MDS Section Q: Reminder for Social Workers and MDS Coordinators

Section Q:  Participation in Assessment and Goal Setting

The Section for Long-Term Care Regulation is posting this reminder to assist providers that may not understand all the requirements and procedures to follow regarding discharge planning within Section Q of the Minimum Data Set (MDS).

On May 1, 2014, the Missouri Department of Social Services issued Nursing Home Bulletin Vol. 26, No. 27 to assist providers with this requirement.  The bulletin contains specific instructions for completing the online referral.  Please view the bulletin here:  DSS Provider Bulletin 36-27 05-01-2014, or visit

Accurate completion of Section Q of the MDS is a requirement of the Centers for Medicare and Medicaid Services.  This section is designed to provide residents who do not have current active plans for discharge, with an opportunity to speak with an outside resource (Local Contact Agency or LCA).  The LCAs are contracted by the Division of Senior and Disability Services within the Missouri Department of Health and Senior Services.

Section Q is an interview process for all comprehensive MDS assessments and asks the following question in Q0500 of all residents who do not have current active discharge plans:  “Do you want to talk to someone about the possibility of leaving this facility and returning to live and receive services in the community?”  If the resident wishes to speak to an options counselor about a potential discharge, no matter how feasible the care plan team thinks discharge may or may not be, the facility is expected to make a referral to the LCA, at  (If the resident answers “yes” to Q0500, also indicate “yes” on question Q0600 and make the referral).

Please remember that this is a Resident’s Rights issue and the facility cannot skip asking the question in Q0500 unless there is current active discharge planning already occurring.  The intent of Section Q is not to address residents who are already planning on discharge.  The intent is to capture all of the long-term care residents who do not have active discharge plans.  These are the residents who would be referred and benefit from speaking with an options counselor from the LCA.  The only time Q0500 would not be asked of the resident is if they have a guardian or invoked durable power of attorney.  In these cases, question Q0500 would be asked of the guardian/invoked durable power of attorney, rather than the resident.

If you have questions about Section Q of the MDS, you may contact Joan Brundick, State RAI Coordinator at 573-751-6308 or