MDS funding model unknown
Friday February 22, 2008 -- Camille Jensen
While many long-term care homes are impressed by the new Resident Assessment Instrument (RAI MDS 2.0), questions regarding how it will improve funding are still in the air.

A pilot project by the Ministry of Health and Long-Term Care,  RAI MDS is entering its final phase of implementation, with more than 200 long-term care homes using the tool.

While homes are enthusiastic about its clinical results, they’d like more answers on how RAI MDS could contribute to funding.

Janet McNabb, director of care and RAI Co-ordinator at Algonquin Nursing Home, says she’s always the first to bring up the issue of funding at meetings.

She is optimistic about the prospects of RAI MDS offering better funding because it incorporates time spent on physiotherapy and other programs.

Currently, Ontario long-term care homes receive funding through an annual report known as the Case Mix Index (CMI).

A large criticism of the current Case Mix Index (CMI) is its failure to properly compensate for residents who become healthier, even though healthier residents often take longer to care for.

Calling the current funding model “punitive,” McNabb says things need to change.

She says the new tool could properly assess for time spent on residents and should translate into more accurate funding.

Many homes are also hoping the new RAI MDS tool will be used to create a quarterly based funding system, replacing the annual CMI.

For care workers, a quarterly based system would be more reflective of an ever-changing environment where residents needs fluctuate throughout the year. 

Kathy Shewell, RAI co-ordinator at Springdale Country Manor, is one of the advocates for a quarterly based funding system.

Shewell says a quarterly-based system would be more reflective of the different types of care homes provide throughout the year and would provide “snapshots” of residents needs through its extensive documentation.

Marlene Thacker, RAI Co-ordinator at Leisureworld Caregiving Centre, North Bay, thinks the new funding system will be an advantage because it will able to provide a benchmark of care, with all the homes using the same assessment tool.

She says standardizing the assessment tool will allow the government to compare residents across the province benefiting both the system and residents.

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