Major Changes on Falls with Major Injury QMs

Listen to this article Your browser does not support the audio element. The Oct. 1, 2025, update to the definitions of “fall” and “major injury” in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual (RAI User’s Manual) has left many nurse assessment coordinators (NACs) with questions about what …

iQIES MDS Error Message Reference Guide and Message List v1.1

This user guide addresses Minimum Data Set (MDS) error messages and troubleshooting. iQIES MDS Error Message Reference Guide v1.1 (posted 12/29/2025) iQIES MDS Error Messages v1.1 (posted 12/29/2025) From https://qtso.cms.gov/providers/nursing-home-mdsswing-bed-providers/reference-manuals

SNF QRP/SNF VBP: CMS Video Offers MDS Data Validation Process Overview

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

FY 2026 ICD-10-CM Code Updates Effective April 1, 2026

These files include updates for FY 2026. Use these codes for discharges occurring from April 1, 2026 – September 30, 2026, and for patient encounters occurring from April 1, 2026– September 30, 2026.  https://www.cms.gov/medicare/coding-billing/icd-10-codes

Q&A: A resident has a healing pressure ulcer that was described as “100% epithelial, with slow blanching erythema” during the ARD window. Would this still be coded as a pressure ulcer?  

Question: A resident has a healing pressure ulcer that was described as “100 % epithelial, with slow blanching erythema” during the ARD window. Would this still be coded as a pressure ulcer?   Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Code the ulcer as present unless completely healed …

Q&A: If a resident is losing weight and ordered supplements as an intervention, can we code as a therapeutic diet?

Question: If a resident is losing weight and ordered supplements as an intervention, can we code as a therapeutic diet? Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC:If the supplements were ordered by a physician or physician extender (as allowed in your state) to increase nutrients in the diet …

Q&A: 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?

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 …

Q&A: 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?

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 …

Weight Loss/Gain Calculation Worksheets and Documentation Tip Sheets to Support MDS Coding

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 …

Crack the Code: E0800, Rejection of Care

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 …