Question: I miscalculated the ARD window for a 5-Day and scheduled the 5-Day/PPS Discharge on day 9 of the Medicare stay. What do I need to do? Answer from Jeff Taylor:Leave everything as it is and bill one day default for the late assessment. Since the 5-Day is one day …
Question: Please clarify if section O “while a resident.” Per the RAI User’s Manual, “Check all treatments, procedures, and programs that the resident received or performed after admission/entry or reentry to the facility and within the last 14 days. If no treatments, procedures or programs were received by, performed on, …
Overview What is the SNF Validation Program? The SNF Validation Program is an audit-driven initiative aimed at evaluating the accuracy of quality measure data elements derived from the Minimum Data Set (MDS), which are used in the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) and Quality Reporting Programs (QRP) for …
This document shows how to upload assessments, create and manage assessments, complete change requests, and review Final Validation Reports (FVR) in iQIES. CMS iQIES Assessment Management for Assessment Submitter v2.0 From https://qtso.cms.gov/software/iqies/reference-manuals
The Centers for Medicare & Medicaid Services (CMS) convened a Technical Expert Panel (TEP) on May 12 and 14, 2025, to obtain input on potential cross-setting updates to the Falls with Major Injury (FMI) measure. The TEP was held in response to concerns regarding potential underreporting on the current measure …
This job aid outlines the user roles and privileges in iQIES. All users must have a role in iQIES. iQIES User Roles Matrix Job Aid v4.5 – 07/29/2025 (PDF 2.56 MB)
From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/confidential-feedback-reporting-review-and-corrections From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/scoring-methodology-payment-adjustment
CDC announces new ICD-10-CM codes effective October 1, 2025. The October 1, 2025 diagnosis code update files are now available. Use these files for discharges occurring from October 1, 2025 – September 30, 2026, and for patient encounters occurring from October 1, 2025 -September 30, 2026. The files in the 2026 …
Question: When should I set an assessment reference date (ARD) for a Significant Change in Status Assessment (SCSA) after a resident elected hospice? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The completion date for the SCSA is the “determination date +14 days.” The ARD can be …
Question: I know that McGeer criteria must be met when coding a UTI that develops in-house during the SNF stay, but what is required when a resident is transferred to the hospital and returns to the SNF with a documented UTI diagnosis (e.g., listed on the discharge summary and on …
