Section O Overhaul: Changes to Therapy Coding

The Long-Term Care Resident Assessment Instrument (RAI) 3.0 User’s Manual (RAI User’s Manual) version 1.20.1, effective Oct. 1, 2025, will bring major changes to section O of the MDS 3.0. The most significant update introduces item O0390, Therapy Services, replacing most of the current O0400 (Therapies) and removing O0420 (Distinct …

Crack the Code: Staff Assessment for Mental Status Items

The nurse assessment coordinator (NAC) plays an essential role in capturing a resident’s cognitive status by coordinating and coding the Staff Assessment for Mental Status in the Minimum Data Set (MDS). The Brief Interview for Mental Status (BIMS) remains the preferred approach. But in certain situations, staff observations must be …

Top Four GG Strategies: Preparing for the October Updates

The importance of accurate coding of section GG, Functional Abilities, continues to grow as this data is used in care planning, Quality Measures, reimbursement, and regulatory compliance. The Centers for Medicare & Medicaid Services (CMS) released the final RAI User’s Manual, v1.20.1, in late August. It includes several clarifications for …

FY 2026 SNF PPS Final Rule: Summary of Responses to AAPACN’s Comments

The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for the fiscal year (FY) 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS), addressing several key recommendations submitted by the American Association of Post-Acute Care Nursing (AAPACN). AAPACN provided detailed input on rate setting, ICD-10 code mapping, …

2025 NAC Work Study and Salary Report: Support NACs and Determine FTE Needs

The American Association of Post-Acute Care Nursing (AAPACN) surveys nurse assessment coordinators (NACs) every other year on aspects of their work, salary, and time. The 2025 AAPACN NAC Work Study and Salary Report offers valuable insights into the challenges NACs face that can help with staff retention. The study also …

Out the Door, On a Leave, or Gone for Good? Uncomplicating Discharges

In the fast-paced position of a nurse assessment coordinator (NAC), keeping track of all the residents’ whereabouts can be challenging. The NAC must know who is coming into the facility and if this resident is a new admission or a readmission, as well as who has left—whether on a leave …

AAPACN Responds: FY 2026 SNF PPS Proposed Rule

Every spring, the American Association of Post-Acute Care Nursing (AAPACN) anticipates the Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule. The Centers for Medicare & Medicaid Services (CMS) provides a 60-day comment period. After a review of the comments, the Final Rule is published in late summer. Historically, …

Quality Measures IQ Series: UTIs and Catheters

The long-stay Quality Measures (QMs), Percent of Residents with a Urinary Tract Infection and Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder, have straightforward methodology but complex underlying implications. Managing these QMs and achieving desired outcomes requires the nurse assessment coordinator (NAC) and the interdisciplinary …

October 2025: Draft MDS Item Sets and RAI User’s Manual

The Centers for Medicare & Medicaid Services (CMS) recently released a second version of the draft item set files for Oct. 1, 2025, updates, version 1.20.1v2, and the draft Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual (RAI User’s Manual). The draft item sets are the collection of different …