Hospital readmissions remain one of the most persistent challenges for long-term post-acute care (LTPAC) facilities. National data shows that roughly 13% to 14% of all hospitalized patients are readmitted within 30 days (Burke et al., 2022). But the rate among nursing home residents can climb significantly to 20% to 25% …
F656, Comprehensive Care Plans, is one of the most commonly cited F-tags during survey in nursing homes; however, with intentional processes in place, these citations are largely preventable. A proactive approach to care planning ensures that each resident’s plan is accurate, up to date, and reflective of their individual needs …
An assessor does not need perfect eyesight to see that vision plays a significant role in the quality of life of residents in long-term care. Accurately evaluating vision, and how it is coded at B1000, helps all staff understand how visual impairments may impact the resident’s daily life, mood, and …
Written by Brenda Schumacher, Staff Writer, AAPACN When a resident discharges before the Admission assessment is complete, nurse assessment coordinators (NACs) must make decisions that directly affect compliance, survey readiness, and resident care planning. Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist for AAPACN, explains that the first …
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 …
The beginning of a new school year has a particular energy—fresh notebooks, sharpened pencils, and a renewed focus on learning the essentials. In the long-term and post-acute care (LTPAC) world, we can take a cue from that “back to school” spirit. No matter how long we have been in the …
The Centers for Medicare & Medicaid Services (CMS) ultimately chose not to implement MDS section R (Health-Related Social Needs) on Oct. 1, 2025. Each skilled nursing facility (SNF) will have to make an individual decision whether to do off-MDS data collection of the HRSN data that would have been captured …
MDS section R (Health-Related Social Needs) did not go into effect on Oct. 1, 2025. The Centers for Medicare & Medicaid Services (CMS) followed through on its proposal and eliminated—prior to implementation—items R0310 (Living Situation), R03020A (Within the Past 12 Months, You Worried That Your Food Would Run Out Before …
The Long-Term Care Resident Assessment Instrument (RAI) 3.0 User’s Manual (RAI User’s Manual) version 1.20.1, effective Oct. 1, 2025, will bring major changes to section O of the MDS 3.0. The most significant update introduces item O0390, Therapy Services, replacing most of the current O0400 (Therapies) and removing O0420 (Distinct …
