Question: Please clarify if section O “while a resident.” Per the RAI User’s Manual, “Check all treatments, procedures, and programs that the resident received or performed after admission/entry or reentry to the facility and within the last 14 days. If no treatments, procedures or programs were received by, performed on, …
The Centers for Medicare & Medicaid Services (CMS) convened a Technical Expert Panel (TEP) on May 12 and 14, 2025, to obtain input on potential cross-setting updates to the Falls with Major Injury (FMI) measure. The TEP was held in response to concerns regarding potential underreporting on the current measure …
CDC announces new ICD-10-CM codes effective October 1, 2025. The October 1, 2025 diagnosis code update files are now available. Use these files for discharges occurring from October 1, 2025 – September 30, 2026, and for patient encounters occurring from October 1, 2025 -September 30, 2026. The files in the 2026 …
Question: When should I set an assessment reference date (ARD) for a Significant Change in Status Assessment (SCSA) after a resident elected hospice? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The completion date for the SCSA is the “determination date +14 days.” The ARD can be …
Question: I know that McGeer criteria must be met when coding a UTI that develops in-house during the SNF stay, but what is required when a resident is transferred to the hospital and returns to the SNF with a documented UTI diagnosis (e.g., listed on the discharge summary and on …
The Centers for Medicare & Medicaid Services (CMS) noted in the FY 2026 SNF PPS Final Rule, “After consideration of the public comments, we are finalizing our proposal to remove four standardized patient assessment data elements (one item for Living Situation (R0310); two items for Food (R0320A and R0320B); and …
Written by Kristine Martinez, BSN, RN, RAC-CT, RAC-CTA, QCP, DNS-CT, MDS Consultants Often, section K on the minimum data set (MDS), along with the associated care area assessments (CAAs) and care planning are delegated to the dietitian to manage. However, when reviewing a comprehensive MDS, it becomes clear that section …
AAPACN has re-released the Nurse Assessment Coordinator (NAC) FTE Calculator for SNF leaders to estimate the time needed to complete assessments as well as project how many hours the NAC needs for meetings and other duties. This AAPACN resource is copyright protected. AAPACN individual members may download or print one …
On July 31, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2026. CMS is publishing this final rule in …
In skilled nursing facilities (SNFs), staff members often find the Patient-Driven Payment Model (PDPM) process complex and unfamiliar, especially when determining how Medicare (and, in many states, Medicaid) payment is calculated. PDPM is based on five separate case-mix adjusted components: Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), …
