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 Centers for Medicare & Medicaid Services (CMS) recently released the FY 2026 Skilled Nursing Facility Value-Based Purchasing (VBP) fact sheet. This fact sheet details the program, measures used, case-minimums, the process for making correction, and where to get more information. This AAPACN resource is copyright protected. AAPACN individual members …
In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026, officially published on April 30, 2025, the Centers for Medicare & Medicaid Services (CMS) offers a mostly positive update to the fee-for-service (FFS) Part A payment rates, projecting that …
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
The Centers for Medicare & Medicaid Services (CMS) does not propose any new quality measures (QMs) for the pay-for-performance Skilled Nursing Value-Based Purchasing program (SNF VBP) in the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026. However, three QMs …
Question: Is a Part A PPS Discharge assessment required if the resident exhausted the 100-day benefit? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, the Part A PPS Discharge MUST be completed when Medicare benefits exhaust. The Part A PPS discharge MDS must be completed every time Medicare …
The expedited determination process (called “fast-track appeals” in regulation) for appeals of service terminations by Medicare Advantage (MA) plans is very similar to—but not exactly the same as—the expedited determination process for service terminations under fee-for-service (FFS) Medicare Parts A and B, notes Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, …
Most methods for auditing Patient-Driven Payment Model (PDPM) reimbursement focus on impacts to the HIPPS code. However, AAPACN’s PDPM Audit by MDS Section tool uses an approach that can result in identifying missed opportunities for items that didn’t directly impact the HIPPS code. Nurse assessment coordinators can use this tool …
