Conference Recording Bundle

APU Items: Impact of Dashes, MDS Coding, and NHSN on PDPM Rate |Carol Maher, RN, GERO-BC, RAC-MT, RAC-MTA, CPC, Hansen Hunter & Co

There are 13 pages of MDS items that can impact the PDPM Medicare Annual Payment Update (APU) if dashed. During this session, the speaker will explain the impact of not assessing items that can impact the APU resulting in dashes on the MDS. Each skilled nursing facility (SNF) is at risk of losing 2% of its Medicare income for each claim in FY 2026 and/or FY 2027. If CMS decides to require the SNF QRP and standardized patient assessment data element items for all short-stay residents regardless of payer, the risk could be even greater. Most MDS coordinators know some of the items that can impact the Medicare APU but are often surprised when different items impact their facility’s payment. Following this session, you’ll be able to:

• State three MDS items that can impact the APU if dashed
• Discuss the percentage of PPS MDSs that can contain a single dash in an APU item that will result in the loss of 2% of the Medicare income for each claim for the next fiscal year
• Identify two processes that can impact the APU other than dashed MDS items
• State which MDS reasons for assessment are used to calculate the APU compliance percentage

Learn and Avoid: Common Probe Audit Findings | Alvin Cabales, Rockport Healthcare Services

The number of Additional Documentation Requests (ADR) that skilled nursing facilities (SNFs) receive are increasing significantly from Medicare contractors to Managed Care companies. The speaker will help facility teams to create a process for responding to the ADR letters efficiently and timely. He will also guide you in determining the best proactive approach in avoiding unfavorable results in the future. Following this session, you’ll be able to:

• Review the common unfavorable findings and the reasons for the denial
• List the medical records that auditors are looking for in supporting documents
• Explain what is considered a skilled service per CMS guidelines and what auditors expect to find in documentation to support skilled coverage
• Describe best practices in responding to ADR letters and define proactive approaches to preventing unfavorable findings

What Every Administrator Wants Their Nursing Leadership to Know: Mastering CBC | Demetrius Kirk, MBA, MSN, RN, LNHA, LSSGB, PAC-NE, SMK Medical

As the healthcare landscape evolves, nursing leadership plays a pivotal role in ensuring the success of Census, Budget, and Compliance (CBC) strategies. It is vital for nursing leaders to align their efforts with administrative priorities, improve operational efficiency, and drive positive outcomes in long-term care facilities. The speaker will focus on practical insights and leadership strategies that foster collaboration and ensure success across clinical and administrative domains. Following this session, you’ll be able to:

• Understand the administrator’s perspective and identify administrator expectations for nursing leadership to improve CBC outcomes
• Employ strategies to improve collaboration between nursing and administrative teams, fostering better operational and clinical outcomes
• Explore leadership techniques that increase census, manage budgets effectively, and ensure compliance
• Implement best practices and develop practical tools to enhance compliance, including documentation, risk management, and leadership strategies to support regulatory standards

From Data Collection to Impact: The MDS as a Starting Point, Not the Finish Line | Sabrena McCarley, Transitional Care Management

Ongoing MDS updates have created new challenges for skilled nursing facilities (SNFs,) including staff training, accurate MDS completion, and fostering interdisciplinary team (IDT) collaboration. The speaker will highlight key MDS updates and the vital role each IDT member plays in gathering data for patient-centered care and discharge planning. You will gain practical resources and best practices to enhance training and improve MDS processes in your facility. Following this session, you’ll be able to:

• Identify the role of each IDT member in the MDS data collection process
• Understand the patient’s voice in the completion of the MDS, patient-centered care, and discharge planning

Harnessing AI for Enhanced Healthcare Education: Lessons Learned | Jessica Burkybile MSN, RN, NPD BC, Healthcare Academy

Artificial Intelligence (AI) has become a cornerstone for innovation in healthcare. In this session, you will explore the use of AI in the training and professional development of staff working in the long-term care sector. The speaker will introduce you to the fundamental principles of AI, learning how it can be harnessed to create dynamic, adaptive, and efficient training modules tailored for staff. Following this session, you’ll be able to:

• Evaluate two benefits of using AI to develop industry-specific training content
• Identify two challenges to implementing AI in healthcare training
• Apply two principles of AI relevant to the design and development of AI-enhanced training modules

Managed Care Makeover: What’s New and What’s Next in 2025 | Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, Celtic Consulting, AAPACN board member

With the Contract Year (CY) 2025 Medicare Advantage and Part D Final Rule effective Jan. 1, 2025, SNFs gain essential tools to address managed care denials, including access to independent reviews and the ability to escalate cases to Administrative Law Judge (ALJ) reviews. The speaker will guide you in navigating the managed care appeals process, using new protections effectively, and provide additional clarifications for last year’s final rule (CY 2024). SNFs are now equipped to provide these beneficiaries with the care they need and ensure fair reimbursement. You’ll learn how to put these tools into action. Following this session, you’ll be able to:

• Recall the key provisions of the CY 2025 Medicare Advantage and Part D Final Rule
• Navigate the managed care appeals process
• Gather critical documentation needed to challenge managed care denials through the appeals process to strengthen cases
• Understand additional clarifications on the CY 2024 Medicare Advantage and Part D Final Rule, which went into effect Jan. 1, 2024

Medical Review and the Contractors that Perform Them | Scott DeMasi, MBA, MSN, RN, BC-NI, CHPQ, CHIAP, COCAS, RAC-CT, RAC-CTA, ACTS Retirement-Life Communities, Inc.

During this session, you will dive into the Office of the Inspector General’s audit workplan, the auditing process, and how information gathered during the audit is used by CMS to inform policies, create audits, and expand education. Additionally, the speaker will compare the various auditing contractors such as the MAC, RAC, CERT, and UPIC, and how they are utilized by CMS in reviewing Medicare billing. Following this session, you’ll be able to:

• Understand the OIG audit process and workplan
• Classify the differences between CMS audit contractors
• Apply best practices in audit response to retain revenue
• Understand the process for responding to a Medical Review audit and the appeals process

Utilizing Behavioral Health Program for Successful Survey Outcomes | Michelle Stuercke, RN, MSN, DNP, MPA, LNHA, QCP, and Linda Riccio, OTR, both of Transitional Care Management

You will explore the vital role of behavioral health programs in achieving positive survey results in long-term care and behavioral health settings. Learn to identify essential elements of these programs that directly influence survey outcomes. You will come away with actionable strategies for implementing and optimizing behavioral health initiatives to meet survey standards while improving resident well-being. Additionally, the speakers will showcase three key programs that have been proven to enhance resident outcomes and boost performance on Quality Measures (QMs), offering practical insights for you to elevate your facility’s performance. Following this session, you’ll be able to:

• Identify essential elements of behavioral health programs that drive positive survey outcomes in long-term care and behavioral health environments
• Formulate effective strategies for implementing and optimizing behavioral health programs that align with survey standards and enhance resident well-being
• Highlight three key programs that significantly improve resident outcomes and enhance performance on quality measures
• Define the relationship between behavior issues and survey tags and ways to minimize survey deficiencies

MDS and DNS Relationship: How to Win | Lisa Chubb, MSN, RN, and Stacy Grondel, RN, BSN, RAC-MT, QCP, both of Brickyard Healthcare

In the world of skilled nursing, a strong partnership between the director of nursing services (DNS) and the MDS coordinator is essential for success. You will dive deep into the intricacies of this relationship, highlighting strategies for collaboration that enhance clinical outcomes, regulatory compliance, and reimbursement accuracy. Explore how to foster communication and teamwork between these key roles, ensuring that care plans reflect accurate resident assessments and align with organizational goals. By understanding each other’s priorities and responsibilities, the DNS and MDS coordinator can create a winning dynamic that drives success in care delivery and operational efficiency. Following this session, you’ll be able to:

• Define the roles and responsibilities of the MDS coordinator and DNS in the SNF, and understand how their collaboration impacts resident care, regulatory compliance, and facility operations 
• Develop strategies to enhance communication and teamwork between the MDS and DNS roles, ensuring that resident assessments, care plans, and documentation are aligned for optimal care outcomes and accurate reimbursement
• Apply best practices for integrating clinical and financial goals through effective MDS documentation, and explore tools that streamline workflow, improve regulatory compliance, and enhance the overall success of the nursing team

Facilitating Interdisciplinary Contribution to Critical/Key Components of MDS Assessments | Julie Wilkins, MPT, CHC, CDP, and Kimberly Twiss, MHS, OTR/L, RAC-CT, both of Powerback Rehabilitation

Optimizing data capture can only happen by leveraging interdisciplinary contribution to key areas of the MDS. Collaboration creates a solid foundation for development of care plans, optimization of outcomes, and enhanced reimbursement. In this session, you will explore the roles of key interdisciplinary team (IDT) members, proactive approaches that can be utilized to positively impact patient outcomes, and best practices for accurately capturing patient data. Following this session, you’ll be able to:

• Define roles and responsibilities of the IDT members, including key areas of contribution for data capture
• Explore proactive approaches that can be integrated into a facility’s practice and lead to improved communication, a positive impact on patient areas of need, and enhanced outcomes
• Identify best practices for optimizing MDS data and accurately capturing patient characteristics

10 of the Most Confusing MDS Coding Questions | Carol Maher, RN, GERO-BC, RAC-MT, RAC-MTA, CPC, Hansen Hunter & Co

During this session, the speaker will build upon this popular topic from last year’s AAPACN Conference. A list of the most confusing MDS coding questions will be compiled ahead of time by polling the AAPACN community and AAPACN Master Teachers, plus state RAI Coordinators will be queried about the most confusing questions they answer regularly. The speaker will provide answers and supporting documentation to the most confusing questions. Following this session, you’ll be able to:

• Identify three commonly misunderstood MDS coding item instructions
• Accurately code the MDS items identified
• Gain clarity of the proper coding of complex MDS items

PDPM Unveiled: Strategies for MDS 3.0 Success in the Evolving Healthcare Landscape | Genice Hornberger, RN, and Eugene Gonsiorek, PhD, NHA, both of PointClickCare

There have been significant changes to the MDS 3.0 over the last two years and a push for states to move to the Patient-Driven Payment Model (PDPM) for Medicaid reimbursement. You will gain insights into how these updates are reshaping MDS coding practices that impact healthcare operations. Discover how states are transitioning to PDPM for Medicaid reimbursement and explore innovative strategies for operational success and quality enhancement. Implement robust PDPM-compliant processes, and leverage data-driven insights for continuous quality improvement. Don’t miss this opportunity to elevate your PDPM expertise. Following this session, you’ll be able to:

• Understand the impact of recent MDS changes and their impact on reimbursement and care planning
• Develop effective strategies to maximize reimbursement and care outcomes through accurate MDS assessments under PDPM
• Integrate PDPM into existing quality improvement initiatives and operational strategies
• Understand how states are implementing PDPM

Enhancing Your Recruitment and Retention Plan to Align with the Facility Assessment | Lisa Thomson, BA, LNHA, HSE, CIMT, Pathway Health Services, AAPACN Education Foundation board member

With the new Minimum Staffing Standards rule, which enhanced the facility assessment requirements, recruitment and retention strategies, and plans are more important than ever. The speaker will provide you with key strategies for a team-based approach to recruitment and retention, aligning with the facility assessment and the enhanced requirements. Throughout this engaging session, the speaker will share keen insights on recruitment strategies for today’s candidate-driven world as well as creative retention tactics that can be used to engage a diverse and multigenerational workforce. Following this session, you’ll be able to:

• Identify the key components of recruitment and retention plans that align with the facility assessment
• Describe how to implement a team-based approach for recruitment and retention
• Review three tools that you can implement within your organization to support your workforce strategy

The Best Defense Comes from the Chart: Using Best Practices to Fortify Documentation Surrounding Adverse Events | Amy Franklin, RN, DNS-MT, RAC-MT, Independent Nurse Educator

In this session, the speakers will share real-life examples of how plaintiff’s attorneys dissect facility records in litigation. They will show how documentation within progress notes, assessments, care plans, incident reports, and the policies and procedures work together to demonstrate compliance with the standard of care by the facility in litigation. You will come away with knowledge and insight to encourage competency-based documentation facility-wide, including why seemingly duplicate documentation is an absolute must in high-risk areas. Following this session, you’ll be able to:

• Define standards of practice and how policies and procedures impact litigation
• Describe three areas to focus on when reviewing your medical records’ assessments, progress notes, incident reports, and adverse events reports
• Explain the role of the QAA committee regarding adverse events and regulatory surveys
• Identify three critical areas where competency-based documentation should be facility-wide

Keeping Your MDS Coding ACTIVE | Beckie Dow, RN, RAC-MT, CHC, CPC-A, Maine Veterans’ Homes

MDS coding impacts Quality Measures (QMs), the SNF QRP, and the Patient-Driven Payment Model (PDPM), which is used for reimbursement across most payers. But are you able to support that critical care components are active in the medical record? In this session, the speaker will discuss strategies to support MDS coding items that impact payment and quality programs in documentation and the active care plan. Following this session, you’ll be able to:

• State five commonly occurring components that impact payment in the PDPM
• Describe how to identify MDS coding items that affect PDPM, SNF QRP, and QMs
• Incorporate key information from resident interviews into the active care plan
• Explain how to perform a pre-MDS submission review to evaluate the active care plan

From the Starting Gate to the Finish Line: Best Practices for Nursing Home Reimbursement Compliance | Alicia Cantinieri, MBA, BSN, RN, CHC, RAC-MT, RAC-MTA, QCP, DNS-CT, Zimmet Healthcare Services Group, LLC

The 2023 Comprehensive Error Rate Testing (CERT) report has been released and SNFs lead in Medicare claim error rates, most of which are due to a lack of documentation. Navigating the intricate landscape of Medicare Part A and B compliance audits in nursing home reimbursement is not an easy journey. During this engaging session, the speaker will shed light on the contemporary challenges facing nursing homes in adhering to Medicare Part A and B regulations. You’ll explore practical strategies and best practices that empower administrators and the interdisciplinary team (IDT) to navigate the intricate web of regulations effectively. Through an interactive approach, incorporating audience polling and real-world examples, you will gain actionable insights and best practices to enhance your compliance practices within the realm of Medicare Part A and B in nursing home settings. Following this session, you’ll be able to:

• Discuss the contemporary challenges SNFs face in adhering to Medicare Part A and B documentation standards
• Apply best practices for documentation and billing processes to avoid common pitfalls and enhance reimbursement accuracy
• Review the types of audit contractors and their scope to best prepare for audit response
• Foster effective communication and coordination among nursing home staff to ensure compliance

Practical Approaches to Managing Behaviors: Person-Centered Care Planning | Amy Lee, RN, BSN, MSN, CRRN, QCP, Coretactics, Inc.

To meet federal quality and safety standards, skilled nursing facilities (SNFs) are required to assess each resident and develop an appropriate plan of care. CMS further mandates that medications may be considered for elderly residents with dementia only if non-pharmacological interventions are ineffective. Following this session, you’ll be able to:

• Understand recent regulatory changes related to behavior management and Trauma-Informed Care
• Describe the evidence regarding the risk of antipsychotic use in persons with dementia
• Recognize early signs of behaviors and how to use person-centered care planning approaches to effectively manage them

Welcoming the Resident and Family as Part of the Resident-Centered Care Planning Team | Linda Winston, RN, MSN, BS, DNS-MT, QCP-MT, RAC-CT, RAC-CTA, and Barbara Bates, RN, MSN, DNS-MT, QCP-MT, both of MDS Consultants

Just as we welcome new faces in our community, the interdisciplinary team (IDT) must try to include our residents and their families as key members of the resident-centered care planning team. The IDT must find ways to show the resident and/or their families that they are interested in them as unique individuals and want to provide care based on their personal needs and goals. The speakers are both long-term care professionals and family members who have experienced being active participants of the IDT but also having been left out of the resident’s circle of caregivers. The speakers will identify ways to positively engage families as caregivers, as well as share care methods that may help the facility IDT improve care for the resident. Following this session, you’ll be able to:

• Identify regulatory requirements to involve the resident and family in care planning
• Recognize behavior that can cause the resident and family to feel excluded as part of the resident care planning team
• Review best practices to engage resident and family in resident-centered care planning
• Establish a link to create improved resident and family involvement in resident-centered care planning through QAPI

Do You Know Your Discharge Function Score? | Joel VanEaton, BSN, RN, RAC-CTA, MT, Broad River Rehab, AAPACN Education Foundation board member

Of the recent G to GG revised Quality Measures (QMs,) the Discharge Function Score seems to be the most complex and difficult to understand. Yet, the QM is the standard outcomes measure across post-acute care via the IMPACT act and the SNF Quality Reporting Program (QRP). This QM affects the Five-Star rating, the SNF QRP reporting requirements and the SNF Value Based Purchasing (VBP) program incentive multiplier. The speaker will help you get up to speed to be able to understand and use the data derived from this measure. Following this session, you’ll be able to:

• Understand the technical specifications of the Discharge Function Score measure
• Interpret the measure calculation
• Identify how the covariates determine the final expected score
• Apply the results to real-world application

Decoding I0020B: Identifying the Primary Diagnosis | Sorah Levy, MSN, RN, RAC-CT, and Deanna Battle, BSN, MS, RN, RAC-CT, IP, both of Engage Healthcare

Establishing each resident’s primary diagnosis is the foundation of a resident-centered plan of care. The speakers will summarize CMS, RAI, and CDC ICD-10 coding guidelines for ascertaining I0020B in the MDS. You will explore the nuances of the MDS process, highlighting best practices for interdisciplinary collaboration, accurate assessment, and compliant documentation. The speakers will recommend effective strategies and provide case studies so that you gain an understanding of the regulation to identify the primary reason for care. Following this session, you’ll be able to:

• Identify steps for determining a resident’s primary diagnosis
• Apply federal regulation to identify primary diagnosis for a resident
• Create effective and sustainable processes for collaboratively identifying, documenting, and care-planning the primary diagnosis
• Engage in case study discussions to practice determining the primary diagnosis using real-life scenarios and ICD-10 coding guidelines

Pardon the Interruption | Robin Hillier, BSN, MS, RN, RAC-CT, IP, BSN, MS, RN, RAC-CT, IP, RLH Consulting, AAPACN board member

One of the many new features of the Patient-Driven Payment Model (PDPM), which is still widely misunderstood, is the interrupted stay policy. Understanding when it applies and how to complete it is critical to being successful with Medicare Part A stays. You will explore the details of when the interrupted stay applies as well as the details regarding how to code the related assessments, reimbursement strategies, and how the physician certification schedule is impacted. Following this session, you’ll be able to:

• List the criteria for an interrupted stay
• Explain how to complete an interrupted stay discharge assessment
• Describe the considerations involved when the beneficiary returns from an interrupted stay

Navigating the Survey Process and Avoiding Rough Seas | Michelle Synakowski, RN, LNHA, RAC-CT, RAC-CTA, RAC-MT, RAC-MTA, ProSynk Healthcare Compliance Services

During this session, you will review the most commonly cited survey deficiencies and discuss compliance strategies for systems to attain and sustain ongoing compliance. In addition to solid quality systems, the way the team performs during the actual survey process can have a significant impact on survey outcomes and citations for deficient practices. The speaker will also review best practices for the team to actively manage the survey process while surveyors are on-site. Following this session, you’ll be able to:

• Understand the importance of a team process to actively manage the survey process while surveyors are in the facility
• Describe the most commonly cited deficiencies and keys to avoiding deficiencies in those areas
• Recognize the impact of employee preparedness for interview strategies on survey outcomes
• Describe several strategies to boost staff competency and help calm the seas during the survey process

iQIES: What Does It Even Stand for and How Can I Use It? | Melanie Tribe-Scott, RN, BSN, DNS-CT, RAC-MT, RAC-MTA, QCP, Zimmet Healthcare, AAPACN Education Foundation board member 

Explore the Internet Quality Improvement & Evaluation System (iQIES) and its essential role in streamlining healthcare reporting. In this session, the speaker will provide a brief overview of the iQIES system, including how to gain access and effectively utilize its reports and dashboards to manage the Minimum Data Set (MDS) process. Learn how to identify and interpret Quality Reports to improve performance on quality measures, as well as how to obtain and use Provider Reports to prepare for the long-term care (LTC) survey process. You will come away with a strong understanding of how to leverage iQIES reports to improve data accuracy, compliance, and care quality. Following this session, you’ll be able to:

• Give a brief overview of the iQIES system and how to gain access
• Utilize iQIES reports and dashboards to manage the MDS process
• Identify Quality Reports to improve quality measures
• Obtain Provider Reports to prepare for the LTC survey process

Quality Measures: Be in the Winner’s Circle | Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, both of AAPACN

No one wants to come in last when it comes to Quality Measures (QMs), but making it into the winner’s circle takes collaboration, MDS accuracy, good clinical systems, and time. During this session, the speakers will discuss how nurse assessment coordinators (NACs) and directors of nursing services (DNSs) can collaborate to ensure QMs accurately reflect the facility’s quality of care and outcomes, as well as how to make sustainable changes to clinical systems when quality improvement is needed. Following this session, you’ll be able to:

• Recognize how clinical documentation and MDS accuracy impact QM outcomes 
• Utilize root cause analysis to identify problems within a clinical system that need to be corrected to improve quality outcomes
• Understand ways to collaborate in quality improvement efforts

Achieve the Medicare Triple Crown: Excellence in Quality of Care, Regulatory Compliance, and Optimal Reimbursement | Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, AAPACN 

A facility’s approach to Medicare Part A and Patient-Driven Payment Model (PDPM) management can sometimes feel like an untrained and sluggish racehorse that falls short of the rest of the pack. During this insightful session, the speaker will take you around the track to achieve excellence by identifying common missteps in managing Medicare Part A and PDPM in skilled nursing facilities (SNFs). Just like a well-run race, every element counts! You will leave equipped with the knowledge needed to maneuver through the complexities of Medicare and PDPM with confidence at every step. Refine your strategies to stay ahead of the pack and achieve the Medicare Triple Crown! Following this session, you’ll be able to:

• Recognize common errors facilities make under Medicare and PDPM that can impact care, compliance, and reimbursement
• Understand the financial and operational consequences of Medicare and PDPM missteps
• Implement actionable strategies to avoid pitfalls and optimize the facility’s quality of care and reimbursement processes
• Improve team communication and coordination to ensure everyone is “on the same track” regarding compliance and documentation

Rolling Out the Red Carpet for New Long-Term Resident Admissions and Employees | Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, AAPACN

Retaining resident census and decreasing staff turnover in the long-term care setting is essential to fostering a positive workplace environment for staff so they can provide quality care to residents. Unhappy residents often leave long-term care facilities against medical advice jeopardizing their own healthcare due to a lack of communication regarding healthcare expectations from the point of admission. Following this session, you’ll be able to:

• Identify the steps to take that will make the best first impression
• Recognize which small details actually do matter
• Understand what truly matters to your staff
• Recall ways to win additional referrals after a resident’s discharge

Revitalize Your Restorative Nursing Program for Positive Outcomes, Compliance, and Reimbursement | Colleen Toebe, RN-MSN, CWCN, RAC-MTA, RAC-MT, DNS-MT, Pathway Health Services

A well-planned Restorative Nursing Program is essential. Providing a good assessment process, identification of person-centered goals, and consistent implementation is essential in providing a program to avoid resident decline and promote quality of care. This fast-paced, information-packed session will provide user-friendly strategies for success! Following this session, you’ll be able to:

• Identify key regulatory and best practice aspects for implementation of a Restorative Nursing Program for quality outcomes
• Explain the documentation necessary to support the MDS 3.0 coding
• Describe three successful leadership strategies for oversight of the Restorative Nursing Program

Section GG: Not for the Faint Hearted | Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC, LeaderStat, AAPACN board member

Section GG, how do I love thee? Let me count the ways. One, you show the functional abilities of my residents, whether they are here for a long time or just a short visit. Two, you help set the reimbursement to my facility for all my Medicare residents, some of my insurance residents, and even my Medicaid residents depending in which state I live. Three, you are a huge player now in Quality Measures (QMs). Four, auditors and reviewers seem to have mixed reactions to you, which is intriguing. Five, CMS likes you so much that they have adopted you into multiple programs like QRP, VBP, and Five-Star. Is your facility supporting section GG the way it needs to be supported and loved? Are you prepared to stand behind your coding, through thick and thin? The speaker will focus on the documentation needed to back up your MDS coding, the ripple effect that inaccurate coding causes, and how far-reaching GG is now and will be in the future. Following this session, you’ll be able to:

• Describe the QMs that utilize section GG data    
• State best practices in section GG documentation  
• List the section GG items that are utilized in HIPPS calculations

Enhancing Behavioral Health Capacity in Nursing Facilities with the COE-NF | Jacob Berelowitz, LNHA, LMSW, CPHQ, CCM, and Jennifer Goodpaster, BS, RN, DNS-CT QCP CPHQ, both of the Center of Excellence for Behavioral Health in Nursing Facilities

Individuals presenting with behavioral health (BH) conditions in nursing facilities can create a significant challenge to the system, as many facilities are not prepared to manage residents with serious mental illnesses (SMI) and substance use disorders (SUD). For the past two years, through a cooperative agreement between the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS), the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) has had the opportunity to provide training, resources, and coaching to certified nursing facilities across the nation to build their capacity to admit residents with SMI and SUD.  This focused support has provided training via live webinars and developed tailored resources on a dedicated website. Technical assistance provided by COE-NF, delivered by regional behavioral specialists throughout the country, allowed for individualized solutions tailored to each facility. In this session, COE-NF program staff will share stories from the field, highlight key resources, lessons learned, and review COE-NF services and resources that nursing facilities can access at no cost to them. Following this session, you’ll be able to:

• Describe the COE-NF purpose, audience, types of service provided, and how to access them
• Understand the individualized solutions offered by the COE-NF and the effectiveness in enhancing facility capabilities
• Define steps and key components of a facility behavioral health needs assessment