The Minimum Data Set (MDS) is a standardized, federally mandated assessment tool used to identify the needs of nursing home residents and rehabilitation and nursing services received on a routine basis. These data can be used to identify people with traumatic brain injury (TBI), where a diagnosis is recorded. However, both limitations of the MDS and the presence of other neurological issues that can be confused with TBI can reduce the likelihood that brain injury is identified where it exists. The article discusses innovative methodological approaches and challenges to using the MDS data to identify people with TBI in nursing homes.