Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual

This webpage includes the current version of the MDS 3.0 RAI Manual and associated documents. This page will be updated when:

• An update is made to the MDS RAI 3.0 Manual
• A newer version of the MDS RAI 3.0 Manual becomes available, or
• Important information regarding the MDS 3.0 RAI Manual needs to be communicated.

Older versions of the MDS 3.0 RAI Manual are available for reference on the Archived: MDS 3.0 RAI Manuals webpage.

On this webpage you will also find the most current MDS 3.0 Item Sets and Appendix B which lists all of the State RAI and Automation Coordinators.

What's New –

November 28, 2025

The November update of Appendix B to the MDS 3.0 RAI User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, and CMS locations and contacts. To ensure accurate formatting, use a current version of Adobe Acrobat Reader to view this PDF. Web-based or mobile browser plug-ins may affect how the file is displayed. The file is located in the Downloads section below.

September 24, 2025

UPDATED: Final MDS 3.0 RAI User’s Manual version 1.20.1

The posted final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 has been updated to align with the revisions to item J1900 in the release of the MDS item sets v1.20.1v4. The updated version is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.

Minor corrections have also been implemented. All changes to the posted version of the final MDS 3.0 RAI User’s Manual v1.20.1 are identified in included chapter/section change tables and in the list below:

• Pg. 3-4: Updated reference to removed sub-items of item O0400.
• Pg. J-37: Updated screenshot for item J1900.
• Pg. X-9: Updated reference to removed sub-item of item O0400.

Please replace any previously downloaded versions of the Final MDS 3.0 RAI User’s Manual v1.20.1 with the version posted on September 24, 2025.

September 23, 2025 

UPDATED: Final MDS 3.0 Item Sets version 1.20.1v4

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v4 and Item Matrix v1.20.1v4 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. 

This revised final version of the MDS v1.20.1 item sets (v4) will go into effect October 1, 2025. It includes updates to the language in item J1900, which have been made in response to provider concerns; these are the only changes from the previous version. The MDS Item Sets v1.20.1v4 will be effective beginning October 1, 2025.

August 29, 2025

NOW AVAILABLE: Final MDS 3.0 RAI User’s Manual version 1.20.1

The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.

This version of the MDS 3.0 RAI User’s Manual includes several key refinements, such as in Section A: Identification Information, item A0800: Gender has been removed and replaced with a new item, A0810: Sex, and item A1250: Transportation has been replaced with item A1255: Transportation. Section GG: Functional Abilities has been restructured to improve clarity for items GG0130: Self-Care and GG0170: Mobility and to align with similar guidance from other manuals. Section J: Health Conditions has received revisions to improve clarity regarding defining falls and major injuries. Additionally, Section K: Swallowing/Nutritional Status includes refined guidance to improve clarity when coding items K0300: Weight Loss and K0310: Weight Gain. Changes to Section O: Special Treatments, Procedures, and Programs include the addition of new item O0390: Therapy Services, the revision of item O0400: Therapies, and the removal of item O0420: Distinct Calendar Days of Therapy. Various minor alignments, clarifications, and corrections have been implemented throughout; specifics can be found in the included chapter/section change tables following the guidance.

Please replace any previously downloaded versions of the Final MDS 3.0 RAI User’s Manual v1.20.1 with the version posted on August 29, 2025.

August 15, 2025 

UPDATED: Final MDS 3.0 Item Sets version 1.20.1v3

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v3 and Item Matrix v1.20.1v3 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. 

This final version of the MDS v1.20.1 item sets (v3) will go into effect October 1, 2025, and includes policies finalized in the FY2026 SNF PPS Final Rule.

May 23, 2025 

UPDATED: Draft MDS 3.0 Item Sets version 1.20.1v3-Section_R_removed

The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1v3-Section_R_removed and Item Matrix v1.20.1v3-Section_R_removed are now available in the Downloads section. 

This version of the MDS v1.20.1 item sets (v3) does not include items R0310. Living Situation, R0320. Food, R0330. Utilities and replaces item R0340. Transportation with item A1255. Transportation.  The final MDS item sets v1.20.1 will be posted in late summer, depending on the decisions finalized in rulemaking.

The SNF PPS Proposed Rule is available here: https://www.regulations.gov/docket/CMS-2025-0031/document

April 1, 2025

NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.20.1

The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.20.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.20.1 will be effective beginning October 1, 2025.

This version of the MDS 3.0 RAI User’s Manual includes changes to Section A: Identification Information, including the removal of item A0800: Gender, addition of new item A0810: Sex, and removal of item A1250: Transportation. Section GG: Functional Abilities has been restructured to improve clarity for items GG0130: Self-Care and GG0170: Mobility and to align with similar guidance from other manuals. Changes to Section O: Special Treatments, Procedures, and Programs include the addition of new item O0390: Therapy Services, the revision of item O0400: Therapies, and the removal of item O0420: Distinct Calendar Days of Therapy. Guidance has been added for Section R: Health-Related Social Needs starting on page R-1, which includes new items R0310: Living Situation, R0320: Food, R0330: Utilities, and R0340: Transportation. Various minor alignments, clarifications, and corrections have been implemented throughout; specifics can be found in the included chapter/section change tables following the guidance.

NOW AVAILABLE: Draft MDS 3.0 Item Sets version 1.20.1

The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1 and Item Matrix are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.20.1 will be effective beginning October 1, 2025.

September 3, 2024

NOW AVAILABLE: MDS 3.0 RAI User’s Manual v1.19.1R Hyperlink Update Supplement

The Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.19.1R Hyperlink Update Supplement is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page.

This is an informational document that includes hyperlinks (links) that have been identified as requiring an update over the lifetime of the MDS 3.0 RAI User’s Manual v1.19.1, effective October 01, 2024. Due to external webpage changes, links may occasionally redirect or become unreachable, or the information provided on the webpage may change. To ensure all links remain current, a list of non-functional/out-of-date links has been compiled, each with an up-to-date replacement link. Replacement pages for each affected page of the MDS 3.0 RAI User’s Manual v1.19.1 can be found following the list.

August 1, 2024

NOW AVAILABLE: Final MDS 3.0 RAI User’s Manual version 1.19.1

The final Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.19.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.19.1 will be effective beginning October 01, 2024.

This version of the MDS 3.0 RAI User’s Manual contains guidance to support the addition of new items N0415K: Anticonvulsant and O0350: Resident’s COVID-19 vaccination is up to date. Additionally, the Discharge Goals column in items GG0130: Self-Care and GG0170: Mobility has been removed; and the guidance and examples in Section GG have been revised to reflect the modification. Expanded guidance has been added regarding Manual Assessment Correction/Deletion Requests in Chapter 3, Section X, and Chapter 5. Various minor alignments, clarifications, and corrections have been implemented throughout; specifics can be found in the included chapter/section change tables following the guidance.

June 3, 2024

NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.19.1

The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.19.1 is now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS 3.0 RAI User’s Manual v1.19.1 will be effective beginning October 01, 2024.

This version of the MDS 3.0 RAI Manual contains guidance to support the addition of new items N0415K: Anticonvulsant and O0350: Resident’s COVID-19 vaccination is up to date. Additionally, the Discharge Goals column in items GG0130: Self-Care and GG0170: Mobility have been removed; and the guidance and examples in Section GG have been revised to reflect the modification. Various minor alignments and corrections have been implemented throughout; specifics can be found in the included chapter/section change tables following the guidance.

May 17, 2024

NOW AVAILABLE: Final MDS 3.0 Item Sets version 1.19.1

The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.19.1 are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The MDS Item Sets v1.19.1 will be effective beginning October 01, 2024.