CMS-10387 Long-Term Care Facility Resident Assessment Instrument U

Centers for Medicare & Medicaid Services'
Long-Term Care Facility
Resident Assessment Instrument (RAI)
User's Manual
October 2017
For Use Effective October 1, 2017

The Long-Term Care Facility Resident Assessment Instrument User's Manual for Version 3.0
is published by the Centers for Medicare & Medicaid Services (CMS) and is a public
document. It may be copied freely, as our goal is to disseminate information broadly to
facilitate accurate and effective resident assessment practices in long-term care facilities.
PRA Disclosure Statement: According to the Paperwork Reduction Act of 1995, no persons
are required to respond to a collection of information unless it displays a valid 0MB
control number. (Note: The RAJ mandated by OBRA is exempt from this requirement.)
The valid 0MB control number for the Medicare Prospective Payment System SNF and
Swing Bed information collection is 0938-1140 and forms have been approved through
TBD. The times required to complete the information collection for the item sets are as
follows:
Estimated response time
Item Set
51 minutes
NP
39 minutes
NOD
26.52 minutes
NO/SO
34.17 minutes
NSD
14.03 minutes
NS/SS

These times are estimated per response, including completion, encoding, and transmission
of the information collection.
If you have comments concerning the accuracy of the time estimates or suggestions for
improving these forms, please write to: CMS, 7500 Security Boulevard, N2-14-26,
Baltimore, Maryland 21244-1850.