MDH Medicare PPS Assessment Form (MPAF)

May, 2002

Information Bulletin 02-6

MDS Medicare PPS Assessment Form (MPAF)

This Bulletin is intended to alert you to a change in the use of MDS Assessment forms to meet Medicare requirements, only. The new MDS Medicare PPS Assessment Form (MPAF) will provide facilities with new options concerning the forms used for Medicare PPS assessments. To allow reduction in assessment burden, facilities can choose to complete and submit the shorter MPAF form rather than a full MDS assessment for Medicare PPS assessments. Regardless of which option the facility chooses, only the items on the MPAF form will be active and stored in the standard MDS database maintained at the state.

It is important to remember that OBRA requirements supercede the use of the MPAF when an assessment is completed to meet an OBRA requirement.

CMS expects that SNFs can begin using the new form on 7/1/02. The MPAF will be available for the Medicare-only assessments - i.e., assessments required under Medicare PPS, but not under the federal requirements of participation.

Where Can I Access The MPAF Form?

You can download and print a copy of the MPAF Form by going to the following website: [expired link]

Where Can I Obtain a Copy of the Facility Options (Version 8 or above) With the MDS MPAF form?

You can download and print information regarding the options for use of the MDS MPAF form by going to the following website: [expired link]

You can get further information about MPAF by going to the MDS 2.0 What's New Website: [expired link]

CMS web site addresses are subject to change. As MDH becomes aware of these changes we will update the CMS address on this bulletin.

If you have any questions regarding this Information Bulletin, please contact in writing:

Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
85 East Seventh Place, Suite 300
PO Box 64900
St. Paul, MN 55164-0900
Telephone: (651) 201-4101

Friday, February 06, 2015 at 01:37PM