The MDS 3.0 Quality Measure Assessment Selection Methods tool simplifies the assessment selection logic used for MDS 3.0 Quality Measures (QMs) in nursing facilities. The assessment selection logic is used to identify which assessments are …
The Discharge Function Score is an incredibly complicated quality measure (QM), notes Joel VanEaton, BSN, RN, RAC-MT, RAC-CTA, RAC-CT, executive vice president of post-acute care regulatory affairs and education for Broad River Rehab in Asheville, …
The Centers for Medicare & Medicaid Services (CMS) implemented the Patient-Driven Payment Model (PDPM) in October 2019 for residents receiving Medicare Part A coverage in the skilled nursing facility (SNF). PDPM replaced the previous legacy …
Question: Our facility recently had a bill rejected because the ICD-10 code of M62.81, Muscle weakness (generalized), and R53.1, Weakness, were both coded on the bill. Does anyone know the reason why they both cannot …
Question: I am working in an older facility, and every bed has bilateral quarter-length side rails. The facility leadership states the rails are for mobility, but they cannot be lowered for any residents. Could these …
Question: A resident recently enrolled in hospice, and we scheduled a Significant Change in Status Assessment (SCSA) for 1/14/25. The resident expired on 1/10, before the ARD of the SCSA. Do I need to complete …
The Centers for Medicare & Medicaid Services (CMS) recently released the Fiscal Year (FY) 2025 Mission & Priorities document (MPD). This document includes the expected responsibilities of the State Resident Assessment Instrument (RAI) coordinator: CMS …
CDC announces no new ICD-10-CM codes effective April 1, 2025. The April 1, 2025 diagnosis code update files now available address revisions and typographical errors. Use these files for discharges occurring from April 1, 2025 …
To register at QSEP and take the course, you just need to provide an email address. https://qsep.cms.gov Updated: January 16, 2025 This course consists of four presentations by the Division of Nursing Homes outlining the …
Project Title: Standing Technical Expert Panel (TEP) for the Development of Post-Acute Care (PAC) Quality Reporting Program (QRP) Interoperability Measure Dates: The Technical Expert Panel (TEP) nomination period opens on January 20, 2025, and closes on February …
Revisions to: QSO-25-07-NH Original release date: November 18, 2024 QSO-25-12-NH Memorandum Summary Revised Surveyor Guidance: CMS is releasing the following revised guidance for nursing home surveyors: • Admission, Transfer & Discharge, Chemical Restraints/Unnecessary Psychotropic Medication, …
Secretary Becerra used his authority in the Public Health Service Act to declare a public health emergency (PHE) on January 10, 2025, giving us the flexibility to support our beneficiaries in the State of California, effective retrospectively …
On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS version 1.20.1 item sets and item matrix for implementation on Oct. 1, 2025. The change history included with the …
Monitoring and reducing the use of antipsychotic medications is a high priority for many nursing facilities. Top concerns are the increased risk of adverse effects for residents taking these medications, the scrutiny of their management …
Question: In section K and O of the RAI User’s Manual, there are items than can be checked “on admission.” Per the manual, this refers to an assessment period of days one through three of …
Question: If the Notice of Medicare Non-Coverage (NOMNC) was not provided timely, is the facility liable for the days daily skilled services were no longer being provided until the last covered day (LCD) issued on …
Question: A resident was previously skilled for 100 days under Medicare Part A for a peg tube and subsequently discharged home with no home health services. If this resident remains at home for 60 days or longer, …
In 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, senior curriculum development specialist with AAPACN, discuss what to expect this January …
In late December, the Centers for Medicare & Medicaid Services (CMS) released an updated version of the MDS 3.0 Quality Measures (QM) User’s Manual (version 17.0), which went into effect Jan. 1, 2025. The major …
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 Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual Version (V)17.0 is now available. The MDS 3.0 QM User’s Manual V17.0 contains detailed specifications for the MDS 3.0 QMs and includes a Notable …
Memo #QSO-25-11-NH Posting Date 2024-12-31 Fiscal Year 2025 Memorandum Summary • Acute Respiratory Illness Reporting Requirements: The LTC facility requirements for reporting COVID-19-related data expired on December 31, 2024, except for reporting COVID-19 resident and staff vaccination …
FFS & MA NOMNC/DENC What’s New 11/18/2024: New NOMNC and DENC for Original Medicare and Medicare Advantage The Office of Management and Budget (OMB) has approved a revised Notice of Medicare Non-Coverage (NOMNC / CMS-10123) …
Data Set Links COVID-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 …
Issue Date 2024-12-27 Implementation Date 2025-02-15 CR # 13918 Publication # 100-04 Transmittal Year 2024 SUBJECT: Billing Instructions Related to Expedited Determinations Based on Medicare Change of Status Notifications (MCSNs) I. SUMMARY OF CHANGES: The purpose of this Change Request …
Upcoming iQIES Service Center Hold Times Due to the Payroll Based Journal quarterly deadline, the iQIES Service Center is projecting an increase in the volume of calls and emails between January 2, 2025, and February …
Quick Reference Guide: Re-Submitting COVID-19 Vaccination Data using the Person-Level Vaccination Forms Introduction This Quick Reference Guide (QRG) will provide information on using the Re-submit all changed weeks button for your facility’s person-level COVID-19 vaccination …
Upcoming proposed and final regulations from CMS, CDC, and other HHS entities https://www.reginfo.gov/public/do/eAgendaMain HHS/CDC Proposed Rule Stage Respirator Fit Capability Standard Test Method, Filter Shelf Life, and Application Requirements for Air-Purifying, Half-Mask Facepiece, Particulate Respirators …
Vaccination Updates for the Respiratory Virus Season Reporting Annual Healthcare Personnel Influenza Vaccination Data This is a friendly reminder that reporting annual influenza vaccination data among healthcare personnel (HCP) is required for CMS-certified free-standing acute …
Nurse assessment coordinators (NACs) who manage Medicare services typically are at least familiar enough with the beneficiary notice requirements that skilled nursing facilities (SNFs) must meet under fee-for-service (FFS) Medicare Part A to monitor those …
Accurate diagnosis coding is critical in nursing facilities (NFs) for care planning, reimbursement, and quality measurement. NF coders must understand ICD-10-CM conventions, general coding guidelines, and chapter-specific coding guidelines that affect how diagnoses are assigned. …
Question: A resident came to our facility for a short stay with a Stage 4 pressure ulcer. The resident has since exhausted his 100 days of Medicare, became a long-term resident, and still has the …
Question: When a resident received IV fluids (K0520A) for hydration, but did not have any calories from the fluids, do we code K0710A (Proportion of total calories the resident received through parenteral or tube feeding) …
Question: A resident was admitted to our facility on Medicare Part A and passed in facility after only a couple of hours. I had scheduled a 5-Day/Admission for the 7th day before she passed. How …
The AAPACN 2024 Quality Virtual Conference concluded each day with a robust live question and answer (Q&A) session, but not all questions had the opportunity to be answered live. AAPACN recently released the answers to …
By Greg Seiple Navigating the complexities of healthcare, especially in post-acute care, can often feel daunting. For professionals involved in skilled nursing facilities, understanding the metrics that influence patient care is crucial. One of these …
CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily. The Nursing Home Compare Web site features a quality rating system that gives each nursing home …
The December 2024 Quarterly Confidential Feedback Reports for the fiscal year (FY) 2026 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via the Internet Quality Improvement and Evaluation System (iQIES). These …
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, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialists with …
By Greg Seiple Discharge planning is an essential component of patient care in skilled nursing facilities. But how do healthcare professionals determine when a resident is ready to leave and manage daily activities independently? Enter …
Question: A resident was recently admitted with multiple fractures related to an ATV accident. Is it appropriate to use Z47.89, Encounter for other orthopedic aftercare, as the principal diagnosis code? Answer from Carol Maher, …
Question: I am confused with what can be included at O0110A1, chemotherapy while a resident. A resident is currently receiving Ibrance, as part of her cancer treatment. Can I code oral chemotherapy? Answer from Scott …
Question: A resident recently admitted to us with over 20 pressure ulcers and 10 of these are deep tissue pressure injuries. M0300 only allows us to enter a single digit amount 0-9 on the MDS. …
The Office of Management and Budget (OMB) has updated the Notice of Medicare Non-Coverage (NOMNC), (Form CMS-10123), and the Detailed Explanation of Non-Coverage (DENC), (Form CMS-10124). Providers must use the current notices until Dec. 31, …
Although spring may seem like a mirage right now, it’s time for nurse assessment coordinators (NACs) to prepare for a literal thaw in the Five-Star Quality Rating System. As of January 2025, the Care Compare …
Care Compare refreshes MDS 3.0 Quality Measure (QM) data quarterly in January, April, July, and October with the most recent four full quarters of data. AAPACN’s Five-Star and Care Compare MDS 3.0 Quality Measure Data …
From https://oig.hhs.gov/compliance/nursing-facility-icpg/ The Nursing Facility ICPG—together with OIG’s General Compliance Program Guidance (GCPG) that applies to all individuals and entities involved in the health care industry—serves as OIG’s updated and centralized source of voluntary compliance program guidance for …
Effective Oct. 31, 2024, skilled nursing facilities (SNFs) now are required to use an updated Skilled Nursing Facility Advance Beneficiary Notice of Noncoverage (SNF ABN), also known as form CMS-10055, and the corresponding revised instructions …
Question: I completed the pain interview with the resident two days before the ARD and he reported no pain. How do I code this when it conflicts with other medical record documentation? Answer from Jeff …
Question: Would it be considered a delusion if a resident who has dementia states that they have a girlfriend in the absence of one, needs to go find their parents/spouse who are deceased, or needs …
Question: Is total parenteral nutrition (TPN) coded in MDS items O0110H (IV Medication), K0520A (Parenteral/IV Feeding), and K0710 (Percent Intake by Artificial Route)? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: TPN is an …
The Centers for Disease Control and Prevention (CDC) recently updated reporting requirements for respiratory pathogens that will become effective Jan. 1, 2025. The CDC announced the following webinar on the National Healthcare Safety Network (NHSN) …
Upcoming Webinars Topic: NHSN LTCF Component: Respiratory Pathogens and Vaccination Updates Initial Webinar: Wednesday, December 11, 2024, at 1:00 PM Eastern Time (US and Canada) Register in advance for this webinar on December 11: https://cdc.zoomgov.com/webinar/register/WN_XUstZ8zQTRG5WqqygPwShA …
Revised Long-Term Care (LTC) Surveyor Guidance: Significant revisions to enhance quality and oversight of the LTC survey process Memo # QSO-25-07-NH Posting Date 2024-11-18 Fiscal Year 2025 Memorandum SummaryRevised Surveyor Guidance: CMS is releasing the …
Backdating, or placing an earlier date than the actual date on a document, is only permissible in limited Minimum Data Set (MDS) scenarios. Has anyone asked the nurse assessment coordinator (NAC) to change the assessment …
Are you confused about which beneficiary notices are needed and when? The Beneficiary Notice Guidelines tool lists scenarios that you might run into, clarifying exactly what notices are needed to reduce the risk of claim denials and …
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 …
The newly revised Clinical Practice Guideline for Diabetes Management in the Post-Acute and Long-Term Care (PALTC) Setting provides (1) new information on overall goals in diabetes care, (2) detailed information on how to use and …
On November 8, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2025 Medicare Part D …
MDS items GG0130 (Self-Care) and GG0170 (Mobility) are a common source of headaches for both the nurse assessment coordinator (NAC) and the interdisciplinary team (IDT). While there is no one-size-fits-all approach for obtaining accurate documentation …
Vaccination measures play a critical role in long-term care, and the Centers for Medicare & Medicaid Services (CMS) closely monitors vaccination data to ensure the safety of residents and staff. Nineteen different measures for vaccination …
Question: When is the new Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) (2024) required to be used? Answer from Jessie McGill, RN, BSN, RAC-MT, RAC-MTA: The updated SNF ABN (2024), CMS form 10055, must …
Question: A resident had a right below-knee amputation (BKA) a month ago and a Significant Change in Status Assessment (SCSA) was completed at that time. The resident is now going back to have a revision …
Question: I transmitted an assessment with an ARD of 10/3/24. Our software scrubber said the assessment had an error because I signed Z0500 on 10/3/24. The assessment was accepted by CMS. Is there a penalty …
In this podcast, AAPACN Curriculum Development Specialists, Jessie McGill, RN, BSN, RAC-MT, RAC-MTA and Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC, discuss a few of the questions asked during the recent AAPACN webinar, “How to …
On Oct. 23, 2024, the Centers for Disease Control and Prevention (CDC) released a memo on the updated Advisory Committee on Immunization Practices’ (ACIP’s) recommendation for people 65 years and older and those who are …
AAPACN offers two great tools to assist nurse assessment coordinators (NACs) in scheduling OBRA assessments. Be prepared for 2025 with these two tools that are free to members: This AAPACN resource is copyright protected. AAPACN …
Final FEMA Exception Memo for Milton: https://www.cms.gov/medicare/quality/snf-quality-reporting-program/reconsideration-and-exception-extension Limited Waiver of HIPAA Sanctions & Penalties During a Declared Emergency: 2024 Public Health Emergency for State of Florida in Response to Hurricane Milton October 8, 2024 What: President Joseph R. …
Long-term care nurses who follow the path of becoming nurse assessment coordinators (NACs) can advance their careers and skill levels through experience and gained knowledge over time. At every stage of professional development, NACs can …
Final FEMA Exception Memo for Helene: https://www.cms.gov/medicare/quality/snf-quality-reporting-program/reconsideration-and-exception-extension Hurricane Helene – South Carolina and Tennessee (2024) Secretary Becerra used his authority in the Public Health Service Act to declare a public health emergency (PHE) on September 30, 2024, …
The Moving Forward Coalition, in partnership with A.G. Rhodes, Kansas State University (KSU), Dash Media, and The John A. Hartford Foundation, presents “The Foundation of Our Work: What Matters Most to Residents”! Why do we …
Section GG has greatly evolved since 2016. It was first introduced as just a few functional items completed only for Medicare Part A residents, but now it requires 26 functional tasks for all long-term care …
Effective communication with residents in skilled nursing facilities (SNFs) is essential to understand their needs and preferences. In accordance with Appendix D of the Long-Term Care Facility Resident Assessment 3.0 User’s Manual (RAI User’s Manual) …
Question: Please clarify the law regarding ICD-10 coding of HIV (B20). Is it a HIPAA violation to include this diagnosis under the medical diagnoses section in the medical record? Answer from Carol Maher, RN, GERO-BC, …
Question: If a long-term resident was transferred to the Emergency Department (ED) and passed away while at the ED, do I complete a Discharge Return Not Anticipated assessment or a Death-in-Facility record? Answer from Scott …
Question: I found that some of our assessments with dashes received both errors -3897 and -3908 for the same assessment. Will both of these errors count against the facility’s SNF QRP annual payment update (APU) …
The Centers for Medicare & Medicaid Services (CMS) announced in the QSO-25-1-NH memo that the Discharge Function Score measure will not be used in the October 2024 Five-Star Quality Rating System and will remain frozen …
The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) has developed a variety of measures that use data from the MDS 3.0, Medicare Fee-for-Service Claims, and Centers for Disease Control and Prevention (CDC) National Healthcare …
Members: $24 | Non-members: $48Continuing Education: 1 CE hourRecording Date: Nov. 21, 2024Duration: 60 minutesSpeaker: Lauren Stenson, MSN, RN, CNDLTC, QCP, DNS-CT The resident population in long-term and post-acute care environments is growing more diverse. Nurse leaders play a …
This communication pertains to the Fiscal Year (FY) 2026 and FY 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program performance standards for the Total Nursing Staff Turnover (Nursing Staff Turnover) measure which the Centers …
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. Also see …
REVISED: Updates to Nursing Home Care Compare Staffing and Quality Measures Memo # QSO-25-01-NH REVISIONS TO QSO-23-21-NH, ORIGINALLY RELEASED ON September 20, 2023. • Adjustment to Staffing and Quality Measures: CMS will update the staffing …
Provider Bulletin #22a October 1, 2024 Dear Colleague, We are pleased to announce several important updates for the provider community and others who rely on Livanta’s services as a Medicare Beneficiary and Family Centered Care …
Question: Can I use ICD-10 diagnoses that are included in physician notes within the last 60 days that are listed as ‘previous medical history’? These diagnoses have no medication orders and are not listed on …
Question: Would bells on a bathroom door be coded as “other alarm” in section P? The bells are placed on the door to alert staff when a resident enters the bathroom alone. Answer from Denise …
Question: How often should the trauma-informed care assessments be completed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The following language is from F699. I would focus your assessment efforts on meeting …
In 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 Quality Measures and some fundamentals about …
In a recent webinar series, the Centers for Disease Control and Prevention (CDC) announced changes to the definition of “up to date” for COVID-19 vaccine reporting in the National Healthcare Safety Network (NHSN). This change …
Draft MDS 3.0 Item Sets version 1.20.1 The draft Minimum Data Set (MDS) 3.0 Item Sets version (v)1.20.1 and Item Matrix are now available. The MDS Item Sets v1.20.1 will be effective beginning October 1, …
The Medicare Part A PPS Discharge assessment (i.e., the NPE item set) is now a crucial assessment with far-reaching impacts for skilled nursing facilities (SNFs) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP), …
