Listen to this article Your browser does not support the audio element. In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2027, officially published on April 7, 2026, the Centers for Medicare & Medicaid Services (CMS) proposes some earth-shaking …
Listen to this article Your browser does not support the audio element. The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP), often regarded as merely an exercise in reporting compliance, also has direct payment implications. Thus for SNFs, compliance reflects both quality and financial issues. The program asks facilities to …
Listen to this article Your browser does not support the audio element. Skilled nursing facilities (SNFs) frequently manage residents who temporarily leave the building or experience a break in Medicare Part A coverage. On the UB-04, these situations may look the same, often reflected as gaps in covered days or …
Overview What is the Data Validation Process? The Data Validation Process evaluates the accuracy of quality measure data elements derived from the Minimum Data Set (MDS), which are used in the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) and Quality Reporting Programs (QRP) for assessing quality of care and measuring …
Listen to this article Your browser does not support the audio element. In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2027, officially published on April 7, 2026, the Centers for Medicare & Medicaid Services (CMS) proposes some earth-shaking …
The Centers for Medicare & Medicaid Services (CMS) recently released the fiscal year (FY) 2027 SNF PPS Proposed Rule. Stakeholders have until June 1, 2026, to submit comments on the proposals. The following is a high-level overview of the proposed changes. CMS proposed to: Additional details can be found on …
Question: A resident admitted after hospitalization is completing therapy but developed an unstageable pressure ulcer during the SNF stay. Can Medicare Part A continue for skilled nursing, even though the condition was not part of the qualifying hospital stay? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The rule …
From https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/list-federal-regulations/cms-1843-p DRAFT SNF QRP New and Modified Items with a Proposed Effective Date of October 1, 2031: FY27_Proposed_Rule_SNF_All_Payer_draft_mockups_MDS__508.pdf (PDF) From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/measures-and-technical-information Draft MDS re: proposed removal of MDS item O0350 on Oct. 1, 2027: CMS-10387 from https://www.cms.gov/regulations-and-guidance/legislation/paperworkreductionactof1995/pra-listing-items/cms-10387
Listen to this article Your browser does not support the audio element. As the clinical leader of the largest operational department in a skilled nursing facility, the director of nursing services (DNS), in tandem with the administrator, plays a key role in financial oversight. Ancillary charges are rooted in nursing-driven …
The director of nursing services should review ancillary billing monthly to ensure that all billed services and supplies are clinically appropriate, documented accurately, and supported by skilled nursing care. The DNS can use this Ancillary Billing Review Checklist to help confirm compliance with Medicare Part A and Part B rules, …
