Medicare Advantage Plan Appeals in Skilled Nursing Facilities Date presented: January 21, 2026 In this webinar, Acentra Health provices a look at a recent focus study on how Medicare Advantage plans use NOMNCs in SNFs. During the webinar, we shared key data, outlined common challenges such as weak care planning, limited …
In this LTC NAC Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist for AAPACN, discuss some of the highlights of LaBay’s AAPACN conference session, “Express Pass to Precision: Tackling Tricky ICD-10-CM …
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Question: Can I set a 5-Day PPS assessment on a non-billable day such as a skip day? The resident was sent to the hospital, did not return prior to midnight, and was not admitted. Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: No, the ARD for the 5-Day cannot …
Listen to this article Your browser does not support the audio element. February’s designation as American Heart Month offers an important opportunity to reflect on the role of cardiovascular health in long-term care (LTC). Cardiac conditions such as heart disease, hypertension (HTN), and heart failure are among the most frequently …
Question: The Skilled Nursing Facility Quality Reporting Program (SNF QRP) Data Validation Audit notification letter requested Admission and Discharge assessments. What assessments should be submitted? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-MT: On the notification letter, there are instructions for the “MDS Assessment Type is Admission” or a “Discharge.” …
The Advanced Beneficiary Notice of Noncoverage (ABN), form CMS-R-131, is used by nursing facilities when Medicare Part B services are ending and the resident does not agree with the decision. The current form, posted on the FFS ABN webpage, expires on Jan. 31, 2026, but an updated form has not …
Impact of Combined Assessments on SNF APU: How Medicare 5-Day and PPS Discharge Combined Assessments Affect Your Facility’s APU Calculation The Centers for Medicare & Medicaid Services (CMS) has released a one-page resource for SNF providers that illustrates how Medicare 5-Day and PPS Discharge combined assessments can impact the APU …
Key report excerpts re: SNFs: Within the Traditional Medicare program, reducing improper payments remains a challenge. The improper payment rate reported in FY 2024, 7.66 percent, has not decreased from the rates reported in FYs 2022 or 2023. The four categories with the largest dollars in improper payments in FY 2024 …
Listen to this article Your browser does not support the audio element. In today’s skilled nursing facility (SNF) landscape, the director of nursing services (DNS) is critical not only in overseeing resident care but also in supporting the organization’s financial stability and regulatory compliance. Both goals require a strong understanding …
Question: When a resident changes payers from Medicare Advantage to Traditional Medicare, are the Medicare Advantage days subtracted from the Medicare 100-day benefit period? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, days billed under Medicare Advantage are subtracted from the resident’s 100-day benefit period. This AAPACN resource …
