Do you know what MDS items impact reimbursement under the Patient-Driven Payment Model (PDPM) or the Skilled Nursing Facility Quality Reporting Program (SNF QRP)? Use this quick guide, MDS Items Impacting Reimbursement for PDPM and SNF QRP, for easy reference to get your payment straight. This AAPACN resource is copyright …
Listen to this article Your browser does not support the audio element. Medicaid Case-Mix: Make the Nursing Component a Top Priority Many Medicaid case-mix states that use the MDS have transitioned or are in the process of transitioning to a case-mix system that is based on the Patient-Driven Payment Model …
Listen to this article Your browser does not support the audio element. A stroke can change a resident’s life in an instant, but its effects often remain long after the treatment of the acute event. In the long-term care (LTC) setting, those residual deficits—difficulty swallowing, aphasia, impaired cognition, hemiplegia, weakness, …
Question: Does providing drain care (emptying and dressing change) three times per week qualify as skilled care for Medicare Part A? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Emptying the drain and completing a dressing change three times per week does not qualify for skilled care, but this …
Question: Is it mandatory for the physician to sign the Medicare certification on the day of admission? If the resident is admitted late in the evening and is not seen by the physician until the following day, may the certification be signed the next day without a penalty? Answer from …
The SNF Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on the compare tool on Medicare.gov and the Provider Data Catalog (PDC) during the October 2026 refresh. Provider Preview Reports for the October 2026 refresh include: Providers have until August 14, 2026, to …
The Payroll-Based Journal (PBJ) system will move into iQIES on Aug. 17, 2026. Moving PBJ into iQIES is part of ongoing work to modernize systems and improve security. Starting Aug. 17, facilities must submit all PBJ staffing data in iQIES. Reporting requirements and quarterly deadlines will not change. Visit the QIES Technical Support Office webpage for more information. This AAPACN …
The Centers for Medicare & Medicaid Services (CMS) is proposing transformational reforms to Medicare’s physician payment and value-based care programs that would expand accountable care, modernize physician payment, reduce administrative burden, and help shift the healthcare system’s focus from treating illness to preventing it. The proposals would make Medicare accountable …
From MLN Connects eNews In a report, the Office of Inspector General found that some skilled nursing facilities (SNFs) didn’t comply with Medicare requirements for reporting related party costs. These SNFs failed to report related parties on their Medicare Cost Reports or reported the costs inaccurately, resulting in overstated costs to …
Listen to this article Your browser does not support the audio element. Medicare Advantage (MA) enrollment continues to grow, with more than half of all Medicare beneficiaries now receiving their coverage through an MA plan. But as enrollment has increased, so have concerns regarding coverage determinations in skilled nursing facilities …
