Listen to this article Your browser does not support the audio element. As summer approaches, many people begin thinking about health goals, wellness check-ins, and how to prepare for more outdoor activities in the warmer months. In the long-term care ICD-10 realm, preparation takes a different form: ensuring documentation and …
The Centers for Medicare & Medicaid Services (CMS) previously announced in March that the updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, was now available, but extended implementation to no later than May 12, 2026. While providers could continue using the previous version through May 11, 2026, facilities should …
The AAPACN ICD-10-CM Coding Decision Tool: Obesity and BMI Reporting helps long-term care staff accurately determine when BMI and obesity-related ICD-10-CM codes can be reported while ensuring compliance with provider documentation requirements. This tool guides users through coding decisions, clarifies the Patient-Driven Payment Model (PDPM) non-therapy ancillary (NTA) point impacts, …
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 …
