10/08/2026

CMS Releases MDS Updates

On October 6, 2026, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS Data Specifications V3.11.0, which are scheduled for implementation October 1, 2027. Notable changes include a new response value of 12 for GG0130 and GG0170 at the discharge and OBRA/Interim time points, a new skip pattern in GG0170, and removal of item O0350. CMS advises stakeholders to review the Item Change and Edit Change Reports for additional details. Section S item additions are not included in the draft specifications but will be included in the final version.

CMS has also released the draft MDS 3.0 Item Sets v1.21.1 and Item Matrix v1.21.1, which will be effective October 1, 2027.

The Skilled Nursing Facility (SNF) Healthcare-Associated Infections (HAI) Requiring Hospitalization Measure Technical Specification and The Discharge to Community–Post Acute Care (DTC-PAC) Skilled Nursing Facility (SNF) Measure Technical Specification Report is now available. The report presents the technical specifications and describes updates to incorporate Medicare Advantage encounter records in addition to Medicare Fee-for-Service claims.

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures and Standardized Patient Assessment Data Elements Affecting Fiscal Year (FY) 2029 Annual Payment Update (APU) Determination table has been updated to reflect the data elements that will be required to meet the APU for the FY 2029 SNF QRP. Facilities should also ensure the interdisciplinary team is referring to the most current MDS 3.0 RAI User’s Manual v1.20.11, effective October 1, 2026. Key refinements include:

• Chapters 1, 2 and 3 - Clarification that state or payer requirements do not replace, modify, or add to CMS coding requirements for non-Section S items.
• Chapter 2 – Assessments for the RAI: New guidance regarding resident transfers during a public health emergency.
• Section A – Identification Information: Updated ethnicity and race reassessment guidance and removal of the resident interview icon from several items.
• Sections C and D – Cognitive Patterns and Mood: Clarified coding guidance when multiple resident interviews, such as the BIMS or Resident Mood Interview, are conducted during the look-back period.
• Section M – Skin Conditions: Updated guidance for pressure ulcers/injuries that are present on admission, subsequently heal, and later reopen, along with new information regarding advanced wound care dressings, skin substitutes, and adhesive bandages.
• Section O – Special Treatments, Procedures, and Programs: Refined guidance related to isolation criteria and skilled respiratory therapy.
• Chapter 6 – Medicare SNF PPS: Revised terminology related to depression signs and symptoms.