In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026, officially published on April 30, 2025, the Centers for Medicare & Medicaid Services (CMS) offers a mostly positive update to the fee-for-service (FFS) Part A payment rates, projecting that …
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code assignment continues to be a bit of an enigma in the long-term care setting. Members regularly ask questions about ICD-10-CM coding in AAPACN’s online communities, as well as in post-education surveys, often confused about how to order the codes. …
The Centers for Medicare & Medicaid Services (CMS) does not propose any new quality measures (QMs) for the pay-for-performance Skilled Nursing Value-Based Purchasing program (SNF VBP) in the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026. However, three QMs …
Urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) remain significant concerns in long-term care settings. They contribute to increased morbidity, extended hospital stays, higher healthcare costs, and reduced quality of life for residents. The Centers for Disease Control and Prevention estimates that 75% of UTIs in hospitalized patients …
Like every proposed rule before it, the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026 offers the director of nursing services (DNS) a preview of likely upcoming changes that the Centers for Medicare & Medicaid Services (CMS) may make …
The long-stay Quality Measures (QMs), Percent of Residents with a Urinary Tract Infection and Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder, have straightforward methodology but complex underlying implications. Managing these QMs and achieving desired outcomes requires the nurse assessment coordinator (NAC) and the interdisciplinary …
A well-run care conference or care plan meeting can help the interdisciplinary team (IDT) improve the resident’s quality of care and quality of life by establishing a more resident-centered, individualized, culturally competent, and trauma-informed care plan, says Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC, director of reimbursement and …
The nurse assessment coordinator (NAC) brings a unique understanding of facility operations and resident needs that can reap critical benefits for the Quality Assurance and Performance Improvement (QAPI) program, says Lauren Stenson, MSN, RN, CNDLTC, QCP, DNS-CT, an AAPACN curriculum development specialist. “You keep track of the documentation that is …
The Centers for Medicare & Medicaid Services (CMS) recently released a second version of the draft item set files for Oct. 1, 2025, updates, version 1.20.1v2, and the draft Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual (RAI User’s Manual). The draft item sets are the collection of different …
The revised surveyor guidance in Appendix PP of the State Operations Manual that goes into effect on April 28, 2025, does not include any updates to F-tag 838 (Facility Assessment), says Robin Hillier, CPA, STNA, LNHA, RAC-MT, president of RLH Consulting in Westerville, OH. “Revised F838 guidance already went into …
