Section F - Preferences for Customary Routine and Activities for MDS 3.0 Data Collection Tool - 100/pad

Description

Use this stand-alone form to capture resident responses to the MDS 3.0 Section F Interview for Daily Preferences. This stand-alone form gives the responsible discipline the ability to maintain their own interview documents and manage their work flow.

Features

Language and format coincide with the MDS 3.0 data set 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

Specifications

Size	8 1/2 x 11
Unit	Pad of 100
Number of Pages	1
Other Info	Handwritten
Hole Punch	5 holes left, 5 holes top

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