Back to PDPM Basics – Part 4: The Nursing Component – Clinically Complex, Behavioral Symptoms and Cognitive Performance, and Reduced Physical Function

Article / Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC

The nursing component of the Patient-Driven Payment Model (PDPM) may appear straightforward: calculate a section GG Nursing Function Score and assign the resident to one of six nursing categories. But accuracy relies on a detailed understanding of coding rules, observation periods, and documentation requirements that determine both compliance and reimbursement …

Q&A: Is there a specific table that shows which items if dashed will count against us for the Skilled Nursing Facility Quality Reporting Program (SNF QRP)?

NAC / Q&A / QAPI and Quality Initiatives

Question: Is there a specific table that shows which items if dashed will count against us for the Skilled Nursing Facility Quality Reporting Program (SNF QRP)? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, CMS releases a document for each fiscal year (FY). The current document, Skilled Nursing …

Q&A: Is a Pure Wick catheter coded as an external catheter?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: Is a Pure Wick catheter coded as an external catheter?   Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Yes, this would meet the definition of an external catheter in the RAI User’s Manual.  EXTERNAL CATHETERDevice attached to the shaft of the penis like a condom, …

Q&A: When assessing a fall with an injury to the head, such as a laceration, bruise, or hematoma, would this automatically be considered a major injury?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: When assessing a fall with an injury to the head, such as a laceration, bruise, or hematoma, would this automatically be considered a major injury?   Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA and Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The RAI User’s Manual definition for …

Follow Up Q&A for AAPACN Sept. 28, 2025 Webinar – Ready or Not: Oct. 1, 2025 MDS Changes

MDS 3.0 and the RAI Process / NAC / Podcast

In this LTC NAC Chat podcast episode, Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist for AAPACN, answer some follow-up questions from the recent AAPACN webinar, “Ready or Not: Oct. 1, 2025 MDS Changes,” hosted …

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ICD-10-CM Coding Convention Terminology Quick Reference Guide

Billing and Reimbursement / NAC / Tool

The ICD-10-CM Coding Convention Terminology Quick Reference Guide provides a concise reference to key ICD-10-CM coding terminology and conventions for long-term care nurse assessment coordinators and coders. This guide simplifies complex terms and coding rules including clear definitions of common terms, a list of important abbreviations, and key coding conventions. …

TIP: COVID-19 Recommendations Updated

MDS 3.0 and the RAI Process / NAC / Tip

The Centers for Disease Control and Prevention (CDC) recently updated guidance for the COVID-19 vaccine administration and the adult immunization schedule. The CDC’s Adult Immunization Schedule webpage was updated Oct. 7, 2025, which changed the color coding of the COVID-19 vaccination for all adult age groups to blue. This indicates …

Resident Interview Toolkit

MDS 3.0 and the RAI Process / NAC / Tool

The AAPACN Resident Interview Toolkit helps nursing home staff conduct effective resident interviews as part of the MDS 3.0 assessment process. It provides clear guidance and resources for the entire interdisciplinary team—nurses, dietary managers, social services, activities, and others—to ask residents about their mood, memory, daily routines, and care preferences. …

Respiratory Therapy MDS Coding Checklist

MDS 3.0 and the RAI Process / NAC / Tool

Respiratory therapy, coded at O0390D and O0400D, must meet definitions and complex instructions per the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual (RAI User’s Manual). AAPACN’s Respiratory Therapy MDS Coding Checklist tool delineates the requirements to validate that all required aspects have been met before coding the Minimum Data Set …

Q&A: How do you code walking if the resident only walks with therapy staff?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: How do you code walking if the resident only walks with therapy staff? Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, and Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: If the resident only walked with therapy, then the assessment for usual performance is based on the resident’s usual performance …