Question: Can the physician certification be met through a detailed order versus a separate certification form? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-MT: CMS does not mandate a specific form or format, but to meet the requirements, the certification must have all the required information. This is found …
Question: We have a resident that had a qualifying hospital stay (QHS), then went to a long-term acute care hospital (LTACH) for more than 30 days. Can the resident still utilize their Medicare benefits in our skilled nursing facility (SNF) or not, since the transfer from acute hospital to SNF …
Question: What is the look-back period for K0100? The RAI User’s Manual does not mention the look-back period or if this can include days during the hospital stay? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: When a look-back period is not specifically mentioned, the look-back is 7 days. …
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 …
AAPACN offers two great tools to assist nurse assessment coordinators (NACs) in scheduling OBRA assessments. Be prepared for 2026 with these two tools that are free to members: This AAPACN resource is copyright protected. AAPACN individual members may download or print one copy for use within their facility only. AAPACN …
Do you have an organized approach to collect MDS data during the 7- and 14-day look-back periods? AAPACN’s MDS Data Collection for the NAC tool provides an organized approach to gathering supporting data from the medical record, medication administration record, treatment record, and more. This tool can save you time …
MDS section L (Oral/Dental Status) is one of the most frequently undervalued areas of the MDS, says Eleisha Wilkes, RN, GERO-BC, RAC-CT, RAC-CTA, DNS-CT, QCP, a senior consultant with Proactive LTC Consulting in Evansville, IN. “Generally, it is perceived as a minor section because it doesn’t directly affect payment in …
The nursing component of the Patient-Driven Payment Model (PDPM) may appear straightforward: calculate a section GG Nursing Function Score and assign the resident to one of six nursing categories. But accuracy relies on a detailed understanding of coding rules, observation periods, and documentation requirements that determine both compliance and reimbursement …
Question: Is there a specific table that shows which items if dashed will count against us for the Skilled Nursing Facility Quality Reporting Program (SNF QRP)? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, CMS releases a document for each fiscal year (FY). The current document, Skilled Nursing …
Question: Is a Pure Wick catheter coded as an external catheter? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Yes, this would meet the definition of an external catheter in the RAI User’s Manual. EXTERNAL CATHETERDevice attached to the shaft of the penis like a condom, …
