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State of California—Health and Human Services Agency
California Department of Public Health

AFL 17-19
September 28, 2017

Nursing Facilities
Skilled Nursing Facilities
Intermediate Care Facilities
Swing Bed Hospitals

Resident Assessment Instrument (RAI) 3.0 User's Manual updates v1.15, effective October 1, 2017

​All Facilities Letter (AFL) Summary

This AFL notifies all certified Medicare and/or Medicaid nursing facilities about the new item set changes and updated in the RAI 3.0 user's manual effective October 1, 2017.

​The Centers for Medicare and Medicaid Services (CMS) publishes the Long-Term Care Facility RAI User's Manual version 3.0 as a public document that providers can copy. CMS's goal is to disseminate information broadly to facilitate accurate and effective resident assessment practices in long-term care facilities.

Starting October 1, 2017, all certified Medicare and/or Medicaid facilities must use the latest RAI 3.0 Manual  v1.15 as a reference in completing the Minimum Data Set (MDS) 3.0.

This version incorporates new guidance, coding instruction, steps for assessments, and clarification in the following chapters:

  • Chapter 1- Overview, content, and components of the RAI;
  • Chapter 2- RAI assessment process, requirements, state designation, and nursing home responsibilities in completing the RAI;
  • Chapter 3- Overview of the item-by-item guide to the MDS. Items in sections N and P are added with new guidance and coding instructions;
  • Chapter 4- Care area assessments (CAA) and care planning guidance and instructions;
  • Chapter 6- Medicare Skilled Nursing Facilities Prospective Payment System (SNF PPS) eligibility criteria.

Providers may find and print the new version of the RAI 3.0 at the CMS website:

CMS - 3.0 RAI Manual

If you have additional questions, please contact the MDS/OASIS Help Desk by email at or by phone at (916) 324-2362.

Please distribute copies of this AFL to MDS Coordinators, Directors of Nursing, and Facility Administrators in our facility.



Original signed by Jean Iacino

Jean Iacino
Deputy Director

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