Improving Resident Care Through Effective Communication: The MDS 3.0 Scripted Interview

Updated May 5, 2026 Effective communication with residents in skilled nursing facilities (SNFs) is essential to understand their needs and preferences. In accordance with Appendix D of the Long-Term Care Facility Resident Assessment 3.0 User’s Manual (RAI User’s Manual) and the principles outlined in the Center for Medicare & Medicaid …

Stop Assuming and Start Assessing: How to Improve Critical Thinking in Nurses

Identifying and dealing with a suspected change in condition before a clinical crisis occurs is a critical aspect of caring for fragile, elderly nursing home residents. To achieve that goal, nursing staff must think critically about the residents in their care. The director of nursing services (DNS) can take steps …

Early Lessons: How Onboarding and Retention Specialists May Boost Staffing 

Over the last decade, a strong orientation and onboarding process has been linked to higher levels of knowledge, critical thinking skills, and job satisfaction among nursing staff—leading to lower staff turnover and improved retention. Conversely, an inadequate onboarding process can quickly turn new hires into former employees, forcing providers to …

PPS Discharge Assessment: 10 Steps to a More Complete, Accurate MDS

The Medicare Part A PPS Discharge assessment (i.e., the NPE item set) is now a crucial assessment with far-reaching impacts for skilled nursing facilities (SNFs) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP), the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, the Five-Star Quality Rating System, and …

I0020B: Avoid Common Sources of Confusion When Coding This MDS Item

The ICD-10-CM code captured in MDS item I0020B (ICD-10 Code/Primary Medical Condition Category) is the foundation of case-mix classification for the Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) payment components in the Patient-Driven Payment Model (PDPM) under the fee-for-service Medicare Part A skilled nursing facility prospective payment …

Updates to ICD-10-CM Coding Guidelines: Key Revisions and Their Implications

The International Classification of Diseases, Clinical Modification, 10th revision (ICD-10-CM), coding system is an essential tool needed to document and bill accurately for healthcare services in the long-term care (LTC) setting. Annual updates to both the coding guidelines and the actual codes reflect updated clinical practices, advancements in medical understanding, …

Nursing Orientation and Onboarding Done Right Can Boost Retention

Working as a nurse in a nursing home can be overwhelming, especially if the director of nursing services (DNS) and executive leadership expect nurses to learn on the job and fail to set up a comprehensive program that includes adequate orientation (short-term training and support) and onboarding (longer-term training and …