90/180 days when interpreting weight changes. 

    Unfortunately, the RAI Manual's instructions on this seem to be somewhat contradictory. On page K-4 of the RAI Manual under "Steps for Assessment" it says:

    • At a point closest to 30-days preceding the current weight.
    • At a point closest to 180-days preceding the current weight. 

    However, on page K-4 of the RAI Manual under "Definitions" it says: 

    • 5% WEIGHT LOSS IN 30 DAYS
      Start with the resident's weight closest to 30 days ago and multiply it by .95 (or 95%). The resulting figure represents a 5% loss from the weight 30 days ago. If the resident's current weight is equal to or less than the resulting figure, the resident has lost more than 5% bodyweight. 
    • 10% WEIGHT LOSS IN 180 DAYS
      Start with the resident's weight closest to 180 days ago and multiply it by .90 (or 90%). The resulting figure represents a 10% loss from the weight 180 days ago. If the resident's current weight is equal to or less than the resulting figure, the resident has lost 10% or more body weight.

    In the first section I referenced, it says to use 30/180 days from the date of the most recent weight, but I have always interpreted the second referenced section to be 30/180 days from the ARD date. My problem with the first section I referenced is that, depending on the date of the "current weight", the "point closest to" 30/180 days from the "current weight" could easily be greater than the 30/180 day lookback period.  

    So, unfortunately, I can't say for sure that my interpretation is entirely correct, but what I can say is that I have been through dozens of surveys here in Ohio and I have never been questioned about my use of the ARD date instead of 30/180 days from the date of the most recent weight. 

    I hope that helps!



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    Jeremy Kinman
    Lancaster OH
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  • 5.  RE: MDS Weight Review Windows

    Posted 07-23-2025 09:08 AM

    Thanks! I will pass this along to our RDNs!



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    Brittany Knick MS, RDN, LDN, CNSC
    Diabetes Educator
    ChristianaCare
    Newark, DE
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  • 6.  RE: MDS Weight Review Windows

    Posted 07-23-2025 08:21 AM

    Hi! 

    This has been a HUGE topic where I work!

    To your question about the look-back is from the ARD date or the last weight obtained -We input the most recent weight within 30 day look back. Then the look back is from that specific weight, not the ARD date. It gets tricky when there are missing weights. I think there's a gray area about 30 day window; at my work we use a bigger range for look-backs. For example, if the weight is at 25-35 days back, we still count that as 30 days. 

    Hope this helps!

    Jessica



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    Jessica Oakes RDN, LD
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  • 7.  RE: MDS Weight Review Windows

    Posted 07-23-2025 09:11 AM

    Thanks! It has been a huge topic for us recently so we are trying to find some consistency. I appreciate your input!!! I will pass this along to my RDNs.



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    Brittany Knick MS, RDN, LDN, CNSC
    Diabetes Educator
    ChristianaCare
    Newark, DE
    ------------------------------