The Resident Assessment Instrument/Minimum Data Set (RAI/MDS) is a comprehensive assessment and care planning process used by the nursing home industry since 1990 as a requirement for nursing home participation in the Medicare and Medicaid programs. The RAI/MDS provides data for monitoring changes in resident status that are consistent and reliable over time. The VA commitment to quality propelled the implementation of the RAI/MDS in its nursing homes now known as VA Community Living Centers (CLC). In addition to providing consistent clinical information, the RAI/MDS can be used as a measure of both quality and resource utilization, thereby serving as a benchmark for quality and cost data within the VA as well as with community based nursing facilities. Workload based on RAI/MDS can be calculated electronically by the interactions of the elements of the MDS data and grouped into 53 categories referred to as Resource Utilization Groups (RUG-IV). Residents are assessed quarterly. The data is grouped for analysis at the Austin Information Technology Center (AITC). Conversion to electronic data entry and transmission to the AITC was completed system-wide by year-end 2000. In 2010, the Centeres for Medicare and Medicaide Services released a significantly upgraded version, MDS 3.0, to begin to be implemented on October 1, 2011 in VHA CLCs. Training is underway currently. The MDS 3.0 will generate a new set of Quality Indicators and Quality Monitors as well the RUGs will increase to 64 RUGs from the current 53 RUG groups.

The Home Based Primary Care (HBPC) database receives and compiles data from local Hospital Based Home Care (HBHC) sanctioned programs at Veterans Affairs Medical Centers (VAMCs) that run home care programs under the Home Based Primary Care program. The primary purpose is to provide HBPC management with case mix, case load, and other performance information. The HBPC information system is referred to as HBC at the VA Austin Information Technology Center and as HBHC at the local level. The HBHC automated a paper-based system of reporting home care episodes. When an admission form is completed, an episode is opened and input into HBHC for a potential home care patient. The patient is evaluated and accepted to or rejected from the program. When a patient leaves the program for any reason an episode is closed and a discharge form completed and input into HBHC. HBHC runs a nightly extract of information within the Veterans Health Information Systems and Technology Architecture. Extractions include information on all Patient Care Encounters (PCEs) with the patient and home visits made by home care providers. Details of which provider(s) made the visit, the date, any diagnosis and any procedures performed are included. Each local application sends its data to the Austin HBC database on a monthly basis. A monthly report is prepared based on this information identifying the active cases at each VAMC. A more detailed quarterly report is produced that includes national comparisons among sites.