HomeCMSCG F-tag ReferenceResident Assessments F635-F646

Resident Assessments F635-F646

Ftag of the Week Reference

483.20 — Resident Assessments (F635–F646)

The Resident Assessments regulatory group establishes CMS requirements for how facilities assess each resident upon admission, following a significant change in condition, and on a quarterly basis. These regulations govern the Resident Assessment Instrument (RAI) process — including the Minimum Data Set (MDS), Care Area Assessments, PASARR screening, and the accuracy, encoding, and transmission of assessment data. Assessment accuracy directly impacts care planning, quality measures, Five-Star ratings, and reimbursement.

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F635 – F646

Resident Assessments — F-Tag Analysis

F635

Admission Physician Orders for Immediate Care

Requirements for written and/or verbal physician orders for essential care upon admission — including medications, dietary needs, and care for devices. Facilities are frequently cited for missing or incomplete admitting orders and failure to clarify orders with the physician.

F636

Comprehensive Assessments & Timing

Requirements for completing comprehensive MDS assessments using the RAI within required timeframes — including admission (14 days), annual (12 months), and significant change assessments. Covers what must be captured, how it must be gathered, and what happens on readmission.

F637

Comprehensive Assessment After Significant Change

Requirements for completing a Significant Change in Status Assessment (SCSA) within 14 days of determining that a resident has experienced a significant change — including definitions of significant change, triggers for improvement and decline, and common citation scenarios.

F638

Quarterly Assessment At Least Every 3 Months

Requirements for completing quarterly MDS assessments at least every three months — including required sections, timing, and the relationship between quarterly assessments and care plan review.

Coming Soon
F639

Maintain 15 Months of Resident Assessments

Requirements for maintaining 15 months of resident assessments in the active record — and using that assessment history to develop, review, and revise the comprehensive care plan. Surveyors can look back at prior assessments to identify missed care planning opportunities.

F640

Encoding/Transmitting Resident Assessment

Requirements for encoding MDS data within 7 days and electronically transmitting it to CMS within 14 days of assessment completion — covering all assessment types, tracking records, and the contingency planning needed when MDS staff are absent.

F641

Accuracy of Assessments (2-Part Series)

F641 is in the national top 10 — and the April 2025 revised guidance made it more consequential. Part 1 covers the absorption of F642 into F641, the new OIG referral procedures for patterns of inaccurate MDS coding, and what the revised guidance means for facilities with Schizophrenia diagnoses on file. Part 2 goes deeper — subscriber access required.

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F642

Coordination/Certification of Assessment

F642 has been absorbed into F641 Accuracy of Assessments per the April 28, 2025 revised guidance. Requirements for RN coordination and certification of assessments, and penalties for falsification, are now addressed under F641.

Absorbed into F641
F644

Coordination of PASARR and Assessments

PASARR coordination is one of those regulatory requirements that sits at the intersection of admission, assessment, and care planning — and gaps are more common than facilities realize. This post covers what facilities are actually responsible for when a resident has a Level II evaluation on file, and where the process most often breaks down on survey.

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F645

PASARR Screening for Mental Disorder & Intellectual Disability

Requirements for screening all Medicaid-certified nursing facility applicants for mental disorders and intellectual disabilities through the PASARR process — including Level I identification, Level II evaluation, definitions, exceptions, and state-specific screening processes.

F646

MD/ID Significant Change Notification

Requirements for notifying the state mental health or intellectual disability authority when a resident with a mental disorder or intellectual disability experiences a significant change in condition.

Coming Soon

Need Support with MDS Accuracy or Assessment Compliance?

Assessment accuracy affects your Five-Star rating, quality measures, reimbursement, and survey outcomes. CMSCG's consultants provide chart auditing, MDS review, and clinical compliance support to help facilities identify and address assessment vulnerabilities before a surveyor does.

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