MDS 3.0 Quality Measure Assessment Selection Methods 

The MDS 3.0 Quality Measure Assessment Selection Methods tool simplifies the assessment selection logic used for MDS 3.0 Quality Measures (QMs) in nursing facilities. The assessment selection logic is used to identify which assessments are used in the measure calculation. For detailed measure specifications, refer to the corresponding tables in …

Q&A: Our facility recently had a bill rejected because the ICD-10 code of M62.81, Muscle weakness (generalized), and R53.1, Weakness, were both coded on the bill. Does anyone know the reason why they both cannot be on the same bill since they do seem to mean two different things?

Question: Our facility recently had a bill rejected because the ICD-10 code of M62.81, Muscle weakness (generalized), and R53.1, Weakness, were both coded on the bill. Does anyone know the reason why they both cannot be on the same bill since they do seem to mean two different things? Additionally, …

Q&A: I am working in an older facility, and every bed has bilateral quarter-length side rails. The facility leadership states the rails are for mobility, but they cannot be lowered for any residents. Could these be a restraint?

Question: I am working in an older facility, and every bed has bilateral quarter-length side rails. The facility leadership states the rails are for mobility, but they cannot be lowered for any residents. Could these be a restraint? Answer from Jeff Taylor: For MDS, restraints are not defined in terms …

Q&A: A resident recently enrolled in hospice, and we scheduled a Significant Change in Status Assessment (SCSA) for 1/14/25. The resident expired on 1/10, before the ARD of the SCSA. Do I need to complete this assessment? 

Question: A resident recently enrolled in hospice, and we scheduled a Significant Change in Status Assessment (SCSA) for 1/14/25. The resident expired on 1/10, before the ARD of the SCSA. Do I need to complete this assessment?  Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The SCSA …

TIP: CMS Releases FY 2025 Expected Responsibilities of State RAI Coordinators and Appendix B Update

The Centers for Medicare & Medicaid Services (CMS) recently released the Fiscal Year (FY) 2025 Mission & Priorities document (MPD). This document includes the expected responsibilities of the State Resident Assessment Instrument (RAI) coordinator: CMS expects the states to continue to provide staff to serve as RAI/MDS educational and technical …

FY 2025 ICD-10-CM Codes and Coding Guidelines: April Update

CDC announces no new ICD-10-CM codes effective April 1, 2025. The April 1, 2025 diagnosis code update files now available address revisions and typographical errors.  Use these files for discharges occurring from April 1, 2025 – September 30, 2025, and for patient encounters occurring from April 1, 2025 -September 30, …

CMS Revised Guidance for Federal Monitoring Surveys

Memo # Admin Info: 25-06-NH Posting Date 2025-01-17 Fiscal Year 2025 Memo Name Contact or Reference Memo Posting Revised: Guidance for Federal Monitoring Surveys (FMS) Memorandum Summary • Guidance on Conducting Federal Monitoring Surveys (FMS) – FY2025 Guidance on how CMS Location staff will conduct Federal Monitoring Surveys (FMS).• EP/LSC and Health FMS Mandates and Focus Concerns– Communicates FY2025 mandates of statutorily …

CMS QSEP Appendix PP Training for March 24, 2025 Implementation

To register at QSEP and take the course, you just need to provide an email address. https://qsep.cms.gov Updated: January 16, 2025 This course consists of four presentations by the Division of Nursing Homes outlining the changes in Appendix PP related to: These presentations provide a resource that can be used …

CMS Seeks TEP Nominations: Development of PAC QRP Interoperability Measure

Project Title: Standing Technical Expert Panel (TEP) for the Development of Post-Acute Care (PAC) Quality Reporting Program (QRP) Interoperability Measure Dates: The Technical Expert Panel (TEP) nomination period opens on January 20, 2025, and closes on February 18, 2025. Submit all nomination materials by the closing date. Project Overview: The Centers for …

Appendix PP Changes: New Effective Date, More F-tags Impacted per Revised CMS QSO Memo

Revisions to: QSO-25-07-NH Original release date: November 18, 2024 QSO-25-12-NH Memorandum Summary Revised Surveyor Guidance: CMS is releasing the following revised guidance for nursing home surveyors: • Admission, Transfer & Discharge, Chemical Restraints/Unnecessary Psychotropic Medication, Resident Assessment, Nursing Services, Payroll Based Journal, Quality of Life and Quality of Care, Administration, Quality …