MANUAL v1.20.1 · 2025-10-01MATRIX v1.20.1v4 · 2025-10-01

Section V: Care Area Assessment Summary

12 of 12 items loaded.

Items From the Most Recent Prior OBRA or Scheduled

PPS Assessment (cont.)

Prior OBRA reason for assessment

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0100B

Prior PPS reason for assessment

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0100C

Prior assessment reference date

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0100D

Prior assessment BIMS summary score

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0100E

Prior assessment PHQ res: total mood severity score

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0100F

Prior assessment PHQ staff: total mood score

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 18 V0200

CAAs and Care Planning

Item Rationale

Manual page V-4 V0200B1

CAA-Assessment process RN signature

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 19 V0200B2

CAA-Assessment process signature date

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 19 V0200C1

CAA-Care planning signature

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 19 V0200C2

CAA-Care planning signature date

This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.

MDS Item Matrix page 19

Find the item. Understand the coding. See the downstream impact.

MDS Section

Section V: Care Area Assessment Summary

Items From the Most Recent Prior OBRA or Scheduled

Prior OBRA reason for assessment

Prior PPS reason for assessment

Prior assessment reference date

Prior assessment BIMS summary score

Prior assessment PHQ res: total mood severity score

Prior assessment PHQ staff: total mood score

CAAs and Care Planning

CAA-Assessment process RN signature

CAA-Assessment process signature date

CAA-Care planning signature

CAA-Care planning signature date