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The California Department of Public Health (CDPH) has issued an All Facilities Letter (AFL) as a supplement to AFL 10-25, providing additional guidance on the Minimum Data Set (MDS) 3.0 "Section S" submission and coding issues for skilled nursing facilities, nursing facilities, intermediate care facilities, and swing bed hospitals. The CDPH has discovered software issues with the "Section S" forms of several states, including California, and is working with the Centers for Medicare and Medicaid Services (CMS) to correct the software. Until further notice from CDPH, every question on the California "Section S" form must have a response to avoid rejection of an MDS, even if the resident does not have a Physician Orders for Life Sustaining Treatment (POLST) form. The POLST is a voluntary form used to document a patient's wishes for medical treatment as end-of-life approaches, giving patients more control over their end-of-life care. The use of a POLST form is not mandatory. For additional information concerning POLST or MDS 3.0, nursing homes and healthcare facilities should refer to AFL 08-29, AFL 09-27, and AFL 10-25.

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