The expected October Care Compare refresh was delayed during the government shutdown, but it was finally refreshed on Nov. 30, 2025. The Centers for Medicare & Medicaid Services (CMS) outlined key updates also included with this refresh: Note: The Medicare Spending Per Beneficiary claims-based measure is based on data from Quarter …
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 …
In long-term care, maintaining a resident’s functional independence is both a clinical and regulatory priority. The Minimum Data Set (MDS) 3.0 Quality Measure (QM), “Percent of Residents Whose Need for Help with Activities of Daily Living (ADLs) Has Increased” reflects one of the most essential goals in skilled nursing: to …
The Centers for Medicare & Medicaid Services (CMS) has released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held on May 12 and 14, 2025. The report provides an overview of the measure, …
Implementation Date 2026-01-05 CR # 14250 Publication # 100-04 Transmittal Year 2025 Downloads
With so many Quality Measures originating from three different payment initiative programs, it’s a lot to keep track of. AAPACN’s At-a-Glance QM, QRP, and VBP tool organizes all of the measures for you. This tool has been updated with the MDS 3.0 Quality Measures User’s Manual Version 17.0 (January 2025), the Five-Star …
AHRQ’s new Toolkit for Improving Skin Care and MDRO Prevention in Long-Term Care strengthens infection prevention in nursing homes, addressing the unique needs of residents and the care environment they live in. The toolkit outlines four evidence-based strategies to reduce infection risks in residents and provides tools and resources to support the …
Nearly All Skilled Nursing Services Provided by Pinnacle Multicare Nursing and Rehabilitation Center Did Not Meet Medicare Payment Requirements Issued on 11/14/2025 | Posted on 11/18/2025 | Report number: A-02-22-01017 Report Materials Why OIG Did This Audit What OIG Found What OIG Recommends We made three recommendations to Pinnacle, including that it refund to the Medicare …
This communication pertains to the Fiscal Year (FY) 2028 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program performance standards for the Number of Hospitalizations per 1,000 Long Stay Resident Days (Long Stay Hospitalization) measure which the Centers for Medicare & Medicaid Services (CMS) published in the FY 2026 SNF Prospective Payment …
This document shows how to upload assessments, create and manage assessments, complete change requests, and review Final Validation Reports (FVR) in iQIES. Nov 18, 2025 CMS iQIES Assessment Management for Assessment Submitter v2.2 From https://qtso.cms.gov/software/iqies/reference-manuals
