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Section F: Daily Routine and Activity Preferences

Scroll down for news, resources, education, and more. If you have any information you'd like to share, please contact Kim. Check out the new  Q and A.

MDS 3.0 ProductsMDS 3.0 for Activity Professionals

Download many of the MDS 3.0 materials related to activities.

CMS MDS 3.0 Training on You-Tube

September 23, 2011
HCPRO discusses changes in the RAI Manual

August 17, 2011

MDS 3.0 Special Report from Long Term Living
Download for FREE
Recreation Therapy is mentioned!

July 13, 2011

RAI MDS 3.0 manual update for Appendix A and Section M.

July 12, 2011

The following videos have been posted on YouTube.

  • Interdisciplinary Team Video: This video addresses some of the common questions about the MDS 3.0. The panelists: Dr. Debra Saliba, Ellen Berry, Ann Spenard and Tracy Montag are clinicians that have been instrumental in the development of the MDS 3.0 and RAI manual. In this video they discuss the MDS 3.0 interviews, particularly the Mood PHQ-9 interview, the importance of the interdisciplinary team and the resident-centered focus of the MDS 3.0.
  • Facility Leadership Video: This video addresses some of the topics that facility management should consider when operationalizing the MDS 3.0 in their facilities. Contributors include Dr. Debra Saliba, Jack Williams (CMS), Karen Schoeneman (CMS), Dr. Christa Hojlo (VA), and Tracy Montag. Included is background on the motivation for creating the MDS 3.0, the use and value of the assessment instrument, impact on resident care, and practical considerations for implementing the MDS 3.0.

June 11, 2011

A memo titled 'The Use of Dashes in Completing the MDS 3.0 Assessment: Potential Impact to Beneficiaries and Nursing Home Facilities' has been posted below in the download section. This memo conveys information to providers on a data issue - regarding the possible overuse of dashes. This memo is intended to help providers understand both when to code dashes and the potential adverse impact of inappropriate use of a dash (-) when completing a MDS assessment.

June 2, 2011 MDS 3.0

Training Materials Update:

MDS 3.0 RAI Manual V1.05 (June 2, 2011)

  • MDS 3.0 RAI Manual May 25, 2011 (a zip file contains 58 files)
    • This zip file is the complete manual and contains all manual chapters / sections / appendices / title page / Table of Contents / forms (58 files). This includes change table files for the revised V1.05 files only.
    • Files containing revisions in this V1.05 release include: Title Page, Table of Contents, Chapter 1, Chapter 2, Chapter 3 (Introduction, Sections: A, B, D, F, G, I, J, K, M, N, O, and Q), Chapter 5, Chapter 6 and Appendices (A, B, C, E, and H).
    • Note that files from earlier versions (e.g., V1.04 September 2010) are contained in the manual but do not have an associated change table file.
    • Please note that the month/year located at the bottom left on the manual pages reflects when that file was last updated (e.g., May 2011 for V1.05).
  • Archived Change Tables May 25, 2011 (a zip file contains 8 files)
  • RAI MDS Coordinators May, 2011

Recreational Therapy and MDS 3.0
January 2, 2011

Wonderful tools developed to help therapists working in nursing homes by the University of North Carolina.

More MDS 3.0 Information
December 29, 2010

Here is a list of CMS links that providers and vendors most frequently need in order to resolve their MDS 3.0 issues:
• It is recommended that individuals requesting assistance check for updates and new downloads often/daily - the best method to keep up-to-date with CMS MDS 3.0 Manual and coding changes not announced anywhere else first. NEW download information may NOT appear in the text at the top of the page, so please check the actual download listing at the bottom of the page on this link:

• Transition Document that CMS updated on Dec.9, 2010. It contains many clarifications of MDS 3.0 coding since the manual was released:

• Open Door Forum (CMS calls for providers):

• CMS Technical information page, which includes jRaven, etc.:

• CMS QTSO page, which includes the vendor, CASPER, RAVEN and error explanation pages. It is strongly recommended that providers access and review the MDS 3.0 Provider User's Guide and the CASPER Reporting User's Manual. For additional assistance, contact the QIES Technical Support Office (QTSO) Help Desk at 1-800-339-9313 or :

• Section Q implementation:

• Section S and other NYS-specific information (Change to this section is expected as of April 1, 2011, subsequent to CMS final approval):

• SNF PPS information, and education by CMS:

• CMS Fiscal Intermediary (reimbursement and eligibility questions): Phone #: 1.888.855.4356

MDS 3.0 Update
December 28, 2010

  • Appendix F – MDS 3.0 Item Matrix has been published as part of the MDS 3.0 RAI Manual available at
    document provides information about which items are required for each assessment type as well as what the items are used for (e.g. RUG, Survey and Certification, Quality Indicators, Quality Measures, etc…).
  • Additional slide presentations from the August 2010 MDS 3.0 National Train-the-Trainer Training Conference have been added to the zip file labeled "MDS 3.0 Training Slides December"
  • The following videos have been posted to YouTube and are also available for download.
    • Section O Special Treatments, Procedures, and Programs
    • Individual clips of the interviews included in the Video on Interviewing Vulnerable Elders (VIVE): Interview Techniques, Preferences, Cognition, Mood, Self Harm 1, Self Harm 2, and Pai

Now Available - YouTube Training Videos for MDS 3.0
December 9, 2010

  • VIVE – Video for Interviewing Vulnerable Elders
  • Gold Standard Nurses Presentation from the April National Train the Trainer Conference in Baltimore
  • RAI Manual Chapter 3 Sections A, B, C, D, E, F, G, H, I, J, K, L, N, P, X, Z, and L-Oral Assessment

Visit the "CMS YouTube Channel" at

Also Available - Downloadable Videos (in MP4) for all training videos also on YouTube.

MDS Webinar Handouts Now Available
November 7, 2010


Missed the MDS 3,0 and CAA webinars provided by Re-Creative Resources Inc.? Well, fear not. you can purchase the handouts! Learn more at

nFree Section F Preferences Cue Cards in Different Languages
November 7, 2010

Courtesy of Activity Director, Linda Bunker from Care One, NJAPA has recently posted a variety of section F preferences cue cards in a variety of languages. Free and downloadable!

Download at

Many MORE Changes the Activity Director/Activity Professional Faces
With the Implementation of the MDS 3.0

November 7, 2010

Read the article:

Many MORE Changes the Activity Director/Activity Professional Faces With the Implementation of the MDS 3.0

New Interview Tools for MDS 3.0 Section F
November 3, 2010

Interview On October 1, 2010, the MDS 3.0 officially began. The biggest change was the addition of the Resident Interviews. The Resident Interviews were added to increase opportunity for the Resident’s voice to be heard, with the intent of including the Resident’s voice in the interdisciplinary care plan.  The tools in this manual will help the individual who is completing the Section F, Preferences for Customary Routine and Activities Interview by providing a variety of ways for Residents to answer the questions,  a system to communicate the Resident Preferences to appropriate staff members and staff training exercises. This manual includes: 3 Training Exercises, IDT Communication Tools, Interview Worksheet, Interview Techniques and 8 Section F Cue Cards which include various styles (pictures, numbers, scales, graphs, words, etc.). Reproducible forms!

Learn More

Notes from the CMS October Open Door Forum
November 1, 2010

Revised Documentation Training Game for Activity and Recreation Professionals
October 18, 2010

QUIZBased off of the infamous Jeopardy Game and updated to include the MDS 3.0, the Recreation Documentation IN-QUIZ-ITION Game was designed to educate Recreation and Activity Professionals about various components of documentation, primarily in the long-term care setting. This game is a great method of educating the staff as well as evaluating their knowledge. The game may be used as part of an in-service or for fun. Only $7 and is downloadable!

Learn More


What Changes in the MDS 3.0 Should the Activity Director look for? A Q and A on the HCPRO Blog.
October 18, 2010

Activity Professionals: Check out this blog on HCPRO that addresses the question, "What Changes in the MDS 3.0 Should the Activity Director look for?". Of course, I added my comments. Please read and add your comments.

Section F from the CMS Training in Las Vegas is Now on You Tube
October 15, 2010

Activity and Recreation Pros: The Sec F session that was provided at the CMS training in Las Vegas is now on You Tube. It's quite short but you can get an idea. Note-the first minute or so is just black screen-let it keep going-it will start. Please watch it. Rena Sheppard does a nice job explaining the importance of activities. Of course, I had to comment on the CMS You Tube Channel. This is a great chance to make your voice heard. Take moment to watch the Section F video and comment.


New MDS 3.0 Article and VIVE Essays
October 5, 2010

MDS 3.0 Section F: Top Ten Questions asked by Activity Professionals                              
By Kimberly Grandal, CTRS, ACC/EDU                                                                         
Executive Director, Re-Creative Resources, Inc

VIVE Essays                                                                                                                         
By Connie Burry and Jennifer Schultz

MDS 3.0 Has Arrived
October 1, 2010

Well, it's been a long time coming and it's hard to believe that the MDS 3.0 has arrived. We officially say good-bye to MDS 2.0. I wish everyone good luck with the interviews and the entire process. You will do great!

Check out this article by McKnights

CAA Webinar Now Available for Activity Professionals
September 24, 2010

MDS 3.0 Update
September 16, 2010

MDS 2.0 to MDS 3.0 Transition Document September 2010 - This document provides guidance to address questions regarding the coding of the MDS 2.0 to MDS 3.0 during the upcoming transition.

MDS 3.0 Training Resources on You Tube and Updates Training Tools
September 15, 2010

Now Available - YouTube Training Videos for MDS 3.0 RAI Manual Chapter 3 Sections B, C, D, K, and and the Video on Interviewing Vulnerable Elders.

MDS 3.0 RAI Manual Chapter 3 Sections B and C (YouTube video)

MDS 3.0 RAI Manual Chapter 3 Section D (YouTube video)

MDS 3.0 RAI Manual Chapter 3 Section K (YouTube video)

MDS 3.0 RAI Manual Chapter 3 Section P (YouTube video)

Video on Interviewing Vulnerable Elders (YouTube video)

Watch the Video on Interviewing below:

Note: You can order this video for free from the CMS website here (Look for conference)

MDS 3.0 Training Slides, Instructor Guides, and Training Aides:

  • MDS 3.0 Training Materials Change Document September 2010 – This document reflects any changes to the Training Slides and Instructor Guides from previously published versions. (Updated September 15, 2010)
  • MDS 3.0 Training Aides – contains algorithms and assessment aides that may be helpful when performing assessments or coding the MDS. (Updated September 16, 2010)

MDS Updates-Changes in the RAI User Manual, Instruction Guides, CAA Resources
September 13, 2010

Under the Downloads section of this page the following materials are now available:

MDS 3.0 RAI Manual Updates:

   Specific Changes:

  • The following revisions to the MDS 3.0 Manual are reflected in this posting (Please Note: All revised sections are indicated with "V1.04 and September 2010" in the file name and within the respective documents):
    • Chapter 2
    • Chapter 3 Sections A, E, F, G, I, J, K, M, O, Q, V, and X
    • Chapter 5
    • Chapter 6
    • Appendices B and C

   General Changes:

  • Revisions to the respective chapters or sections are reflected in a separate change document (Example File Name for the Change Document – "MDS 3.0 Appendix B V1.04 September 2010 (change-table).pdf").
  • The change documents only reflect changes made from the last published version.

Download changes at

You can also download the updated Section F, Section O and CAA Resources below-scroll down to MDS Downloads.

DH Special Services
September 6, 2010

Debbie Hommel from DH Special Services added a MDS 3.0 page to her site. Check out great information at

MDS 3.0 Section Crossword Puzzle-NEW!

MDS Crossword Puzzle

Free Course: Interviewing for MDS 3.0 Resident Assessment
August 25, 2010

This a great course-geared toward nursing, but as an Activity Professional, I found it helpful. Plus it's free and we just love FREE!

Learn the interview skills that lead to better nursing home resident care while ensuring MDS 3.0 compliance.

Recreation Department Review Manual 2nd Editionc

August 25, 2010

The Recreation Department Review Manual has been updated to include the MDS 3.0. The primary change has been to the Documentation Audit Tool.

To learn more click here.


More Great Resources to Check out On-line Regarding the MDS 3.0
August 23, 2010

Operational Strategies to Implement the New MDS 3.0 Process Sponsored by MDI Achieve

MDS 3.0 Basic Comprehensive Test Question and Answer Sheet by National Resident Assessment Institute

MDS 3.0 Checklist for Transition by Health MedX

MDS 3.0 Journey Readiness Checklist by the Aging Services of Minnesota

Preparing for MDS 3.0 by Keane Care

HCPro MDS Central

Free Newsletter about the MDS 3.0 Here's a free newsletter you can receive regarding the MDS 3.0. Plus their website is very helpful too. MDSCB/MDS-30-Update.html

A Closer Look at the MDS 3.0: News and Overview for Activity and Recreation Professionals

MDH MDS 3.0 Web Ex MDS 3.0 Handouts (alot of them!)

An Overview of the Various Sections on the MDS 3.0 by Briggs

Getting Ready for MDS 3.0 Implementation-Montana Healthcare Assocation

MDS 3.0 Resident Interview and Cue Cards by Kansas Foundation for Medical Care

The MDS 3.0 to Dramatically Affect Survey Process

Change is Coming MDS 3.0 by Lori Costa

MDS Interviewing Guidebook - Section F by Recreation Therapy Consultants

HCPro Posts Updates from the Las Vegas MDS 3.0 Training
August 23, 2010

MDS 3.0 Updates
August 16, 2010

MDS 3.0 Update. CMS finally posted the revised Chapter 4 which explains the CAA's. There were also some minor changes throughout the RAI manual so you should re-download that at its/45_NHQIMDS30TrainingMaterials.asp#To pOfPage

Scheduled for September 22, 2010 in Basking Ridge NJ (4 contact hours) Learn more at

MDS 3.0 Seminar

Free Cue Cards for Section F-Daily and Activity Preferences
August 10, 2010

The RAI Manual and the Video on Interviewing Vulnerable Elders discuss the use of Cue Cards during the interview process. Here are two cue cards you can download.

Preferences Cue CardPreferences Cue Card


‘VIVE’:Interviewing Frail Elders
August 9, 2010


The systematic inclusion of the resident’s voice in her or his own assessments represents an enormous advance in the new Minimum Data Set 3.0 (MDS 3.0). The Video on Interviewing Vulnerable Elders (VIVE) demonstrates best-practice approaches for implementing the new MDS interviews for cognition, mood, preferences and pain. Specific video sections explain why interviews have been added; review techniques to improve communication with older, frail populations; and demonstrate each interview being conducted. Using real-life nurses interacting in scenarios based on actual situations, VIVE helps to build understanding and ease implementation of MDS 3.0 for nursing home staff members. The goal of VIVE, funded by Picker Institute and developed by the UCLA/Jewish Home Borun Center, is to help staff members build the confidence and skills they need to interview their residents both for MDS 3.0 and for other clinical evaluations.

View the VIVE video online

MDS Downloads

July 15, 2010 (August 16th- re-posted section F and Section 0)

September 13th-reposted Section F and Section O

The MDS 3.0 downloads and training materials can be found on the CMS website. To view and download these files, CLICK HERE. Scroll down to the bottom of the page to the DOWNLOAD section. You can also download some items below (remember, CMS is the official site for the downloads.)


Older News below!

MDS 3.0 RAI User Manual and Webcast News

January 20, 2010

The MDS 3.0 RAI user manual is now available for download at Follow the link, scroll down the page and click on MDS 3.0 RAI Manual Jan 2010 to download the entire manual. The section for Customary Routine and Activities is called section F and is located in the Chapter 3 file folder. The section which refers to Recreation Therapy can be found in section 0, Special Treatments and Procedures.

CMS provided a webcast, entitled, MDS 3.0: Part 1- An Introduction, on December 17, 2009. You can view this archived webcast for free at

This webcast was the first of a three part series focused on providing information about the MDS 3.0. The other webcasts in the series include:

              2nd Part: Coding the MDS 3.0 (late spring/early summer, 2010)

              3rd Part: CMS Programs impacted by the MDS 3.0 (summer, 2010)

New MDS 3.0 Files and Downloads

November 2, 2009

CMS recently added new MDS 3.0 files and downloads on their website. The following items were added in late October, 2009:

  • MDS 3.0 Item Subsets  – A file that contains the various subsets of the  MDS 3.0 assessment and tracking document such as admission, quarterly, annual, significant change, discharge, etc.
  • MDS 3.0 Item Matrix  - This document identifies the items required for each type of assessment along with how the item is used (e.g. QMs, QIs, CATs, RUG-IV, or RUG-III).
  • MDS 3.0 Data Submission Specifications - Detailed data submission specifications for MDS 3.0.
  • MDS 3.0 CATs Specifications - This document provides Care Area Trigger (CAT) specifications for the MDS 3.0 items used in triggering the Care Area, the conditions for triggering, and Visual Basic code for triggering. The CATs are replacing the MDS 2.0 Resident Assessment Protocols RAPs. Psychosocial well-being and activities still have areas that will trigger.

If you are eagerly awaiting the MDS 3.0 RAI Manual as I am, chapters 1, 2, 3, 5, and 6 are expected to be published in November. Chapter 4 (Care Area Assessments (CAAs) & Appendix C (CAA resources) should be posted in December. The manual will include: Description and instructions for types of assessments and tracking documents, each MDS 3.0 item, the Care Area Assessment, submission and correction of MDS 3.0 records, Skilled Nursing Facility and Swing Bed Prospective Payment System (SNF PPS) policy for the MDS 3.0, and the RUG-IV classification system.

CMS highly recommends that everyone should hold back from training until after the "Train-the-Trainer" sessions have been completed. The Train-The Trainer sessions are scheduled for the spring of 2010.

Download all of the MDS 3.0 forms and information at

MDS 3.0 implementation date is scheduled for October 1, 2010

Questions regarding the data specifications should be directed to

MDS 3.0 is Postponed!

March 6, 2009

On Thursday, March 5, 2009 CMS officials announced that they have postponed the implementation of the MDS 3.0. The new start date is October, 2010 which is one year later than originally planned. To review MDS drafts, timelines, crosswalks and more click here. Activity Professionals really should review the MDS 3.0 draft and send your comments to CMS!

Overview of the MDS 3.0

The Centers for Medicare & Medicaid Services (CMS) held an Open Door Forum (ODF) regarding the Minimum Data Set, Version 3.0 (MDS 3.0) in Baltimore, Maryland on January 24, 2008 from 1:00 pm to 3:00 pm EST and reported on the findings of a 5-year CMS Nursing Home MDS 3.0 Validation Study.

There are many advantages to the MDS 3.0 such as:

  • Increased  resident’s voice
  • Increased clinical relevance for assessment
  • Increased accuracy, both validity and reliability
  • Increased clarity and efficiency
  • 45% reduction in the average time for completion
  • Supports the movement of items toward future electronic formats

A section with significant revisions is the “Customary Routine and Activity Section”. The customary routine staff assessment is replaced by the MDS 3.0 Preference Assessment Tool. Residents are to be interviewed for their activity interests and routine preferences. The residents are to rate the level of importance by using the following codes:

1. Very important

2. Somewhat important

3. Not very important

4. Not important at all

5. Important, but can’t do or no choice

9. No response or non-responsive

Some of the questions to ask the residents include:

  • How important is it to you to have books, newspapers, and magazines to read?
  • How important is it to you to listen to music you like?
  • How important is it to you to be around animals such as pets?
  • How important is it to you to keep up with the news?
  • How important is it to you to do things with groups of people?
  • How important is it to you to do your favorite activities?
  • How important is it to you to do things away from the nursing home?
  • How important is it to you to go outside to get fresh air when the weather is good?
  • How important is it to you to participate in religious services or practices?
  • If your doctor approves, would you like to be offered alcohol on occasion at meals or social events?
    • No
    • Yes
    • 5 Yes, but can’t or no choice
    • 9 No response or non-responsive answer

For residents who cannot answer the questions, a staff assessment of activities and daily preferences is available. Staff is also instructed to observe the resident’s response during activity programs.  A variety of routine and activity preferences are listed and staff is to check off each item as it applies. Some of the recreational items include:

  • Reading books, newspapers, or magazines
  • Listening to music
  • Being around animals such as pets
  • Keeping up with the news
  • Doing things with groups of people
  • Participating in favorite activities
  • Spending time away from the nursing home
  • Spending time outdoors
  • Participating in religious activities or practices
  • None of the above

In a sample of individuals that completed the revised Customary Routine and Activity Section, findings indicated that:

  • 81% rated the interview items as more useful for care planning
  • 80% found that the interview changed their impression of resident’s wants
  • 1% felt that some residents who responded didn’t really understand the items
  • More likely to report that post-acute residents appreciated being asked

Another section of special interest to Activity Professionals and Recreation Therapists is that of “Special Treatments and Therapies”. Recreational Therapy is included as a therapeutic service, beyond the general activity program, as it is currently in the MDS 2.0. Under the section of Recreation Therapy, however, it is indicated that Music Therapy is included as well.



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