In this podcast, Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist with AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss some of the most pressing questions about …
Question: Can a winged versus a concave mattress be considered a restraint if it fits the definition? Can a tilt and space wheelchair be considered a restraint? It is being explained to me that it …
Question: If a resident on a Medicare Part A stay expires the same day as admission, is it a billable day? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC:Yes, if a Medicare A …
Question: A long-term resident has had a feeding tube for more than 10 years. He exhausted his Medicare Part A benefits years ago. He recently experienced recurrent aspiration and had an extended hospitalization with a …
The end of the COVID-19 public health emergency (PHE) on May 11, 2023, has marked the end of many waivers, including the 3-day qualifying hospital stay and benefit period waivers. For many new nurse assessment …
Restorative nursing can impact fee-for-service Medicare Part A payment in the Behavioral Symptoms and Cognitive Performance category and the Reduced Physical Function category of the nursing component in the Patient-Driven Payment Model (PDPM), says Carol …
The American Association of Post-Acute Care Nursing (AAPACN) team collaborated with its members and post-acute care experts to advocate for skilled nursing facility (SNF) professionals by making comments on the fiscal year (FY) 2024 SNF …
This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP). It is a one-stop shop containing a multitude of reference materials that are provided to the surveyors going …
The MDS Data Specifications V3.01.1 (FINAL) and the OSA Data Specifications V3.01.0 (FINAL) are now available for download. These specifications will go into effect on October 1, 2023. There are both item and edit updates in …
The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available. The NP, NPE, and SD Item Sets have been replaced with revised versions; the remaining item sets …
Table of Contents 1. Launch/Help Questions 1.1 Will iQIES have the same spec version at launch as QIES (version 3.00.1 including Errata Version3.00.8)? _____________________________________________ 1.2 How do I register for iQIES? 1.3 Whom can I …
Five-Star, NHQI, SNF QRP, SNF VBP, PBJ data Data sets: Provider Information General information on currently active nursing homes, including number of certified beds, quality measure scores, staffing and other information used in the Five-Star …
The June 2023 Quarterly Confidential Feedback Reports for the fiscal year (FY) 2024 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via the Internet Quality Improvement and Evaluation System (iQIES). …
CS1963652 Resolved Reports ALL iQIES Users are currently experiencing issues generating reports in HTML or downloading them in CSV/PDF format, presenting no data or limited data to users. Team is investigating and resolving actively 05/31/2023 …
Question: What staff member in a SNF can complete data collection and entry for section GG items? Answer from Melissa Brown, OTR/L, RAC-CT, CDP, CSRS: I think what may be causing confusion here is the …
Question: If a Medicare Part A resident goes on a therapeutic leave of absence (LOA) of four days for a funeral, what MDS assessments/records, if any, are required? Answer from Jeff Taylor: No additional MDS …
Question: Can a comprehensive MDS be completed before day 14, such as on day 9 or 10, as long as it is completed by day 14? For example, we have a 5-Day combined with an …
In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist for AAPACN, discuss the upcoming …
Nurse assessment coordinators can use AAPACN’s When MDS 3.0 Quality Measure Triggers Start and Stop quick guide to determine when a resident will start and stop triggering an MDS 3.0 Quality Measure (QM) based on …
In April 2023, the Centers for Medicare & Medicaid Services (CMS) released an updated Advanced Beneficiary Notice (ABN) form, CMS-R-131. This ABN form is used when Medicare Part B services end and a beneficiary notice …
This Oct. 1, 2023, MDS 3.0 item O0100 (Special Treatments, Procedures, and Programs) will be retired and replaced with O0110 (Special Treatments, Procedures, and Programs) as part of the transition to the v1.18.11 MDS item …
The tables list the Section S items that will be active on MDS 3.0 records with a target date on or after October 1, 2023. The active item on each item subset code (ISC) is …
The Centers for Medicare & Medicaid Services (CMS) recently released the draft Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual v.1.18.11. With several changes coming this October, the American Association of Post-Acute Care …
Direct links: SNF Training Program Overview SNF Understanding Changes to the MDS 3.0 RAI Manual v1.18.11 Training Webinar SNF Social Determinants of Health and New Data Elements in Section A Training Webinar SNF Section C: …
The HCP Flu Vaccination Module, which is part of the HCP component in NHSN, is used to input required NHSN data for the SNF QRP. This site provides access to the HCP Vaccination Module: Influenza …
The American Geriatrics Society (AGS) released the 2023 update to the AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults (DOI: 10.1111/jgs.18372). The AGS Beers Criteria® serves as a comprehensive list of medications …
The federal PHE for COVID-19, declared under Section 319 of the Public Health Service Act, expired at the end of the day on May 11, 2023. Learn more by reading Frequently Asked Questions: CMS Waivers, Flexibilities, …
Transmittal # R12052CP Issue Date 2023-05-18 Subject July 2023 Quarterly Update to Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement Implementation Date 2023-07-03 CR # 13192 …
UPDATED Certification and Survey Provider Enhanced Reports (CASPER) Daily Minimum Data Set (MDS) Census Reports for Nursing Homes The 1704D Daily MDS Census Detail and 1704S Daily MDS Census Summary reports in the Payroll-Based Journal …
In the 1730s, Benjamin Franklin wrote “An ounce of prevention is worth a pound of cure” to inspire the city of Philadelphia to adopt better fire prevention techniques. What he delivered to history was a …
Question: I have a resident who had a recent 3-day qualifying stay for Medicare Part A. He had exhausted all benefits in January but continued to have Medicare Part B therapy 5 days a week for …
Question: When coding section E (Behaviors), does this need to be supported by episode charting in the medical record for each behavior or does this require progress notes stating what behavior occurred? Answer from Jeff …
Question: For the Nursing component of PDPM, a resident with a diagnosis of Parkinson’s disease with a function score of 15 was calculated into the Physical Function Reduced PA1 case-mix group and not into Clinically …
The Centers for Medicare & Medicaid Services (CMS) clarified on a recent MLN Connects newsletter that skilled nursing facilities (SNFs) must continue to use the condition code DR (disaster related) on Medicare Part A claims …
Diagnosis accuracy, long a critical component of the MDS, is escalating in importance. With the recently released draft Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual version 1.18.11, which will become effective October …
Transmittal 12032 issued May 10, 2023, is being rescinded and replaced by Transmittal 12037, dated May 15, 2023, to make a minor clarification (that claims will be adjusted/denied if an improper payment is identified) and …
The Centers for Medicare & Medicaid Services (CMS) is offering a virtual training program that provides instruction on the updated guidance for the Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Resident Assessment Instrument …
HHS Fact Sheet: Telehealth Flexibilities and Resources and the COVID-19 Public Health Emergency Letter to U.S. Governors from HHS Secretary Xavier Becerra On planning for the COVID-19 PHE Fact Sheet: End of the COVID-19 Public …
Issue Date 2023-05-08 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Patient-Driven Payment Model (PDPM) Claims Processing Updates to Current Editing Transmittal 11988 issued April 21, 2023, is being rescinded and replaced by Transmittal 12023, …
Nursing Home Visitation – COVID-19 (REVISED to align with the end of the COVID-19 PHE) Memo # QSO-20-39-NH REVISED 05.08.2023 Fiscal Year 2023 Summary • CMS is committed to continuing to take critical steps to …
Infection Control Guidance Updated May 8, 2023 For healthcare personnel, see Isolation and work restriction guidance. For strategies to mitigate healthcare personnel staffing shortages, see Contingency and crisis management. For healthcare professionals advising people in non-healthcare settings …
CMS has posted the Discharge Function Score for Skilled Nursing Facilities (SNFs) Draft Technical Report: Imputation Appendix File, which accompanies the Discharge Function Score for Skilled Nursing Facilities (SNFs) Draft Technical Report. The Imputation Appendix …
On April 3, 2023, the Centers for Medicare & Medicaid Services (CMS) released the final MDS Nursing Home Item Sets version 1.18.11. Nursing homes will be required to implement the new item sets—with their many …
Celebrating the AAPACN Education Foundation 2023 Scholarship Recipients Individuals who choose a career in post-acute care are driven by a passion to improve the quality of life and care for those living in long-term care. …
Key excerpt: Nursing Homes We know that compliance helps an organization remain focused on providing high-quality care. OIG work has pinpointed breakdowns in quality of care across many health care sectors. Perhaps the most pronounced …
Screening for Delirium: What Clinicians Should Know https://www.capc.org/blog/screening-for-delirium-what-clinicians-should-know/ Managing Delirium: What Clinicians Should Know https://www.capc.org/blog/managing-delirium-what-clinicians-should-know/
Nursing Home Cost Reporting 101 with Betsy Rust MAY 10, 2023 @ 1:00 PM – 2:00 PM Nursing home cost reports offer a ton of information to advance quality improvement. Learn how to read and …
The draft Long-Term Care Resident Assessment Instrument (RAI) 3.0 User’s Manual v1.18.11, released in early April, presents revised care area triggers (CATs) in chapter 4 and care area assessment (CAA) worksheets in appendix C. To …
Effective Oct. 1, 2023, section G (Functional Status) will officially be retired from the MDS 3.0 except in states that choose to implement the Optional State Assessment (OSA) with its limited four-item section G for …
In late April, CMS updated the resource “Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency.” This document addresses key questions regarding billing for vaccines, Medicare coverage, the 3-day …
Are your MDS assessments and tracking forms ready for submission to the national database? This checklist will prepare users to submit MDS item sets in the electronic health record (EHR) to the Centers for Medicare …
In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist for AAPACN, discuss the changes …
Question: Where do I find the Five-Star reports in iQIES? Answer from Kim Steele RN, WCC, RAC-CT, RAC-CTA: It can’t be accessed in iQIES at this time. You will continue to access some reports or …
Question: We have a resident who was in our facility in 2017 and then returned as a new admission this year. We noted her last name was misspelled on all assessments in 2017. Our billing …
Question: A resident had a fall at home that resulted in an acetabular fracture but did not receive surgery. The provider’s progress notes indicated, “Unspecified fall, initial encounter” (W19.XXXA), as the primary medical diagnosis. Should …
The Centers for Medicare & Medicaid Services (CMS) issued several blanket waivers and updates during the COVID-19 public health emergency (PHE). While many of these waivers have already been terminated, several will remain in place …
Includes a three-page section, Long Term Care Facilities (Skilled Nursing Facilities (SNFs) and/or Nursing Facilities (NFs)), plus guidance for all providers on staff vaccinations and emergency preparedness. Memo # QSO-23-13-ALL Posting Date 2023-05-01 Fiscal Year …
Question: The look-back period for J1800 is for falls since admission/entry or reentry or prior assessment (OBRA or scheduled PPS), whichever is more recent. For this look-back, is the Part A PPS Discharge assessment considered …
Question: If a resident’s BIMS interview cannot be completed, when is it appropriate to code C0100, “Should the Brief Interview for Mental Status be Conducted?” as “No”? Surveyors asked about our rationale for coding resident …
Question: A resident on Medicare Part A went out on a leave of absence (LOA) for a temporary home visit on Saturday and returned on Monday. How do we bill this? Answer from Carol Maher, …
On April 24, the Centers for Medicare & Medicaid Services (CMS) posted the Optional State Assessment (OSA) Item Set, OSA Manual, and OSA Change History table in the Downloads section on the Minimum Data Set …
AAPACN received clarifying information from the Centers for Medicare & Medicaid Services (CMS) related to the end of the COVID-19 public health emergency (PHE) and how residents covered under Medicare Part A using the 3-day …
While many nurse assessment coordinators (NACs) are understandably focused on the changes in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, important MDS items that will remain as-is effective Oct. 1, …
According to the Centers for Medicare & Medicaid Services (CMS), “Skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to …
The Optional State Assessment (OSA) Item Set, OSA Manual, and OSA Change History table are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. The OSA is …
Through this Notice, OIG is notifying the public of the following: • OIG will no longer publish updated or new CPGs in the Federal Register. All current, updated, and new CPGs will be available on …
SNOW IDs Status Categories Provider Types Description Date Reported Date Resolved Open Reports SNF Please be advised that the Submission Status for the HCP Influenza Vaccine measure is displaying incorrectly on the SNF Provider Threshold …
Short exposure to bright light could help shift workers generally combat fatigue 21-Apr-2023 7:45 PM EDT, by McGill University Newswise — Nurses exposed to 40 minutes of bright light before their night shifts feel less fatigued and …
With the migration of Minimum Data Set (MDS) assessment submissions and reporting into iQIES, the Provider and Quality Measure reports that are currently available in the Certification and Survey Provider Enhanced Reporting (CASPER) system will …
The Centers for Medicare & Medicaid Services (CMS) recently posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is good—a 3.7 percent …
Manual: CMS iQIES MDS Upload an Assessment v1.0 The How to Upload an Assessment for MDS Users training video provides steps for uploading MDS assessments to iQIES.
This 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. CMS iQIES …
Fact Sheet: HHS Announces Intent to Amend the Declaration Under the PREP Act for Medical Countermeasures Against COVID-19 APRIL 14, 2023 | NEWS RELEASE Letter to U.S. Governors from HHS Secretary Xavier Becerra on renewing …
Members: $49 | Non-members: $98Continuing Education: 1.5 CE hoursRecording Date: May 18, 2023Duration: 90 minutesSpeaker: Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC In early April, the Centers for Medicare & Medicaid Services (CMS) released the draft version of the …
The Centers for Medicare & Medicaid Services (CMS) has announced the COVID-19 public health emergency (PHE) will end on May 11, 2023. The end of the PHE declaration also marks the end of temporary waivers …
The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 01/31/2026 will be mandatory on 6/30/23. …
An updated Quick Reference Guide is now available. The Quick Reference Guide provides high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links. https://www.cms.gov/files/document/pac-snf-quickreferenceguide-20230207.pdf From https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Data-Submission-Deadlines
The MDS 3.0 CAT specifications (V1.06.0) are now available. The specifications currently consist of the PDF documentation files, which describe the logic changes and provide pseudocode. Note that many of the CAT triggers are changing …
On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is …
Proposed rule: https://www.federalregister.gov/public-inspection/2023-07137/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities Fact Sheet: On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the …
Restorative nursing programs are effective interventions to maintain or improve a resident’s independence in tasks of daily living. According to the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, on page O-42, “Restorative …
The Centers for Disease Control and Prevention (CDC) now uses the term “post-COVID conditions” (PCC) to label the multitude of physical and mental health consequences that some people—including those who had an initial mild or …
Question: A resident fell in the facility and hit the back of her head. She was evaluated in the emergency room and had a CAT scan completed the same day, but showed no injuries. Five …
Question: The RAI User’s Manual states that respiratory therapy must be performed by a “respiratory therapist” or a “respiratory nurse.” What is a “respiratory nurse”? Answer from Jeff Taylor:Appendix A of the RAI User’s Manual provides …
Question: If an interim payment assessment (IPA) is determined to have a new primary diagnosis, does therapy need to re-evaluate the resident or can they continue treatment based on the 5-Day diagnosis? Answer from Carol …
In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss the …
On March 2, 2023, the Centers for Medicare & Medicaid Services (CMS) hosted a Skilled Nursing Facilities (SNF)/Long-Term Care (LTC) Open Door Forum. During the call, a CMS official clarified the answer to a question …
NOW AVAILABLE: Draft MDS 3.0 RAI User’s Manual version 1.18.11 The draft Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual version (v)1.18.11 is now available. The MDS 3.0 RAI User’s Manual v1.18.11 …
Measure specifications and calculations are detailed in this manual. March 2023 updates APPENDIX – Claims-based Measures Technical Specifications Updates 03-20-23.pdf and Nursing Home Compare Claims-based Measures Tech Specs 2023 From https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures
Transmittal 11879 issued February 24, 2023, is being rescinded and replaced by Transmittal 11932, dated, March 29, 2023, to update Business Requirement (BR) 12896.3 to match FISS new reason code and to add BR 12896.3.1. …
This report presents the Discharge Function Score measure specifications. Section 2 provides an overview of the measure and a high-level summary of the key features of the measure that are described in detail in the …
The Medicare Payment Advisory Commission (MedPAC) has released its March 2023 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in traditional fee-for-service (FFS) Medicare and reviews the status of Medicare …
The American Association of Post-Acute Care Nursing (AAPACN) will host the annual conference this year April 19 – 21 in Las Vegas, NV. Long-term and post-acute care professionals from across the nation will gather to …
