The importance of accurate coding of section GG, Functional Abilities, continues to grow as this data is used in care planning, Quality Measures, reimbursement, and regulatory compliance. The Centers for Medicare & Medicaid Services (CMS) released the final RAI User’s Manual, v1.20.1, in late August. It includes several clarifications for …
The Patient-Driven Payment Model (PDPM) 5-Character HIPPS code can be difficult to decipher. The PDPM HIPPS Code At-a-Glance tool will help nurse assessment coordinators quickly identify the key elements impacting Medicare reimbursement. This AAPACN resource is copyright protected. AAPACN individual members may download or print one copy for use within …
The MDS Data Specifications V3.10.2 (FINAL) are now available for download. This version reflects changes finalized in the FY 2026 SNF PPS final rule (90 FR 37310). Note that there are some minor changes since DRAFT 3 (below) was posted, including a new edit -4096. Please reference the Item Change and Edit Change …
In this LTC NAC Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist for AAPACN, discuss a new way for NACs to test their knowledge – the NAC Competency Evaluation. Additional Resources:
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MDS section R (Health-Related Social Needs) is officially no more. The big news for nurse assessment coordinators (NACs) in the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Final Rule for Fiscal Year (FY) 2026, released on July 31, 2025, and published on Aug. 4, is …
The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for the fiscal year (FY) 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS), addressing several key recommendations submitted by the American Association of Post-Acute Care Nursing (AAPACN). AAPACN provided detailed input on rate setting, ICD-10 code mapping, …
Since the implementation of the Patient-Driven Payment Model (PDPM), nursing facilities have had to take a more nuanced approach to how a resident’s needs are assessed and documented. As discussed in part 1 of this series, Medicare payment, as well as Medicaid payment in many states, is determined using PDPM …
The Centers for Medicare & Medicaid Services (CMS) recently announced the August 2025 Performance Score Reports for the fiscal year (FY) 2026 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are available for download via the Internet Quality Improvement and Evaluation System (iQIES). Access this report to review the performance information …
The Centers for Medicare & Medicaid Services (CMS) convened a Technical Expert Panel (TEP) on May 12 and 14, 2025, to obtain input on potential cross-setting updates to the Falls with Major Injury (FMI) measure. The TEP was held in response to concerns regarding potential underreporting on the current measure …
From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/confidential-feedback-reporting-review-and-corrections From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/scoring-methodology-payment-adjustment
