Interim final rule with comment period. SUMMARY: This interim final rule with comment period repeals provisions of the final rule titled “Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting.” This action is taken in view of changes made by by public …
Question: Can I code a diagnosis of pneumonia when the nurse practitioner initiated antibiotics for a documented reason of pneumonia, but there was not a chest x-ray completed to confirm the diagnosis? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: If the physician/extender diagnosed the resident with pneumonia after …
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 …
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 …
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 …
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 …
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 …
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 …
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, …
Implementation Date 2026-01-05 CR # 14250 Publication # 100-04 Transmittal Year 2025 Downloads
