Q&A: If a resident initiates his/her discharge for the following day and the facility was able to organize home care, equipment, etc., is this considered a planned or unplanned discharge?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: If a resident initiates his/her discharge for the following day and the facility was able to organize home care, equipment, etc., is this considered a planned or unplanned discharge? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA: There is a distinct difference between being able to prepare for a …

Q&A: The RAI User’s Manual guidance for mechanically altered diet mentions “soft solids.” Would that include solids that are naturally soft or solids that we would “soften”?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: The RAI User’s Manual guidance for mechanically altered diet mentions “soft solids.” Would that include solids that are naturally soft or solids that we would “soften”? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The diet needs to be mechanically altered to facilitate eating/swallowing in order to code …

Coding High-Risk Drug Classes: How to Improve N0415 Accuracy

Article / MDS 3.0 and the RAI Process / NAC

N0415 (High-Risk Drug Classes: Use and Indication) is much more than just paperwork. This MDS item  impacts resident care through the care area triggers (CATs) and the care area assessments (CAAs), as well as facility performance across the Skilled Nursing Facility Quality Reporting Program (SNF QRP), the Skilled Nursing Facility …

Out the Door, On a Leave, or Gone for Good? Uncomplicating Discharges

Article / MDS 3.0 and the RAI Process / NAC

In the fast-paced position of a nurse assessment coordinator (NAC), keeping track of all the residents’ whereabouts can be challenging. The NAC must know who is coming into the facility and if this resident is a new admission or a readmission, as well as who has left—whether on a leave …

From the CATs to the QMs: Key Impacts of MDS Section N

Article / MDS 3.0 and the RAI Process / NAC

MDS section N (Medications)—in particular item N0415 (High-Risk Drug Classes: Use and Indication)— plays a key role in a nursing home’s ability to provide comprehensive, resident-centered care via the care area triggers (CATs) and the care area assessments (CAAs) in the care planning process. N0415 also may affect a facility’s …

Q&A: If the resident was in the emergency department (ED) and then admitted to the hospital before readmitting to the nursing home, can I capture IV fluids at the ED visit?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: If the resident was in the emergency department (ED) and then admitted to the hospital before readmitting to the nursing home, can I capture IV fluids at the ED visit?   Answer from Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: IV fluids from pre-admission are captured under K0520A2, while not …

Q&A: A long-term care resident has a Quarterly assessment due on 6/19 and an Annual assessment due on 6/27. Can I do the Annual assessment early, before the Quarterly deadline?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A long-term care resident has a Quarterly assessment due on 6/19 and an Annual assessment due on 6/27. Can I do the Annual assessment early, before the Quarterly deadline? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, you can absolutely do this. Set the ARD for the …

SNF QRP Quick Reference Guide

Billing and Reimbursement / DNS / MDS 3.0 and the RAI Process / NAC / Post-Acute Care News / QAPI and Quality Initiatives

An updated Quick Reference Guide is now available. The Quick Reference Guide provides high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links. PAC-SNF-QuickReferenceGuide-20250508 (PDF) From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/submission-deadlines

ICD-10-CM Diagnosis Sequencing

Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC / Podcast

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss the sequencing of ICD-10-CM diagnosis coding. Additional Resources: AAPACN Articles:  ​​​​​​​AAPACN Education: ​​​​​​​AAPACN Tool:

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Deep Dive into ICD-10-CM: Diagnosis Sequencing Guidelines

Article / Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC

The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code assignment continues to be a bit of an enigma in the long-term care setting. Members regularly ask questions about ICD-10-CM coding in AAPACN’s online communities, as well as in post-education surveys, often confused about how to order the codes. …