Get Roster Sample Matrix

The Roster Sample Matrix (CMS-802) is an essential document used to list the current residents of a facility and their pertinent care categories. This guide will provide detailed, step-by-step instructions on how to fill out this form effectively.

Follow the steps to complete the Roster Sample Matrix online.

1. Click the ‘Get Form’ button to access the Roster Sample Matrix. This will allow you to download and open the form for editing.
2. Begin by entering the name and room number of each resident in the designated fields. Ensure that all information is current as of the survey date.
3. Proceed to complete the appropriate columns (6-30) for each resident, marking all pertinent care categories relevant to their needs. Ensure that you refer to the specific instructions provided for each column.
4. Review the definitions for each category carefully to ensure that you are accurately representing the resident's status. Utilize your facility's MDS data as a reference but do not copy it directly.
5. After filling out all sections, verify that all information is correct. It is essential that a knowledgeable staff member reviews the form before finalizing.
6. Once all necessary fields are completed, you can choose to save the changes, download, print, or share the filled form as needed.

Complete your Roster Sample Matrix online to ensure accurate documentation of your facility's residents.