CMS Has New Resource Available on Data Validation Process for the SNF Assessment-Based Measures

The Centers for Medicare & Medicaid Services (CMS) is offering a recorded presentation that describes the new data validation process. This training will support skilled nursing facilities (SNFs) in understanding the purpose and structure of the data validation process including the notification and submission process, required activities for selected SNFs, …

TIP: Consolidated Billing Updates for 2026

Consolidated billing specifies that the SNF is the responsible party for the billing of the entire package of care the resident receives during a covered Part A SNF stay, as well as identifies a limited number of services specifically excluded from consolidated billing, and therefore, separately payable. The Centers for …

TIP: CMS Released Updated MDS 3.0 Quality Measures User’s Manual v18.0

The Centers for Medicare & Medicaid Services (CMS) recently released the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual, version (V)18.0, which will go into effect Jan. 1, 2026. This update contains the re-specification of the Long Stay Antipsychotic Measure to include Medicare and Medicaid claims and encounter data, in …

TIP: CMS Releases New Technical Specification Report for Falls with Major Injury Measure

The Centers for Medicare & Medicaid Services (CMS) has released the official Long-Stay Nursing Home – Falls with Major Injury Respecification: 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, …

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 …

TIP: CMS Audits and Surveys Expected to Ramp Up

With the federal government now reopened after the 43-day shutdown, the Centers for Medicare & Medicaid Services (CMS) is expected to move quickly from the contingency plans outlined in the QSO-26-01-ALL REVISED memo and back to routine survey and oversight activity, including the validation audits. The data validation audits were expected …

TIP: AHRQ Launches New MDRO Toolkit

The Agency for Healthcare Research and Quality (AHRQ) released a new Toolkit for Improving Skin Care and MDRO Prevention in Long-Term Care, which outlines four evidence-based strategies to reduce infection risks and maintain skin integrity among long-term care residents. The toolkit strategies include keeping skin clean and safe, reducing MDRO transmission, using antibiotics …

TIP: Updated QSO Memo on the Government Shutdown

The Centers for Medicare & Medicaid Services (CMS) released an updated memo regarding “Contingency Plans – State Survey & Certification Activities in the Event of Federal Government Shutdown,” QSO-26-01-ALL Revised, on Oct. 31, 2025. CMS had previously clarified that, “during a lapse in appropriation, it is not legal for CMS …

TIP: COVID-19 Recommendations Updated

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 …

TIP: Updated MDS 3.0 RAI User’s Manual Changes – New Definitions for Fall, Injury, and Major Injury

The Centers for Medicare & Medicaid Services (CMS) released the final version of the RAI User’s Manual, version 1.20.1, which went into effect Oct. 1, 2025. CMS made several changes, including a new definition for a fall, injury (except major), and major injury, which are as follows: This AAPACN resource is …