On July 31, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2026. CMS is publishing this final rule in …
In skilled nursing facilities (SNFs), staff members often find the Patient-Driven Payment Model (PDPM) process complex and unfamiliar, especially when determining how Medicare (and, in many states, Medicaid) payment is calculated. PDPM is based on five separate case-mix adjusted components: Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), …
Myers and Stauffer provides documentation resources and training opportunities for several state Medicaid programs. Learn more below. State Clients Alabama Iowa North Carolina Arkansas Kentucky Ohio California Louisiana Oregon Colorado Maryland Tennessee Connecticut Minnesota Texas Florida Mississippi Utah Georgia Missouri Vermont Hawaii Montana Wisconsin Idaho Nevada West Virginia Indiana New …
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 …
In this LTC NAC Chat podcast episode, 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, curriculum development specialist with AAPACN, discuss the Medicare appeals process in skilled nursing facilities. Additional Resources:
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In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026, the Centers for Medicare & Medicaid Services (CMS) does not reveal any firm proposals for new quality measures (QMs). However, CMS does serve up a simple reminder for nurse …
An updated Quick Reference Guide is now available. The Quick Reference Guide provides high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links. PAC-SNF-QuickReferenceGuide-20250508 (PDF) From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/submission-deadlines
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, curriculum development specialist with AAPACN, discuss the sequencing of ICD-10-CM diagnosis coding. Additional Resources: AAPACN Articles: AAPACN Education: AAPACN Tool:
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The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code assignment continues to be a bit of an enigma in the long-term care setting. Members regularly ask questions about ICD-10-CM coding in AAPACN’s online communities, as well as in post-education surveys, often confused about how to order the codes. …
FY 2026 SNF VBP Program Fact Sheet (PDF) From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing (also updated with FY 2026 information) SNF VBP Program: FY 2026 Incentive Payment Multiplier Calculation Infographic (PDF). From https://www.cms.gov/medicare/quality/nursing-home-improvement/value-based-purchasing/scoring-methodology-payment-adjustment
