Accurate PDPM Reimbursement: Four Areas of Focus to Shore Up MDS Documentation

The Patient-Driven Payment Model (PDPM) has been the case-mix classification model used for Medicare Part A skilled nursing facility (SNF) reimbursement since October 2019. Although this payment system has been in place for nearly four years for Medicare payment, some states have recently transitioned to PDPM for Medicaid payment. That …

RAI Manual v1.18.11 Surprises: Standout Issues in Sections D and K

Note: This is the second in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse assessment coordinators (NACs). The first article was RAI Manual v1.18.11 Surprises: Section M and N …

Develop an Action Plan for CMS’s Schizophrenia MDS Audits

Written by: Jessica Stucin, RN, BSN, LNHA, RAC-CT, Assistant Director of Education, MDS Consultants On Jan. 18, 2023, the Centers for Medicare & Medicaid Services (CMS) announced they will be conducting offsite audits in nursing homes for assessment accuracy and coding of residents with a diagnosis of schizophrenia. Along with …

RAI Manual v1.18.11 Surprises: Section M and N Updates Include Course Corrections

Note: This is the first in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse assessment coordinators (NACs). Even seemingly small changes to the draft RAI User’s Manual coding instructions …

Using New MDS Items Beyond the MDS

Several new items added or revised on the Minimum Data Set (MDS) this October are considered social determinants of health (SDOHs): ethnicity, race, language, transportation, health literacy, and social isolation. SDOHs are nonmedical factors that can affect health outcomes. On the MDS, these items are collected directly from the resident. …

BIMS MDS Coding Video Tutorial Updated

The Centers for Medicare & Medicaid Services (CMS) is offering an updated video tutorial to assist providers with guidance application and interview strategies for the cognitive assessment known as the Brief Interview for Mental Status (BIMS) found in the MDS 3.0 RAI v1.18.11, effective October 1, 2023. This video tutorial …

TeamSTEPPS 3.0: Evidence-Based Teamwork Resources for Healthcare Teams

TeamSTEPPS is an evidence-based program designed to optimize the performance of healthcare teams. The Welcome Guides in this section provide an introduction to TeamSTEPPS 3.0 adapted to the needs of various TeamSTEPPS roles, including:   The Welcome Guides provide a general overview of the content and structure of the TeamSTEPPS 3.0 …

When MDS 3.0 Quality Measure Triggers Start and Stop

Nurse assessment coordinators can use AAPACN’s When MDS 3.0 Quality Measure Triggers Start and Stop quick guide to determine when a resident will start and stop triggering an MDS 3.0 Quality Measure (QM) based on the assessment-selected logic, such as whether an assessment uses a target, initial, look-back scan, or …

2023 update to the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

The American Geriatrics Society (AGS) released the 2023 update to the AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults (DOI: 10.1111/jgs.18372). The AGS Beers Criteria® serves as a comprehensive list of medications that older people should potentially avoid or consider using with caution because they often present …