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MED-PASS:  Designing Solutions for Senior Care

Resident Interviews MDS 3.0 Data Collection Tool - 100/pack


Availability: In stock

Price: $34.00
  • Buy 5-9 for $31.50 each and save 8%
  • Buy 10 or more for $27.50 each and save 20%

Capture all your MDS 3.0 resident interview responses on this 4-page form. The 4-page format consolidates all of the interviews to provide the MDS coordinator with a single, convenient document.

Each page documents a different interview:

  • Section C - BIMS
  • Section D - PHQ-9©
  • Section F - Daily/Activity Preferences
  • Section J - Pain

If you prefer a separate document for each discipline, consider our stand-alone interview forms. Click the titles below in Related Products to learn more.

  • Language and format coincide with the MDS 3.0 data set
  • Each interview is on a separate page with a separate signature line so multiple disciplines can document on the same form.
  • Each interview includes prompts to confirm items A1100 (Language) and B0700 (Makes Self Understood) essential in the interview process
  • RAI Version 3.0 Manual page numbers pertinent to the interview topic are listed at the bottom of the page for quick reference
  • Resident Interview Cue Cards and MDS 3.0 Resident Interview Cards for BIMS (When Administered in Writing) created to assist in the resident interview process available for English speaking residents and Spanish speaking residents - see Related Products below.
Size 11 x 17 folds to 8 1/2 x 11
Unit Package of 100
Number of Pages 4
Other Info Handwritten
Hole Punch 5 holes left, 5 holes top