MDS 3.0 and the RAI Process
The MDS 3.0 and the RAI (Resident Assessment Instrument) is a comprehensive nurse assessment and care planning process used by the long-term and post-acute care field as a requirement for reimbursement under Medicare and Medicaid. AAPACN nurse experts help you stay up to date on changes to the MDS with breaking news, articles, and practical tools.
- CMS Nursing Home Data Sets UpdatedCOVID-19 Vaccination Rates – State and National Averages State and National averages for facility resident and healthcare personnel COVID-19 vaccination rates. Data are presented as one row per state or territory plus a row for …
- MDS Data Specifications V3.02.0 (DRAFT) AvailableThe MDS Data Specifications V3.02.0 (DRAFT) are now available for download under the Downloads section at the bottom of this webpage. The Section GG goal items will be removed, and three new items will be added: O0350 …
- Q&A: How do you set section GG discharge goals for a resident who is also receiving care for end of life? Question: How do you set section GG discharge goals for a resident who is also receiving care for end of life? Answer from Jeff Taylor: Goals can include maintenance or even managed decline. This AAPACN …
- Q&A: What is the consequence of a late MDS submission?Question: What is the consequence of a late MDS submission? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: There is no impact on Medicare payment if an MDS is submitted late. The facility could …
- Interrupted Stays: Five Takeaways To RememberThe interrupted-stay policy in the Patient-Driven Payment Model (PDPM) of the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) governs when multiple SNF stays are combined into a single interrupted stay (i.e., …
- iQIES Essentials for the Nurse Assessment CoordinatorIn the ever-evolving realm of healthcare data management, the transition of the Minimum Data Set (MDS) submission process to the Internet Quality Improvement and Evaluation System (iQIES) in April 2023 marked a significant milestone for …
- MDS 3.0 Final Validation Reports Quick Facts and ResourcesNurse assessment coordinators (NACs) are responsible for the coordination and completion of the MDS assessments; however, to ensure these assessments are accepted without error into the National Submissions Database, the Final Validation Report must also …
- RAI Manual Appendix B UpdateThe February update of Appendix B to the RAI 3.0 User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, and CMS locations and contacts. To ensure accurate formatting, use a current version of …
- Deep Tissue Injury: Section M Assessment and Coding TipsPressure-related deep tissue injury (DTI) coded in M0300G (Unstageable Pressure Injuries Related to Deep Tissue Injury) does not play a role in Medicare payment under the Patient-Driven Payment Model (PDPM). While DTI is an unstageable …
- Q&A: An audit found a missed Significant Change in Status Assessment (SCSA) after a hospice election. The resident is still in the facility. Is an SCSA still needed?Question: An audit found a missed Significant Change in Status Assessment (SCSA) after a hospice election. The resident is still in the facility. Is an SCSA still needed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, …
- Q&A: When a resident is admitted to the nursing facility for hospice services, do we have to use the admitting hospice diagnosis as the primary diagnosis?Question: When a resident is admitted to the nursing facility for hospice services, do we have to use the admitting hospice diagnosis as the primary diagnosis? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, …
- FY 2026 (Calendar Year 2024) SNF QRP Program Data Collection & Final Submission Deadlines REVISEDUpdated February 2024 The FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal …
- SNF QRP Listening Session Summary ReportSUMMARY REPORT PUBLISHED: SNF QRP Listening Session: Possible Expansion of MDS Data Submission to All SNF Patients Regardless of Payer CMS has published a summary report on the virtual SNF QRP Listening Session that was …
- iQIES Resources Site UpdatediQIES is the Internet Quality Improvement and Evaluation System, which is the system that the MDS submissions system is being transferred to. The QIES Technical Support Office maintains a website with iQIES reference materials, including …
- Q&A: If a resident on a Medicare Part A stay leaves the facility on a leave of absence (LOA) with the family and is back in the facility after two midnights, are any assessments required?Question: If a resident on a Medicare Part A stay leaves the facility on a leave of absence (LOA) with the family and is back in the facility after two midnights, are any assessments required? …
- Q&A: For the “Admission Performance” in section GG, if therapy is started on day two and the resident’s performance improved on day two, do we still have to code their baseline usual functions from day one data?Question: I have a question about coding Functional Abilities in section GG for self-care and mobility on admission for a Medicare A resident. When the RAI User’s Manual states this is to reflect the resident’s …
- Getting Care Area Assessments Back on TrackIn this podcast, 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, curriculum development specialist for AAPACN, discuss the common challenges nurse assessment coordinators …
- Respiratory Outbreak! How to Protect the MDS and Capture Key Assessment DataWith the influenza season in full swing plus the ongoing peaks and valleys of COVID-19 and respiratory syncytial virus (RSV) outbreaks across the United States, nurse assessment coordinators (NACs) should take steps both to protect …
- Q&A: If a resident is discharged to the hospital on day 14, does an Admission MDS need to be completed?Question: If a resident is discharged to the hospital on day 14, does an Admission MDS need to be completed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Per the Federal rules …
- Q&A: When does the Pain Assessment interview need to be conducted? Question: When does the Pain Assessment interview need to be conducted? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: The questions must be asked during the 7-day observation period, but the resident must answer …
- Q&A: Is there a standard letter or beneficiary notice that we have to use when a resident exhausts Medicare benefits?Question: Is there a standard letter or beneficiary notice that we have to use when a resident exhausts Medicare benefits? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: No, there isn’t a required …
- Partner Podcast: MDS…The Hidden Piece of Your Facility’s PuzzleIn this podcast, Kim Hicks, vice president of business development for AAPACN, and Jessica Stucin, RN, BSN, LNHA, RAC-CT, RAC-CTA, assistant director of education for MDS Consultants, LLC, an AAPACN Diamond Business Partner, discuss some …
- TIP: CMS Released the Draft MDS Item Sets for Oct. 1, 2024The Centers for Medicare & Medicaid Services (CMS) recently posted the draft Minimum Data Set (MDS) 3.0 Item Sets, version (v)1.19.1 and Item Matrix in the Downloads section on the Minimum Data Set (MDS) 3.0 …
- Anticonvulsants on the MDS: What to Expect in October 2024The Centers for Medicare & Medicaid Services (CMS) announced on the Dec. 7 Skilling Nursing Facilities/Long-Term Care Open Door Forum that the drug classification of anticonvulsants will be added to the Minimum Data Set (MDS) …
- FY 2025 Draft MDS 3.0 Item Sets version 1.19.1 Effective Oct. 1, 2024The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.19.1 and Item Matrix are now available. The MDS Item Sets v1.19.1 will be effective beginning October 01, 2024. From https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual
- CMS iQIES MDS Error Message Reference GuideThis user guide addresses Minimum Data Set (MDS) error messages and troubleshooting. CMS iQIES MDS Error Message Reference Guide v1.1 (posted 01/08/2024) From https://qtso.cms.gov/providers/nursing-home-mdsswing-bed-providers/reference-manuals
- Speak Up! Improve Communication to Bolster the MDS ProcessEffective communication is the glue holding the MDS process together, says Stacy Grondel, BSN, RN, RAC-MT, CMAC, QCP. director of reimbursement operations at QRM in Addison, TX. “The nurse assessment coordinator (NAC) who is a …
- Q&A: A resident was admitted to the hospital while on a leave of absence (LOA). He had a qualifying hospital stay and was readmitted to our SNF on Medicare Part A. What date do I use for the OBRA Discharge Assessment?Question: A resident was admitted to the hospital while on a leave of absence (LOA). He had a qualifying hospital stay and was readmitted to our SNF on Medicare Part A. What date do I …
- Q&A: A resident was admitted skilled, under managed Medicare, on 11/28. He transferred from managed care to traditional Medicare Part A on 12/29. Are we required to complete another 5-Day for the Medicare stay starting 12/29?Question: A resident was admitted skilled, under managed Medicare, on 11/28. He transferred from managed care to traditional Medicare Part A, on 12/29. Are we required to complete another 5-Day for the Medicare stay starting …
- Q&A: Can staff interviews for the PPS discharge assessment be performed after the ARD date or do all the interviews need to be “dashed” since they were not performed?Question: We have a resident on traditional Medicare Part A who was issued a NOMNC on 12/22, with a last covered day of 12/24. Can staff interviews for the PPS discharge assessment be performed after …
- Dec. 7, 2023 SNF/LTC Open Door Forum Transcript and Q&A DocumentNote: The audio file listed in the title may not be available. Thursday, December 7, 2023: Transcript, Q&A, Agenda and Audio File- Skilled Nursing Facilities/Long Term Care Open Door Forum (ZIP) From https://www.cms.gov/training-education/open-door-forums/about/odf-podcast-and-transcripts
- MDS 3.0 Quality Measures (QM) User’s Manual V 16.0 Effective Oct. 1, 2023 REVISEDIn response to provider questions related to the MDS 3.0 QM User’s Manual posted on September 20, 2023, an updated MDS 3.0 QM User’s Manual v16.0, effective 10-1-2023, is now posted. Additionally, the updated .zip file titled MDS …
- MDS Daily Startup for the NAC Backup ToolWhen the nurse assessment coordinator (NAC) goes on vacation, there’s a lot to keep track of while they are out of office. The MDS Daily Startup for the NAC Backup tool is intended to help …
- Keep Significant Corrections Simple: Tips for NACsThe nurse assessment coordinator (NAC) role is a complex one that requires managing numerous deadlines, compliance regulations, and the involvement of the interdisciplinary team (IDT) in the Minimum Data Set (MDS) assessment. The job can …
- Coding Hallucinations and Delusions on the MDS: Keys to Accuracy and Better Care PlansMDS items E0100A (Hallucinations) and E0100B (Delusions) are qualifiers for the Behavioral Symptoms and Cognitive Performance category in the nursing component of the Patient-Driven Payment Model (PDPM). Even more importantly, these conditions that form the …
- Pharmacist Panel Discussion – Perspectives on Section N, Understanding Medication Indication of Use Versus DiagnosisIn this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, Marti Wdowicki, PharmD, director of clinical operations for PharMerica, and Jeff Herr, PharmD, manager of clinical operations in the …
- Q&A: A resident was unable to complete the PHQ-2 interview, therefore my software did not allow us to complete the staff interview. Is this correct? Question: A resident was unable to complete the PHQ-2 interview, therefore my software did not allow us to complete the staff interview. Is this correct? D0100 was coded as “Yes”, interview should be conducted. D0150 …
- Q&A: While most facilities require two-person assist with stand lift transfers, is there any guidance in the RAI User’s Manual regarding when a stand lift is used with one staff assist?Question: While most facilities require two-person assist with stand lift transfers, I have found that not all do. The RAI User’s Manual only addresses a stand lift transfer with two helpers as dependent. Is there …
- Q&A: A resident went on a leave of absence (LOA) home for a few days and expired in his home. Would a discharge assessment be required?Question: A resident went on a leave of absence (LOA) home for a few days and expired in his home. Would a discharge assessment be required? Answer from Jeff Taylor: Since this isn’t a discharge, …
- LTC Facilities Should Track MDS Assessment and Software Issues for Quality AssuranceSince the implementation of the RAI User’s Manual version 1.18.11 on Oct. 1, 2023, several long-term care nursing facilities have experienced electronic health record (EHR) software issues as well as complications with the MDS 3.0 …
- Care Planning: A Team EventA surveyor investigating a resident with multiple falls approaches a nurse and asks why the care plan wasn’t updated with the latest fall prevention interventions. The nurse tells the surveyor that she doesn’t have anything …
- Common Barriers and Risks Associated with Care Planning and How the DNS Can Support the Nursing TeamIn this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, curriculum development specialist for AAPACN, discuss common barriers in the care …
- Fall 2023 Unified Regulatory Agenda for CMS and Other HHS AgenciesSome items of potential interest: HHS/FDA Proposed Rule Stage Medical Devices; General and Plastic Surgery Devices; Classification of Certain Solid Wound Dressings, Wound Dressings Formulated as a Gel, Cream, or Ointment, and Liquid Wound Washes …
- CMS: Upcoming SNF QRP Measure RemovalsThe Centers for Medicare & Medicaid Services (CMS) is alerting Skilled Nursing Facility (SNF) providers of upcoming measure removals from the SNF Quality Reporting Program (QRP). The following quality measures are planned for removal from …
- TIP: CMS Announced Updated MDS Specifications FileThe Centers for Medicare & Medicaid Services (CMS) recently released the MDS Data Specifications V3.01.1 (FINAL) Errata, which updated the previous MDS Data Specifications file. CMS addressed six additional issues that will be implemented on …
- Sections K and O Assessment PeriodsEffective Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) added columns for MDS items K0520 and O0110 to assess services provided “on admission” and “at discharge.” This change results in different assessment …
- Q&A: A new wound specialist disagrees with a wound that was previously coded as a Stage 3 pressure ulcer by the physical therapist and physician. Should I do a modification of the MDS to remove the Stage 3 pressure ulcer? Question: A wound certified physical therapist staged a sore as a Stage 3 pressure ulcer. This was also verified with the physician and coded on the last MDS assessment. We have a new wound specialist …
- Q&A: What is the best practice for capturing the three days of discharge performance for section GG for an unplanned or emergent transfer?Question: What is the best practice for capturing the three days of discharge performance for section GG for an unplanned or emergent transfer? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: I …
- Q&A: For a long-term patient readmitted from the hospital, what are the clinical conditions that would require a Significant Change in Status Assessment on readmission? Question: For a long-term patient readmitted from the hospital, what are the clinical conditions that would require a Significant Change in Status Assessment on readmission? Also, can I combine this assessment with a Medicare 5-Day …
- Errata V3.01.4 for MDS Data Specifications V3.01.1 (FINAL), FY2024 ICD-10 Codes for Item I0020B, CAT Specifications V1.06.0 Test Files, and OSA Data Specifications V3.01.0 (FINAL)Errata V3.01.4 for MDS Data Specifications V3.01.1 (FINAL) is now available for download. Six issues were added to the errata. As a result, four edits were revised, and there were several mapping changes of items …
- iQIES User Roles Matrix Job AidThis job aid outlines the user roles and privileges in iQIES. All users must have a role in iQIES. Version 4.1 is now available at https://qtso.cms.gov/system/files/qtso/iQIES%20User%20Roles%20Matrix%20Job%20Aid%20v4.1%20FINAL%2011.14.2023_0.pdf
- Schizophrenia Audit Takeaways for NACs and the IDTIn the Jan. 18, 2023, Quality, Safety, and Oversight (QSO) memo QSO-23-05-NH, the Centers for Medicare & Medicaid Services (CMS) announced plans to conduct offsite audits to assess whether nursing homes appropriately assess, document, and …
- Q&A: What is the definition for intermittent oxygen therapy? Question: What is the definition for intermittent oxygen therapy? Answer from Jeff Taylor: Item O0110C3, Intermittent oxygen therapy, is based on the amount of continuous time administered, not ordered. Greater than 0 but less than …
- Q&A: If a resident is admitted to the hospital “for observation” and returns within 24 hours, is an OBRA Discharge assessment required? Question: If a resident is admitted to the hospital “for observation” and returns within 24 hours, is an OBRA Discharge assessment required? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: I …
- Q&A: What is the section GG performance period for a Medicare 5-Day and what is the performance period for an OBRA Admission assessment?Question: What is the section GG performance period for a Medicare 5-Day and what is the performance period for an OBRA Admission assessment? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: It would …
- The Basics of Significant Change and What Has ChangedIn this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss some of the common concerns …
- TIP: CMS Addressed Section GG on Unplanned DischargesThe Centers for Medicare & Medicaid Services (CMS) recently released a Questions and Answers document from the Oct. 12, 2023, Skilled Nursing Facility/Long-Term Care Open Door Forum. A question was asked regarding if it was …
- PDPM Grouper UpdateThe “PDPM Grouper JAR Package V2.2001.zip” is now available. This V2.2001 release is an update to adjust the OBRA logic for target dates on or after October 1, 2023. The logic for standalone OBRA assessments will …
- OBRA Scheduling Tools for Calendar Year 2024AAPACN offers two great tools to assist nurse assessment coordinators (NACs) in scheduling OBRA assessments. Be prepared for 2024 with these two tools that are free to members: This AAPACN resource is copyright protected. AAPACN …
- The Physician and “I”: Part 1 on Diagnoses and MDS Coding RelationshipsWritten by Michelle Olear, RHIT, BSN Director of Documentation Analysis and Professional Coding Services Minimum Data Set Consultants, LLC The physician’s role in the skilled nursing facility (SNF) is essential to delivering skilled, quality care for skilled …
- Patient Health Questionnaire Completion DeterminationEffective Oct. 1, 2023, the full Patient Health Questionnaire (PHQ)-9 will only be completed if the resident responds to the gateway PHQ-2 questions in a certain way. The Patient Health Questionnaire Completion Determination chart clarifies …
- Putting the Significant Change in Status Assessment Criteria into Clinical PracticeThe Significant Change in Status Assessment (SCSA) has been a federal requirement since the inception of the Resident Assessment Instrument (RAI) process that resulted from the Omnibus Budget Reconciliation Act of 1987. The specifications of …
- Stop and Read: Skilled Documentation Audit and Education Lessons for the NACSkilled nursing facilities (SNFs) are increasingly subject to skilled medical review audits from both fee-for-service Medicare (e.g., the SNF Five-Claim Probe and Educate initiative) and individual Medicare Advantage plans. Audit success ultimately hinges on documentation …
- Q&A: If a resident discharges from a Medicare Part A stay, but is remaining in the facility, how do we answer A2121, provision of reconciled medication list to subsequent provider? Question: If a resident discharges from a Medicare Part A stay, but is remaining in the facility, how do we answer A2121, provision of reconciled medication list to subsequent provider? Answer from Jeff Taylor: See …
- Q&A: Do we have to mark “no” on indication for use in section N just because the nurse missed updating the order with the indication even though the medical record from the hospital clearly states the indication for use?Question: Do we have to mark “no” on indication for use in section N just because the nurse missed updating the order with the indication even though the medical record from the hospital clearly states …
- Q&A: If a resident discharges home with skilled home health, how do we code the discharge status and do we provide the reconciled medication list to the home health provider or to the resident?Question: If a resident discharges home with skilled home health, how do we code the discharge status and do we provide the reconciled medication list to the home health provider or to the resident? Answer …
- TIP: CMS Released Updated Errata DocumentThe Centers for Medicare & Medicaid Services (CMS) recently released an update to the RAI User’s Manual, MDS 3.0 RAI User’s Manual (v1.18.11R) Errata (v2). The update, issued on Oct. 20, 2023, provided additional clarification …
- MDS 3.0 RAI Manual: CMS Adds a Second Errata Effective Oct. 1, 2023The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.v2.October.20.2023” is now available. The errata document contains revisions to the MDS 3.0 RAI Manual version (v)1.18.11R to provide clarity and additional guidance in Section D and Chapter 6 to support item D0100, …
- MDS Data Collection for the NAC ToolDo you have an organized approach to collect MDS data during the 7- and 14-day look-back periods? AAPACN’s MDS Data Collection for the NAC tool provides an organized approach to gathering supporting data from the …
- UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v6The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available. Changes in this version (listed below) align the item sets with the Errata V3.01.3 for MDS Data Specifications …
- The Significant Change in Status Assessment: Key Issues Related to v1.18.11 and BeyondThe Significant Change in Status Assessment (SCSA) was not a major focus of the revisions in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11. However, some of the v1.18.11 MDS coding changes …
- TIP: CMS Issued Corrections to the FY 2024 Final Rule and MDS SpecificationsThe Centers for Medicare & Medicaid Services (CMS) released two important correction notices recently. NOTE: CMS clarified on the Oct. 12, 2023, Skilled Nursing Facility/Long-Term Care Open Door Forum, that assessments that did not allow …
- OSA or PDPM? A State-Level DecisionAs of Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) has retired the A0300 Optional State Assessment (OSA) from the federally required MDS 3.0 v1.18.11 that is submitted by nursing facilities. The …
- Q&A: Part of the new coding instructions for section O “while a resident,” states to include services performed or received since admission OR in the last 14 days. Does this mean it includes services from before entry into the facility and within the last 14 days?Question: Part of the new coding instructions for section O “while a resident,” states to include services performed or received since admission OR in the last 14 days. Does this mean it includes services from …
- Relieving the Pressure of Coding Reopened Pressure UlcersIn the updated Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, v1.18.11, the Centers for Medicare & Medicaid Services (CMS) added several clarifications to help ease the pressure that nurse assessment coordinators (NACs) …
- Section M Pressure Ulcer/Injury: Algorithms for Present on AdmissionProperly coding pressure ulcers or injuries can be tricky. AAPACN’s Section M Pressure Ulcer/Injury: Algorithms for Present on Admission helps guide the assessor on whether to code present on admission in variety of situations. …
- CMS iQIES Reports User Manual v2.5This user manual provides information for CMS, Providers, Vendors, Accrediting Organizations, Contractors, and State Agencies to effectively perform Reports functions and the processes necessary to request, view, download, and save reports in iQIES. Also see …
- MDS v1.18.11 Is Here: How to Double-Check Efficiency for Long-Term SuccessNow that the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are in play, there are still steps that nurse assessment coordinators can take to ensure …
- Q&A: We completed a combined 5-Day/Admission assessment on day 15 of the stay. After submission, our system shows we are out of compliance for CAAs/MDS based on the signature/completion date. Do we need to bill default for the one day we were out of compliance?Question: We completed a combined 5-Day/Admission assessment on day 15 of the stay. After submission, our system shows we are out of compliance for CAAs/MDS based on the signature/completion date. Do we need to bill …
- What Changed from the Draft RAI User’s Manual to the Final?In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, AAPACN curriculum development specialist, discuss what changed from the draft RAI …
- 4 Essential MDS Changes Documents NACs May Have MissedThe Centers for Medicare & Medicaid Services (CMS) recently released the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual version 1.18.11, and also a document outlining the draft-to-final changes and updated item sets …
- CMS iQIES Notice of Upcoming SNF QRP Measure Removals The Centers for Medicare & Medicaid Services (CMS) is alerting Skilled Nursing Facility (SNF) providers of upcoming measure removals from the SNF Quality Reporting Program (QRP). The following quality measures are planned for removal from …
- Implement the New and Revised Resident Interviews on the MDS: How to Be Ready for Oct. 1Most of the changes in the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are resident-driven, says Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, a curriculum …
- Q&A: A resident has a catheter for urinary retention. Would this be coded as neurogenic bladder or obstructive uropathy?Question: A resident has a catheter for urinary retention. Would this be coded as neurogenic bladder or obstructive uropathy? Answer from Jeff Taylor:Neither. Retention is a symptom used when the physician hasn’t determined the cause …
- Q&A: Can I code isolation in section O for Extended Spectrum Beta-Lactamase (ESBL) of urine with contact isolation?Question: Can I code isolation in section O for Extended Spectrum Beta-Lactamase (ESBL) of urine with contact isolation? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: The RAI User’s Manual prohibits coding isolation …
- Q&A: For OBRA assessments starting Oct. 1, 2023, will section O therapies data elements be collected or is this item being removed completely?Question: For OBRA assessments starting Oct. 1, 2023, will section O therapies data elements be collected or is this item being removed completely? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Therapy minutes/days …
- CMS QSO Memo: Updates to Nursing Home Care Compare Staffing and Quality MeasuresMemo # QSO-23-21-NH Posting Date 2023-09-20 Fiscal Year 2023 Title Memorandum Summary • Adjustment to Staffing and Quality Measures: CMS will update the staffing level case-mix adjustment methodology and replace some of the Quality Measures …
- FY 2024 ICD-10-CM Codes and Coding Guidelines Effective Oct. 1, 2023: Errata and Updated Files2024 release of ICD-10-CM October 1, 2023 release of ICD-10-CM The FY2024 ICD-10-CM codes are to be used from October 1, 2023 through September 30, 2024. Note: This replaces the FY 2023 – April 1, …
- FY 2024 PDPM ICD-10-CM Mappings File UpdatedFrom https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/patient-driven-model
- SNF QRP FAQs for FY 2024An 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 …
- NACs Like a Reasonable Challenge: 2023 AAPACN NAC Work Study and Salary ReportOver the last few years, nurse assessment coordinators (NACs) are being hired with less long-term care experience, being paid more, and facing a multitude of challenges including stress and burnout, staffing shortages, and increased workloads. …
- Q&A: Can the MDS 3.0 scripted interviews be coded directly on the MDS or is additional separate documentation required? Question: Can the MDS 3.0 scripted interviews be coded directly on the MDS or is additional separate documentation required? Answer from Kim Steele RN, WCC, RAC-CT, RAC-CTA: You are not required to document the answers …
- Q&A: How do you code GG0130E, Shower/bathe self, when the resident did not have a bath scheduled during the three-day assessment period? Question: How do you code GG0130E, Shower/bathe self, when the resident did not have a bath scheduled during the three-day assessment period? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: If there was …
- Nurse Assessment Coordinator FTE Calculator Tool FY 2024AAPACN has re-released the Nurse Assessment Coordinator (NAC) FTE Calculator for SNF leaders to estimate the time needed to complete assessments as well as project how many hours the NAC needs for meetings and other …
- TIP: CMS Clarified Section GG Documentation Requirement In late August, the Centers for Medicare & Medicaid Services (CMS) released the post-event question and answer (Q&A) document from the SNF MDS 3.0 RAI v1.18.11 Guidance Training Program available in the Downloads section of …
- Most Frequently Asked Questions on Oct. 1 MDS Updates for Section GGIn this podcast, 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, curriculum development specialist with AAPACN, discuss the answers to the most frequently …
- FY 2025 (Calendar Year 2023) SNF QRP APU Table for the MDS Data Submission Threshold–RevisedThe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2025 …
- FY 2026 (Calendar 2024) SNF QRP Data Collection and Final Submission Deadlineshe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2026 …
- FY 2025 (Calendar 2023) SNF QRP Data Collection and Final Submission Deadlines — RevisedThe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2025 …
- Section GG Q&A from AAPACN’s 2023 Live Virtual Conference – MDS Updates Prep and PolishOn Aug. 23, 2023, AAPACN hosted the AAPACN 2023 Live Virtual Conference – MDS Updates Prep and Polish event, with educational sessions designed to help implement the MDS changes effective Oct. 1. This one-day event …