On August 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the final version of the Minimum Data Set (MDS) 3.0 Item Sets, version 1.20.1v3, along with the updated Item Matrix. These documents are now available for download on the MDS 3.0 Resident Assessment Instrument (RAI) Manual page. The revised item sets will take effect on October 1, 2025.
This update reflects changes finalized in the FY 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule. Among the updates are modifications to demographic and service-related items, including changes to how sex and transportation needs are documented. Several therapy-related data elements have also been streamlined to reduce provider burden and improve clarity. Additionally, Section R, which previously captured social determinants of health, has been removed in alignment with recent policy decisions.
Providers are encouraged to review the final item sets to prepare for the upcoming implementation and ensure accurate assessment and reporting practices.
Access the updated MDS 3.0 Resident Assessment Instrument Manual and related materials from CMS here.
Compliance Perspective
Issue
On August 15, 2025, CMS released the final version of the MDS 3.0 Item Sets, which will take effect on October 1, 2025. These updates reflect changes finalized in the FY 2026 SNF PPS Final Rule and include modifications to demographic and service-related items, such as how sex and transportation needs are documented. Several therapy-related elements have been streamlined, and Section R—previously used to capture social determinants of health (SDOH)—has been removed. These changes will impact assessment practices, care planning, and data reporting. Facilities should review the finalized item sets and updated matrix to ensure that policies, staff training, and internal review processes are aligned with the new requirements.
Discussion Points
- Review and update policies and procedures related to MDS assessment coding, particularly those addressing demographic data collection, transportation services, and therapy reporting. Remove references to Section R and update procedures to match the new item changes. Consider working with a consultant to ensure your documentation practices and policy updates are aligned with current regulatory expectations.
- Educate staff, particularly those involved in MDS coordination, clinical documentation, care planning, and interdisciplinary assessments, on the finalized changes to the item sets. Training should highlight the revised requirements for documenting demographic details, transportation needs, and therapy services. Med-Net Academy offers the course Understanding and Using the Medicare Triple Check Process, which is designed to help staff improve billing accuracy for skilled services, avoid false claims, minimize denials or adjustments, ensure residents receive the benefits they’re entitled to, and better align clinical documentation with financial data.
- Conduct audits of current MDS assessments to identify any documentation or coding issues before the October 2025 changes take effect. A pre-implementation review—possibly through a mock survey or focused chart audit—can help pinpoint problem areas and allow for timely updates. Engaging a consultant for this process can provide an external perspective and support a thorough, objective review of compliance and documentation standards.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*