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Site Updated
Friday, February 03, 2012
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MED-PASS MDS 3.0 Products
In response to the CMS release of new V1.08 MDS 3.0 RAI User’s Manual and Item Sets, scheduled to be implemented April 1, 2012, pertinent products on this page are being reviewed and updated. For product specific update details, select the product links below or contact
MED-PASS customer service at 800-438-8884.
MDS 3.0 User Manuals
Each RAI User Manual comes as a two-volume set. Volume One includes Chapter 1 - 6 and Appendices A - G in a three-ring binder with Appendix H provided as a second, softbound volume.
Item # H50353   Resident Assessment Instrument User Manual Version 3.0 with CD and Updates
Updated for MDS 3.0 RAI Users Guide changes posted by CMS which are effective 10/01/2011. This version of the RAI User’s manual includes a free year of updates and quick-reference features that make it best suited for the MDS Coordinator and other members of the interdisciplinary team that reference MDS information on a regular basis.
Item # H50333   Comprehensive User Manual Version 3.0 Resident Assessment Instrument with CD and Updates
Updated for MDS 3.0 RAI Users Guide changes posted by CMS which are effective 10/01/2011. Designed for the specific needs of the MDS coordinator, this comprehensive, one-of-a-kind manual includes a year of free updates, hundreds of cross-references throughout Volume One and a CD containing a PDF that makes it quick and easy to search and locate needed information throughout the entire manual.
Item # H50363   Long-Term Care Resident Assessment Instrument User's Manual Version 3.0 - No Updates
Updated for MDS 3.0 RAI Users Guide changes posted by CMS which are effective 10/01/2011. Save money with this economical version of the RAI User’s Manual that includes a three-ring binder that allows users to easily insert updates they create themselves when clarifications/changes are released.
MDS 3.0 Departmental Guides
Item # H50310   Activity Services MDS 3.0 Departmental Guide
Item # H50311   Social Services MDS 3.0 Departmental Guide
Item # H50312   Dietary Services MDS 3.0 Departmental Guide
MDS 3.0 Item Sets
New V1.005 forms, which address changes in therapy requirements and documentation, effective October 1, 2011.
Item # CP9100H    MDS 3.0 Nursing Home Comprehensive (NC) Item Set
Great for training and new admissions, this form helps a facility’s interdisciplinary team recognize the importance of accurate MDS assessments for reimbursements and quality of care issues.
Item # CP9101H    MDS 3.0 Nursing Home PPS (NP) Item Set
Nursing Home Quarterly (NQ) Item Set
Item # CP9104H    Nursing Home Discharge (ND) Item Set

Item # CP9105H    Nursing Home and Swing Bed Tracking (NT/ST) Item Set

Item # CP9106H    Nursing Home/Swing Bed OMRA (NO/SO)

MDS 3.0 Support Forms
Item # CP3000    Resident Interviews MDS 3.0 Data Collection Tool
Item # CP3001-C    Section C - BIMS Interview for MDS 3.0 Data Collection Tool
Item # CP3001-D    Section D - Mood Interview for MDS 3.0 Data Collection Tool
Item # CP3001-F    Section F - Preferences for Customary Routine and Activities for MDS 3.0 Data Collection Tool
Item # CP3001-J    Section J - Pain Interview for MDS 3.0 Data Collection Tool
Item # CP3011    MDS 3.0 Resident Interview Cue Cards
Item # CP3011-S    MDS 3.0 Resident Interview Cue Cards - Spanish Version
Item # CP3012    Resident Interview Cards for BIMS (When Administered in Writing)
Item # CP3012-S    Resident Interview Cards for BIMS (When Administered in Writing) - Spanish Version
Item # CP3002    MDS 3.0 Staff Observation Tool - Cognitive Patterns (Section C)
Item # CP3003    MDS 3.0 Staff Observation Tool - Mood (Section D)
Item # CP3004    MDS 3.0 Staff Observation Tool - Preferences for Customary Routine and Activities (Section F)
Item # CP3006    Section C Signs and Symptoms of Delirium
Item # CP3007    Mood/Behavior Monitoring
Item # CP3020    7 Day Observation Form
Item # CP3021    7-Day/3-shift ADL Observation Form - Self Performance/Support Provided
Item # CP3022    31-Day, 1-Shift CNA-ADL Tracking Form - Support Provided
Item # CP3023    31-Day, 1-Shift CNA-ADL Tracking Form - Support Provided and Self Performance
Item # CP3024    ADL Tracker - Single Entry
Item # CP3025    ADL Tracker - 2 Entries
Item # CP3026    8-DAY, 3 Shift Late Loss ADL Tracker Tool Self-Performance/Support Provided
Item # CP3027    ADL Tracker - 2 Entries (Spanish Language Version)
Item # CP3028 31-Day, 3-Shift CNA-ADL Tracking Form - Support Provided and Self Performance
MDS 3.0 Related Forms
Item # CP1620    Daily Skilled Nurse's Notes - 1 Shift
Item # CP1621    Daily Skilled Nurse's Notes - 3 Shifts
Item # CP1700    Evaluation of Bowel
Item # CP1706    Fall Risk Evaluation
Item # CP1708    Data Collection / Evaluation Nutritional
Item # CP1720    Initial Social Service History
Item # CP1721    Social Service Review
Item # CP1901    Weekly Wound Tracking Worksheet
Item # CP3130    Weekly/Monthly Summary
Item # CP3131    Interdisciplinary Care Plan
Item # CP3205    Weekly Care Summary
Item # MP4901    Pain Flow Sheet
Item # MP4902    Pain Flow Sheet
Item # MP5436    Pain Evaluation
Item # MP5438CRD    Pain Pocket Card
Item # MP5447    Pain Evaluation
Item # MP5450    Activities Evaluation
Item # MP5451    Individual Resident Daily Participation Record
Item # MP5453    Daily Record of Resident Activity Participation
Item # MP5461CRD    Pocket Card for Wound Documentation
Item # MP5465    Guide for Wound Evaluation & Documentation
Item # MP5474    Hydration Risk Evaluation
MDS 3.0 Reference Tools
Item # CP9116SP    MDS Navigator® 3.0
Updated and reformatted to reflect and accommodate changes related to SNF PPS FY2012 that became effective October 1, 2011 and Leap Year 2012, to provide the Nurse Assessment Coordinator with a great tool for navigating the maze of OBRA and Medicare required MDS assessments.
Item # A96980RCK    MDS Drug Class Index Reference Card
Use to quickly determine a particular medication's drug class when filling out section N of the MDS 3.0.
Item # CP9095    MDS Assessment Planner 3.0 (MAP)
Updated with the new 2012 insert which makes it possible to use the MDS Assessment Planner (MAP) For MDS 3.0 to "map" your MDS schedule for residents beginning in January 2012 through December 2012.
Item # CP7004    RUG-IV Pre-Admission Worksheet
Great tool for learning RUG-IV basics and worksheet to review a resident's reimbursement potential.
MDS 3.0 Email Updates
Sign-up for MDS 3.0 news and product updates - click here.

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