Question: Can Z codes be used as the admitting diagnosis on the claim? Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC: Admission Diagnosis codes (Field Locator 69 on the claim) should be the code that is the reason the resident is being admitted to the facility, versus a lower …
Question: A long-term care resident has a Quarterly assessment due on 6/19 and an Annual assessment due on 6/27. Can I do the Annual assessment early, before the Quarterly deadline? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, you can absolutely do this. Set the ARD for the …
The AAPACN Resident Interview Toolkit helps nursing home staff conduct effective resident interviews as part of the MDS 3.0 assessment process. It provides clear guidance and resources for the entire interdisciplinary team—nurses, dietary managers, social services, activities, and others—to ask residents about their mood, memory, daily routines, and care preferences. …
The Centers for Medicare & Medicaid Services (CMS) released a memo that will have a significant impact on the health inspection star rating and how the long-star antipsychotic measure is calculated, among other changes: Health Inspection Star Rating: Long-Stay Antipsychotic Measure Methodology: Other changes: For more details, see the memo: …
Navigating Medicare Part A coverage in skilled nursing facilities (SNFs) is a matter of regulatory compliance. But it’s also a daily ethical test for facility staff and administrators. In many ways it depends on the honor system, and those responsible for billing and care case management must understand and apply …
The Centers for Disease Control and Prevention (CDC) has updated the “Staying Up to Date with COVID-19 Vaccines” guidance several times since requiring COVID-19 vaccinations to be coded on the MDS as of October 2024. Facility teams can track these changes by using AAPACN’s COVID-19 Vaccine “Up to Date” Guidance …
Memo # QSO-25-20-NH Posting Date 2025-06-18 Fiscal Year 2025 Memorandum Summary • Post Performance Data for Nursing Home Chains – “Chains” refers to groups of Medicare-certified nursing homes that are connected through common owners, and operators (also called “affiliated entities”). CMS will begin posting aggregated performance information for these nursing homes on …
Question: When a resident returns from an interrupted stay, is an IPA required or any kind of readmission assessment if no change? Answer from Jeff Taylor: IPAs are always optional. In an interrupted stay, no new Medicare MDS is required. You would do the required OBRA Discharge assessment and an …
Question: A resident on a Medicare Part A stay discharged return not anticipated. His last covered day of Medicare was the day before. Can I combine the Part A PPS Discharge with the OBRA discharged return not anticipated? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, when a …
Question: For section GG documentation, the direct care staff was given the wrong dates. It was supposed to be the ARD and the two days before, but they did the first 3 days of the look-back period. Am I able to use any of the GG documentation they completed? Answer …
