Draft Appendix PP Revisions: A REVISED Overview

On March 24, 2025, new and revised surveyor guidance, as well as revised critical element pathways, will go into effect during survey, according to the Jan. 16, 2025 Quality, Safety, and Oversight memo QSO-25-12-NH, which revises and replaces the Nov. 18, 2024 memo QSO-25-07-NH. These revisions to Appendix PP of …

It’s Time to Solve the Mystery of the Discharge Function Score QM

The Discharge Function Score is an incredibly complicated quality measure (QM), notes Joel VanEaton, BSN, RN, RAC-MT, RAC-CTA, RAC-CT, executive vice president of post-acute care regulatory affairs and education for Broad River Rehab in Asheville, NC. “Its technical specifications are as close to rocket science as we have ever seen …

Sepsis Assessment and Reporting: Tips for Nursing Staff

Nurses play a key role in the early identification and treatment of sepsis, assessing the resident and reporting to the physician or nonphysician practitioner (NPP), as well as potentially managing residents with sepsis in-house in some cases. Nurse leaders can take the following steps to help nursing staff effectively assess …

October 2025 MDS Draft Item Sets: The SDOH Should Drive the NAC’s Planning

On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS version 1.20.1 item sets and item matrix for implementation on Oct. 1, 2025. The change history included with the item sets indicates planned changes to sections A (Identification Information), B (Hearing, Speech, and Vision), …

HHS Office for Civil Rights Proposes Measures to Strengthen Cybersecurity in Health Care Under HIPAA

The Department’s Office for Civil Rights seeks to update HIPAA Security Rule for the first time since 2013 On December 27, 2024, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), issued a proposed rule to improve cybersecurity and better protect the U.S …

Upcoming iQIES Service Center Hold Times: February PBJ Submission Deadline 

Upcoming iQIES Service Center Hold Times Due to the Payroll Based Journal quarterly deadline, the iQIES Service Center is projecting an increase in the volume of calls and emails between January 2, 2025, and February 14, 2025. Did you know:  For More Information:  Please contact the iQIES Service Center by …

Residents on Part B Therapy? Provide Beneficiary Notices to Avoid a Financial Hit

Nurse assessment coordinators (NACs) who manage Medicare services typically are at least familiar enough with the beneficiary notice requirements that skilled nursing facilities (SNFs) must meet under fee-for-service (FFS) Medicare Part A to monitor those processes. “However, NACs may not always be as aware that facilities also have a responsibility …

Direct-Care Staff Are Front-Line Defenders Against Sepsis: What They Need to Know

Since the COVID-19 pandemic began in 2020, the risk of developing sepsis has increased nationwide, according to the September 2024 report An Assessment of Sepsis in the United States and Its Burden on Hospital Care (Sepsis Assessment) from the Agency for Healthcare Research and Quality (AHRQ). Sepsis-related inpatient stays in …

GG0130 and GG0170: Using Clinical Judgment to Establish Usual Performance

The ability to exercise clinical judgment to define usual performance in MDS items GG0130 (Self-Care) and GG0170 (Mobility) offers nursing homes unprecedented opportunity to impact quality measures (QMs), says Rosanna Benbow, RN, CCM, ICC, IP, DNS-CT, QCP, RAC-CTA, regional director of operations at Proactive LTC Consulting in Evansville, IN. “You …

SNF ABN Update: What Changed and How to Keep the Process Running Smoothly

Effective Oct. 31, 2024, skilled nursing facilities (SNFs) now are required to use an updated Skilled Nursing Facility Advance Beneficiary Notice of Noncoverage (SNF ABN), also known as form CMS-10055, and the corresponding revised instructions to provide financial liability notifications to residents under fee-for-service (FFS) Medicare Part A. Note: The …