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• A newer version of the MDS RAI 3.0 Manual becomes available, or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.