The Medicare Part A PPS Discharge assessment (i.e., the NPE item set) is now a crucial assessment with far-reaching impacts for skilled nursing facilities (SNFs) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP), the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, the Five-Star Quality Rating System, and …
Effective Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) removed column 2, discharge goals, from items GG0130 and GG0170 on the Minimum Data Set (MDS). Many nurse assessment coordinators will welcome the reduced coding of these expansive GG items. But just because these goals are no longer …
The ICD-10-CM code captured in MDS item I0020B (ICD-10 Code/Primary Medical Condition Category) is the foundation of case-mix classification for the Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) payment components in the Patient-Driven Payment Model (PDPM) under the fee-for-service Medicare Part A skilled nursing facility prospective payment …
The International Classification of Diseases, Clinical Modification, 10th revision (ICD-10-CM), coding system is an essential tool needed to document and bill accurately for healthcare services in the long-term care (LTC) setting. Annual updates to both the coding guidelines and the actual codes reflect updated clinical practices, advancements in medical understanding, …
Working as a nurse in a nursing home can be overwhelming, especially if the director of nursing services (DNS) and executive leadership expect nurses to learn on the job and fail to set up a comprehensive program that includes adequate orientation (short-term training and support) and onboarding (longer-term training and …
The facility has a high number of discharges to the community every month, and the director of nursing services (DNS) feels the discharge process is a good one, as she has received no complaints from residents or staff. However, a review of the facility’s Quality Measures (QMs) tells a different …
Providing residents with the appropriate level of assistance in the activities of daily living (ADLs) is foundational to care in nursing homes, yet the ADLs consistently remain a common citation risk in the survey process. From 2021 to summer 2024, F677 (ADL Care Provided for Dependent Residents) is the eighth most-cited F-tag …
Like care plan management and evaluation and observation and assessment of a resident’s condition, teaching and training activities are a core nonskilled component of resident care that can rise to the level of a skilled service. Another way that these indirect skilled services are alike is that they historically haven’t …
The newest section GG Quality Measure (QM), the Discharge Function Score, has left many nurse assessment coordinators (NACs) with more questions than answers about how it is calculated. This measure estimates the percentage of Medicare Part A skilled nursing facility (SNF) stays that meet or exceed an expected Discharge Function …
The Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule, released on July 31, 2024, and scheduled for publication on Aug. 6, 2024, largely finalized “as-is” the FY 2025 SNF PPS proposed rule. On the positive side, SNFs should see an aggregate $1.4 billion payment …
