These links provide information on the Resident Assessment Instrument (RAI) and Minimum Data Set (MDS) 3.0. Many of the links will exit the Wisconsin Department of Health Services (DHS) website.
The MDS 3.0 Final Item set v1.17.2, dated October 1, 2020, is available under Downloads on the CMS MDS 3.0 RAI Manual webpage. Draft item set v1.18.11 Oct2023 is also available for download.
The MDS Item Sets and Data Submission Specifications can be downloaded from the CMS MDS 3.0 Technical Information webpage.
Wisconsin RAI/MDS items
Wisconsin does not have a Section S for MDS 3.0.
Wisconsin does not require the submission of State Optional items.
Wisconsin will not require the completion of the Optional State Assessment (OSA).
RAI/MDS educational forum
The Division of Quality Assurance (DQA) sponsors a quarterly forum to help nursing homes stay updated with evolving RAI/MDS information. The forum also gives nursing home staff a chance to ask questions. The forum is hosted jointly by DQA's RAI/MDS education and automation coordinators.
- Join Zoom forum. (Select this link to go straight to the room. No need for a meeting ID and password.)
- Meeting ID: 160 836 5011
- Passcode: 048192
- Join by Phone: 551-285-1373
- Enter 1608365011 # when asked for the meeting ID
- Enter 048192 # if asked for passcode
- Enter # if asked for participant ID
- The next forum is scheduled for March 15, 2023, 1-2 p.m. Agenda (PDF)
Past forums and trainings
- February 1, 2023
- December 21, 2022
- October 25, 2022
- September 21, 2022
- August 31, 2022
- June 28, 2022
- June 14, 2022
- March 16, 2022
- CMS MDS 3.0 Training
- CMS Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Training provides links to trainings such as:
- Cognitive and mood assessment
- Achieving a full annual payment update
- Section J
- Section N
- Section GG
- DHS Nursing Home Pressure Injury Information
- ICD-10-CM Official Guidelines for Coding and Reporting (PDF)
- ICD-10-CM April 1, 2023, Update with NCHS
- SNF QRP Covid-19 Public Reporting Tip Sheet 3rd Edition (PDF)
- Covid-19 Vaccine: Percent of Residents Who Are Up to Date Draft (PDF)
- Nursing Homes all Datasets (ZIP)
- Care Compare Nursing Home Five-Star Quality Rating System (PDF)
- Updates to Chapter 10 of Pub. 100-08 (PDF)
- Payroll Based Journal Daily Nurse Staffing
- Expanded Coverage for Permanent Telehealth Policy (PDF)
- SOM Appendix PP (PDF)
- ICD-10-CM Guidelines for Coding and Reporting FY23 (PDF)
- Methods of Implementation for Nursing Home Payment Rates (Medicaid) (PDF)
- Draft NH Comprehensive (NC) Item (PDF)
- SNF QRP Measure Calculations and Reporting Manual V4.0 (PDF)
- PDPM Grouper JAR Package V2.1000 (ZIP)
- SNF 30-day All-Cause Readmission Measure (PDF)
- QSO-19-08-NH Improvements to NH Compare and the Five Star Rating System (PDF)
- MDS VUT v3.6.1 Effective October 1, 2022
- SNF QRP APU Determination FY25 (PDF)
- SNF QRP Data Collection & Final Submission Deadlines for FY24 (PDF)
- SNF QRP Data Collection & Final Submission Deadlines for FY25 (PDF)
- SNF QRP FAQs (PDF)
- jRAVEN 1.8.2
- Revision History for LTC Survey Process Documents and Files (PDF)
- NH Compare Five-Star Quality Rating System (PDF)
- Finalized VBP Overview (PDF)
- My Medicines List
- Web Pricer
- FY23 ICD-10-CM Table of Drugs and Chemicals Errata (PDF)
- Annual Influenza Vaccine Data Reporting 22-23 Season (PDF)
- COVID-19 Blanket Waivers (PDF)
- Care Compare NH Five-Star Quality Rating System: Technical User’s Guide (PDF)
- PDPM Claim Edit Enhancements (PDF)
Only Omnibus Budget Reconciliation Act (OBRA) and Medicare Prospective Payment Systems (PPS) assessments are allowed to be submitted.
- All Medicare and/or Medicaid certified Swing Beds, or agents of those facilities must transmit required MDS data to the CMS Quality Improvement and Evaluation System (QIES) Assessment and Submission and Processing (ASAP) system. Additional information related to transmitting MDS Data is in Chapter 5 of the MDS 3.0 RAI Manual (PDF).
- Do not submit assessments that are completed for purposes other than OBRA and SNF PPS (such as private insurance including Medicare Advantage plans).
- Test data should not be submitted to the QIES ASAP system. Please review 5.8 Special Manual Record Correction Request (PDF) for additional information.
MDS correction policy
The MDS correction policy is described in the MDS 3.0 RAI Manual (PDF) under Chapter 5.5 MDS Correction Policy.
QIES Technical Support Office (QTSO) Submission Information and User's Guide
Find technical guidance such as references and manuals, software tools, and training materials on the QIES Technical Support Office (QTSO) website. See the QTSO Nursing Home (MDS)/Swing Bed Providers page for more details.
- Software (jRaven)
- Reference & Manuals
- Access Forms
- Important Links
- Appendix A-Quick Reference (PDF) to MDS 3.0 submissions, submission status, and final validation reports
- Appendix B- Resident Match Process
CMS user account registration
QTSO is moving toward a single sign-on option to access the secure side of the website. Providers will need to register for a Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) account.
All providers must request a CMSNet User ID to access secure CMS websites for submissions and reports unless another secure connection has been established. Account registration instructions are on the QTSO MDS Individual Access webpage.
Please reference Certification And Survey Provider Enhanced Reports (CASPER) Reporting User's Guide For MDS Providers for information on creating a CASPER account.
- The MDS 3.0 Quality Measure User's Manual is under Downloads on the CMS Quality Measures website.
- Section 11 of the CASPER Reporting Users Manual provides information for how to generate the MDS 3.0 Quality Measures reports.
- Medicare Nursing Home Compare
- CMS Five Star Rating System
- CMS Nursing Home Quality Initiative
- Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Measures and Technical Information
- CMS Nursing Home Quality Assurance & Performance Improvement (QAPI)
- Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Public Reporting includes information for Provider Preview Reports
- CMS SNF PPS
- Patient Driven Payment Model
- Medicare Benefit Policy Manual Chapter 8 (PDF)
- Medicare Claims Processing Manual Chapter 6 (PDF)
- National Government Services—Medicare claims
- Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program
- MDS 3.0 Section Z items Z0200 and Z0250 don't have to be coded and may be left blank.
- Wisconsin Medicaid uses the MDS 3.0 HIPPS code generation for Medicaid residents.
The Program Participation System (PPS) was discontinued in 2021, and the automated referral system implemented in October 2021. Due to customer and provider feedback it has been determined that a new process will be implemented for Section Q referrals as of Dec. 1, 2022.
- MDS referral process
- The nursing home completed the MDS assessment.
- If the resident expresses they would like to talk to someone about returning to the community, complete Nursing Home MDS 3.0 Section Q Referral and Non-MDS Q Referral, F-00311 (Word) to refer a resident to the Aging and Disability Resource Center (ADRC).
- Submit the form to the county of responsibility of the resident. For questions regarding county of responsibility contact (include contact information).
- Include the resident's face sheet, current diagnoses, activated pow of attorney documentation, guardianship court order, protective placement court orders, and other documents specific to this referral as applicable.
- Completed form must be submitted by fax or email within 10 business days of completing the Section Q of the MDS Assessment.
- View Find my ADRC to locate ADRC contact information.
- See form for more detailed instruction.
- Non-MDS referral
- A non-MDS Q is when a resident requests to talk with someone separate from the MDS Section Q assessment and shall be treated the same as an MDS referral.
- See form for more detailed instruction.
- The ADRC will follow up as necessary with the customer and the nursing home.
- The ADRC will document the referral outcomes.
- Skilled Nursing Facility Center
- SNF/Long Term Care Open Door Forum
- CMS SNF Consolidated Billing
- Nursing Home Certification and Compliance
- State Operations Manual (SOM) and SOM Appendix (PDF)
- CMS Form 672 Resident Census and Conditions of Residents (PDF)
- CMS Policy & Memos to States and Regions
- CMS Staffing Data Submission PBJ (QTSO Reference & Manuals webpage)
- Medicare Learning Network
- Form 20132 which is located in the "Survey Resources" ZIP folder on the CMS Nursing Homes webpage
CMS Nursing Homes webpage includes links to the critical element pathways, CMS-802, and other valuable resources.
- DQA Email Subscription Service (Listserv)
- The Wisconsin Health Care Association (WHCA) / Wisconsin Center for Assisted Living (WiCAL) is a non-profit organization dedicated to representing, protecting, and advancing the interests of Wisconsin's long-term care provider community and the residents they serve.
- Metastar—Wisconsin's Quality Improvement Organization
- Clinical Resource Center
For questions about the RAI, coding MDS items, or clinically related information contact Heather Newton, RAI education coordinator:
- Email email@example.com.
- Call 920-360-6102.
For technical or automation questions about submitting MDS records, interpreting validation report messages, and generating CASPER reports, contact Emily Virnig, MDS automation coordinator:
- Email firstname.lastname@example.org.
- Call 608-266-1718.