Q&A: What date would be used in A2400C (Medicare end date) for an unplanned discharge to the hospital when the assessment is a combined a 5-Day, OBRA discharge, and a PPS discharge?

Question: What date would be used in A2400C (Medicare end date) for an unplanned discharge to the hospital when the assessment is a combined a 5-Day, OBRA discharge, and a PPS discharge? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The Medicare end date would be the date of …

Q&A: Can we still use dementia as a primary diagnosis for our long-term residents?

Question: Can we still use dementia as a primary diagnosis for our long-term residents? Our facility was recently told we can no longer use the dementia diagnosis (F03.90) although it maps to medical management? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: If there is no known cause of …

Weight Loss/Gain Calculation Worksheets and Documentation Tip Sheets to Support MDS Coding

AAPACN’s Weight Loss/Gain Calculation Worksheets and Documentation Tip Sheets to Support MDS Coding helps clinicians accurately calculate and document weight changes to support compliant MDS section K coding. This easy-to-use resource outlines how to identify the correct 30- and 180-day weights, apply required calculation formulas, determine physician-prescribed weight changes, and …

TIP: Overview of Changes with November Care Compare Refresh

The expected October Care Compare refresh was delayed during the government shutdown, but it was finally refreshed on Nov. 30, 2025. The Centers for Medicare & Medicaid Services (CMS) outlined key updates also included with this refresh: Note: The Medicare Spending Per Beneficiary claims-based measure is based on data from Quarter …

Crack the Code: E0800, Rejection of Care

Understanding and accurately coding E0800, Rejection of Care, is essential both to reflect the resident’s behavior patterns and to ensure the care plan captures both the resident’s behaviors and his or her preferences. Misinterpreting rejection can lead to coding errors that distort the resident’s needs and obscure opportunities for effective …

Quality Measure IQ Series: Need for Help with ADLs Has Increased

In long-term care, maintaining a resident’s functional independence is both a clinical and regulatory priority. The Minimum Data Set (MDS) 3.0 Quality Measure (QM), “Percent of Residents Whose Need for Help with Activities of Daily Living (ADLs) Has Increased” reflects one of the most essential goals in skilled nursing: to …

Falls With Major Injury (FMI) NHQI Technical Specification Report

The Centers for Medicare & Medicaid Services (CMS) has released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held on May 12 and 14, 2025. The report provides an overview of the measure, …

At-a-Glance QM, QRP, and VBP Tool

With so many Quality Measures originating from three different payment initiative programs, it’s a lot to keep track of. AAPACN’s At-a-Glance QM, QRP, and VBP tool organizes all of the measures for you. This tool has been updated with the MDS 3.0 Quality Measures User’s Manual Version 17.0 (January 2025), the Five-Star …

AHRQ Toolkit: Skin Care for Infection Prevention in Nursing Homes

AHRQ’s new Toolkit for Improving Skin Care and MDRO Prevention in Long-Term Care strengthens infection prevention in nursing homes, addressing the unique needs of residents and the care environment they live in. The toolkit outlines four evidence-based strategies to reduce infection risks in residents and provides tools and resources to support the …