Oct. 1, 2023 Will See Performance Period Data Collection for Five SNF VBP QMs

The key takeaway of the Fiscal Year (FY 2024) Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule, published on Aug. 7, 2023, is that the director of nursing services (DNS) will need to hit the ground running on Oct. 1, 2023, with a systematic, comprehensive, and interdisciplinary approach …

FY 2024 SNF PPS Final Rule Initial Timeline for NACs: How/When the MDS Takes Center-Stage

Breathing room will be in short supply for nurse assessment coordinators (NACs) and other interdisciplinary team members who need to implement and monitor the multitude of changes to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) and the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP) that are in …

NACs Like a Reasonable Challenge: 2023 AAPACN NAC Work Study and Salary Report

Over the last few years, nurse assessment coordinators (NACs) are being hired with less long-term care experience, being paid more, and facing a multitude of challenges including stress and burnout, staffing shortages, and increased workloads. The 2023 AAPACN NAC Work Study and Salary Report received responses from 632 NACs. The …

Proposed Staffing Rule: CMS Focuses on a Comprehensive Approach

In the long-awaited Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule, the Centers for Medicare & Medicaid Services (CMS) proposes a three-pronged, comprehensive staffing approach for Medicare- and Medicaid-certified skilled nursing facilities (SNFs) and nursing facilities (NFs): “Literature evidence [e.g., here, here, …

How the Director of Nursing Services Can Support the MDS Process

The Minimum Data Set (MDS) determines Medicare and often state Medicaid reimbursement; prompts initial and MDS-assessment-based care planning; provides data that the Centers for Medicare & Medicaid Services (CMS) uses to calculate Quality Measures (QMs) included in the Five-Star Quality Rating System, Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, …

Behavioral Health: Eight Ways to Boost Compliance—and Help Residents—Under F740

F740 (Behavioral Health Services) is not a frequently cited F-tag so far in calendar year (CY) 2023, according to QCOR data posted on Aug. 13, 2023. However, the consequences can be severe—surveyors often issue this citation at the level of immediate jeopardy (IJ) when it does occur. Specifically, F740 is …

Finalized RAI User’s Manual: Eight Key Points to Know

In preparation for the upcoming Oct. 1, 2023, implementation of the also-just-updated v1.18.11v5 MDS item sets, the Centers for Medicare & Medicaid Services (CMS) has released the final Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual version 1.18.11 and a draft-to-final change table. Highlights of these revisions include the …

Solving the Mystery: How to Document for Section GG

Section GG, Functional Abilities and Goals, will expand to all OBRA assessments starting Oct. 1, 2023, with the retirement of the section G activities of daily living (ADL) items. This change disrupts the long-standing practices and policies facilities have developed to capture episode-level-of-care information from nurse aides on the section …

RAI Manual v1.18.11 Surprises: PPS Discharges Get More Complex

Note: This is the third in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse assessment coordinators (NACs). The first two articles were “RAI Manual v1.18.11 Surprises: Section M and …