Question: How do I code the “Will [care area] be addressed in the care plan” question when a resident discharges return not anticipated before the care plan is complete? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: Federally, if the care plan was not completed because the resident …
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 …
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: Is a Significant Change in Status Assessment (SCSA) required for a new pressure ulcer? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: A Significant Change in Status Assessment is required if there are two or more areas of decline or improvement that will not resolve on its own …
Question: If a Discharge – return not anticipated was completed for a resident discharge against medical advice (AMA), and he returned less than 30 days later, is a new OBRA Admission assessment required? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA: When the OBRA discharge is named “Return not anticipated” …
Listen to this article Your browser does not support the audio element. The Oct. 1, 2025, update to the definitions of “fall” and “major injury” in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual (RAI User’s Manual) has left many nurse assessment coordinators (NACs) with questions about what …
This user guide addresses Minimum Data Set (MDS) error messages and troubleshooting. iQIES MDS Error Message Reference Guide v1.1 (posted 12/29/2025) iQIES MDS Error Messages v1.1 (posted 12/29/2025) From https://qtso.cms.gov/providers/nursing-home-mdsswing-bed-providers/reference-manuals
The Centers for Medicare & Medicaid Services (CMS) is offering a recorded presentation which describes the new data validation process. This training will support facilities in understanding the purpose and structure of the data validation process including the notification and submission process, required activities for selected SNFs, and where to …
These files include updates for FY 2026. Use these codes for discharges occurring from April 1, 2026 – September 30, 2026, and for patient encounters occurring from April 1, 2026– September 30, 2026. https://www.cms.gov/medicare/coding-billing/icd-10-codes
Question: A resident has a healing pressure ulcer that was described as “100 % epithelial, with slow blanching erythema” during the ARD window. Would this still be coded as a pressure ulcer? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Code the ulcer as present unless completely healed …
