Q&A: We had a resident on a Medicare Part A stay admit and discharge back to the hospital that same evening after a few hours. We could not assess much information during that brief amount of time. What are all the required MDS assessments that need to be completed on this resident? I know an entry tracker and an OBRA discharge, but do we need to also complete a 5-Day PPS?

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

Question: We had a resident on a Medicare Part A stay admit and discharge back to the hospital that same evening after a few hours. We could not assess much information during that brief amount of time. What are all the required MDS assessments that need to be completed on …

Q&A: The new definition of a fall includes an overwhelming external force, but the definition of fracture related to a fall states, “Do not include fractures caused by trauma related to car crashes or pedestrian versus car accidents or impact of another person or object against the resident.” Does this instruction contradict the new definition of a fall?

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

Question: The new definition of a fall includes an overwhelming external force, but the definition of fracture related to a fall states, “Do not include fractures caused by trauma related to car crashes or pedestrian versus car accidents or impact of another person or object against the resident.” Does this instruction …

Q&A: Can Isolation be coded for methicillin-resistant staphylococcus aureus (MRSA) on a wound?

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

Question: Can Isolation be coded for methicillin-resistant staphylococcus aureus (MRSA) on a wound? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: No, the RAI User’s Manual specifically states that isolation cannot be coded for a wound infection. See page O-8 (bold text added for emphasis): Code only when the …

PDPM At-a-Glance Tool

Billing and Reimbursement / DNS / NAC / Tool

The PDPM At-a-Glance tool breaks down the complex methodology of each component used in the Patient-Driven Payment Model—physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), non-therapy ancillaries (NTA), and nursing. This tool provides key payment information organized to provide the nurse assessment coordinator (NAC) with quick access to understanding …

FY 2028 (CY 2026 Data) SNF QRP Reporting Requirements and Data Submission Deadlines

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

SNF QRP Data Collection and Final Submission Deadlines The SNF QRP Data Collection and Final Submission Deadlines have been updated to provide the data collection time frames and final submission deadlines for the FY 2028 SNF QRP.  From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/submission-deadlines SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient …

FY 2027 (CY 2025 Data) Revised SNF QRP MDS Reporting Requirements and Data Submission Deadlines

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

SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2027 APU Determination and Data Collection and Final Submission Deadlines for FY 2027 posted The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures …

FY 2026 SNF QRP FAQs

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

An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in Fiscal Year (FY) 2026 and includes other useful resources available to providers. From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/faqs

CMS Fiscal Year Mission & Priorities Document (MPD) – Transition to Web-Based Updates

Administrator / DNS / Post-Acute Care News / Survey and Regulatory Compliance

Memo # Admin Info-25-11-ALL Posting Date 2025-09-12 Fiscal Year 2025 Summary Memorandum Summary The Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG) remain dedicated to ensuring the health and safety of all Americans. The Fiscal Year (FY) 2026 MPD reflects this dedication, along with our ongoing …