Summary of MDS Version 1.20.1 Draft Changes
Implementation Date: October 1, 2025
Item Set and Matrix Release
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CMS has released the draft MDS version 1.20.1 item sets and matrix, effective October 1, 2025.
Key Changes to Existing Sections
| Section | Change Summary |
|---|---|
| A | Updates to Identification Information |
| B | Updates in Hearing, Speech, and Vision |
| I | Updates to Active Diagnoses |
| O | Removal of item O0400 (Therapies), replaced with O0390 (Therapy Services) |
Major Addition – New Section R: Health-Related Social Needs (HRSN)
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Introduces 5 new/modified items to address Social Determinants of Health (SDOH).
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Goal: Promote equitable post-acute care and improve discharge planning.
Section R SDOH Items
| Item Code | Description |
|---|---|
| R0310 | Living Situation |
| R0320A | Food insecurity – worry about food running out |
| R0320B | Food insecurity – food didn’t last |
| R0330 | Utilities insecurity |
| R0340 | Transportation access (Revised from A1250) |
Implications for the Interdisciplinary Team (IDT)
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IDT and Nurse Assessment Coordinators (NACs) should:
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Begin educating staff about Section R’s intent and application.
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Use Section R data to tailor care planning and discharge coordination to resident social needs.
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Interview Timing & Guidelines
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All SDOH items must be resident self-reported.
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Interviews must be:
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Completed within the Assessment Reference Period (ARP).
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Finalized by the ARD (Assessment Reference Date).
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Reporting Requirements (Effective October 1, 2025)
Standalone OBRA Assessments Must Report:
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A1005, A1010, A1110A, A1110B, D0700
Note:
B1300 and A1250 are not included unless specified.
A1250 will be discontinued after September 30, 2025.
PPS Assessments for SNF QRP/APU:
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All SDOH items will be required on:
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PPS 5-Day
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Part A PPS Discharge assessments
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Section R items only collected on 5-Day PPS if stay is < 366 days
Transition Notes
| Change | Effective Date |
|---|---|
| A1250 (Transportation) retired | Sept. 30, 2025 |
| Replaced by R0340 | Oct. 1, 2025 |
| FY 2027 SNF QRP Data Window | Oct. 1 – Dec. 31, 2025 |
| Standard Collection for FY 2028+ | Begins after Dec. 31, 2025 |
Recommended Preparatory Actions
| Action | Purpose |
|---|---|
| Educate IDT on Section R | Ensure team understands SDOH intent and usage |
| Complete timely SDOH interviews | Meet ARD and CMS standards |
| Update internal policies and training | Align with October 2025 implementation |
| Develop new workflows | Integrate Section R data into care planning and discharge processes |