The Patient-Driven Payment Model (PDPM) 5-Character HIPPS code can be difficult to decipher. The PDPM HIPPS Code At-a-Glance tool will help nurse assessment coordinators quickly identify the key elements impacting Medicare reimbursement. This AAPACN resource is copyright protected. AAPACN individual members may download or print one copy for use within …
The MDS Data Specifications V3.10.2 (FINAL) are now available for download. This version reflects changes finalized in the FY 2026 SNF PPS final rule (90 FR 37310). Note that there are some minor changes since DRAFT 3 (below) was posted, including a new edit -4096. Please reference the Item Change and Edit Change …
In this LTC NAC Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist for AAPACN, discuss a new way for NACs to test their knowledge – the NAC Competency Evaluation. Additional Resources:
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MDS section R (Health-Related Social Needs) is officially no more. The big news for nurse assessment coordinators (NACs) in the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Final Rule for Fiscal Year (FY) 2026, released on July 31, 2025, and published on Aug. 4, is …
The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for the fiscal year (FY) 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS), addressing several key recommendations submitted by the American Association of Post-Acute Care Nursing (AAPACN). AAPACN provided detailed input on rate setting, ICD-10 code mapping, …
Since the implementation of the Patient-Driven Payment Model (PDPM), nursing facilities have had to take a more nuanced approach to how a resident’s needs are assessed and documented. As discussed in part 1 of this series, Medicare payment, as well as Medicaid payment in many states, is determined using PDPM …
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) recently announced the August 2025 Performance Score Reports for the fiscal year (FY) 2026 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are available for download via the Internet Quality Improvement and Evaluation System (iQIES). Access this report to review the performance information …
Question: Can I count IV fluids and IV antibiotics that were administered in the hospital before admission and within the 7-day look-back period? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: IV fluid provided during the hospital stay within the 7-day look-back period of the ARD can be coded …
Question: I miscalculated the ARD window for a 5-Day and scheduled the 5-Day/PPS Discharge on day 9 of the Medicare stay. What do I need to do? Answer from Jeff Taylor:Leave everything as it is and bill one day default for the late assessment. Since the 5-Day is one day …
