Q&A: When a resident changes payers from Medicare Advantage to Traditional Medicare, are the Medicare Advantage days subtracted from the Medicare 100-day benefit period?

Billing and Reimbursement / NAC / Q&A

Question: When a resident changes payers from Medicare Advantage to Traditional Medicare, are the Medicare Advantage days subtracted from the Medicare 100-day benefit period? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, days billed under Medicare Advantage are subtracted from the resident’s 100-day benefit period. This AAPACN resource …

Q&A: If a Discharge – return not anticipated was completed for a resident discharge against medical advice (AMA), and he returned less than 30 days later, is a new OBRA Admission assessment required?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: If a Discharge – return not anticipated was completed for a resident discharge against medical advice (AMA), and he returned less than 30 days later, is a new OBRA Admission assessment required? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA: When the OBRA discharge is named “Return not anticipated” …

TIP: Consolidated Billing Updates for 2026

Billing and Reimbursement / NAC / Tip

Consolidated billing specifies that the SNF is the responsible party for the billing of the entire package of care the resident receives during a covered Part A SNF stay, as well as identifies a limited number of services specifically excluded from consolidated billing, and therefore, separately payable. The Centers for …

Five-Star and Care Compare MDS 3.0 Quality Measure Data Periods

NAC / QAPI and Quality Initiatives / Tool

Care Compare refreshes MDS 3.0 Quality Measure (QM) data quarterly in January, April, July, and October with the most recent four full quarters of data. AAPACN’s Five-Star and Care Compare MDS 3.0 Quality Measure Data Periods tools identify exactly which quarters will be publicly reported and used in Five-Star with each Care …

iQIES MDS Error Message Reference Guide and Message List v1.1

MDS 3.0 and the RAI Process / NAC / Post-Acute Care News

This user guide addresses Minimum Data Set (MDS) error messages and troubleshooting. iQIES MDS Error Message Reference Guide v1.1 (posted 12/29/2025) iQIES MDS Error Messages v1.1 (posted 12/29/2025) From https://qtso.cms.gov/providers/nursing-home-mdsswing-bed-providers/reference-manuals

SNF QRP/SNF VBP: CMS Video Offers MDS Data Validation Process Overview

Billing and Reimbursement / DNS / MDS 3.0 and the RAI Process / NAC / Post-Acute Care News

The Centers for Medicare & Medicaid Services (CMS) is offering a recorded presentation which describes the new data validation process. This training will support facilities in understanding the purpose and structure of the data validation process including the notification and submission process, required activities for selected SNFs, and where to …

 AHRQ Toolkit for Improving Skin Care and MDRO Prevention in LTC Includes Tabletop Game

Clinical Care Solutions / DNS / Infection Control / NAC / Post-Acute Care News

From AHRQ: A new tabletop game turns infection prevention training into a collaborative, story-driven escape room. When players notice a change in a resident’s skin, they work together to interact with environmental services staff, a physician, an infection preventionist, and a resident while revisiting core topics such as skin assessment, …

Consolidated Billing HCPCS Code List Update: 2026 Part A MAC Update

Billing and Reimbursement / DNS / NAC / Post-Acute Care News

ADD – EFFECTIVE 01/01/2026 Major Category I. B. – Cardiac Catheterization Major Category III. A. – Chemotherapy Major Category III. C. -Radioisotopes and their Administration TERMINATE – EFFECTIVE 01/01/2026 Major Category III. A. – Chemotherapy Major Category III. D. – Customized Prosthetic Devices Downloads From https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2026-part-mac-update

FY 2026 ICD-10-CM Code Updates Effective April 1, 2026

Billing and Reimbursement / DNS / MDS 3.0 and the RAI Process / NAC / Post-Acute Care News

These files include updates for FY 2026. Use these codes for discharges occurring from April 1, 2026 – September 30, 2026, and for patient encounters occurring from April 1, 2026– September 30, 2026.  https://www.cms.gov/medicare/coding-billing/icd-10-codes

Physician Certification Tracker

Billing and Reimbursement / NAC / Tool

The AAPACN Physician Certification Tracker tool helps nurse assessment coordinators track physician certification due dates by calculating required timeframes based on user-entered data and displaying upcoming and overdue certifications to support compliance. The accuracy of the tool depends on the accuracy of the information entered, so timely and precise data …