The calculation for the nursing component of the Patient-Driven Payment Model (PDPM) can look deceptively simple. The two steps entail calculating a section GG nursing function score and then placing the resident into one of six nursing categories. But completing these two steps correctly requires understanding a number of coding …
Question: Can Isolation be coded for methicillin-resistant staphylococcus aureus (MRSA) on a wound? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: No, the RAI User’s Manual specifically states that isolation cannot be coded for a wound infection. See page O-8 (bold text added for emphasis): Code only when the …
When a resident’s condition changes during the Medicare Part A stay, the facility team must decide if an Interim Payment Assessment (IPA) is indicated. The AAPACN IPA Quick Calculator interactive tool can help the team analyze the changes in HIPPS codes, case-mix groups, case-mix indexes, and rates. Two tools are …
The PDPM At-a-Glance tool breaks down the complex methodology of each component used in the Patient-Driven Payment Model—physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), non-therapy ancillaries (NTA), and nursing. This tool provides key payment information organized to provide the nurse assessment coordinator (NAC) with quick access to understanding …
SNF QRP Data Collection and Final Submission Deadlines The SNF QRP Data Collection and Final Submission Deadlines have been updated to provide the data collection time frames and final submission deadlines for the FY 2028 SNF QRP. From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/submission-deadlines SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient …
SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2027 APU Determination and Data Collection and Final Submission Deadlines for FY 2027 posted The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures …
This file can be used by NACs to determine how ICD-10-CM codes entered on the MDS “map” to PDPM payment components. https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/patient-driven-model
An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in Fiscal Year (FY) 2026 and includes other useful resources available to providers. From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/faqs
Memo # Admin Info-25-11-ALL Posting Date 2025-09-12 Fiscal Year 2025 Summary Memorandum Summary The Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG) remain dedicated to ensuring the health and safety of all Americans. The Fiscal Year (FY) 2026 MPD reflects this dedication, along with our ongoing …
Summary What is already known about this topic? Influenza vaccination protects against influenza and its potential complications. The Advisory Committee on Immunization Practices makes influenza vaccination recommendations for each influenza season. What is added by this report? Information for the 2025–26 influenza season includes the updated vaccine composition, approval of …
