FY 2024 SNF PPS Final Rule Initial Timeline for NACs: How/When the MDS Takes Center-Stage

Breathing room will be in short supply for nurse assessment coordinators (NACs) and other interdisciplinary team members who need to implement and monitor the multitude of changes to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) and the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP) that are in …

Effective Business Case Development for Budget Wins and Better Care Outcomes

The phrase “budget development time” often elicits moans and groans from facility leadership. During this process, leadership usually asks the director of nursing services (DNS) if he or she has any requests of items to include in the budget. Often, the DNS makes a list of nursing department wants and …

The DNS’s Role in the Annual Budget

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, curriculum development specialist for AAPACN, discuss the director of nursing services’ (DNS’s) role in the annual budget.

BIMS MDS Coding Video Tutorial Updated

The Centers for Medicare & Medicaid Services (CMS) is offering an updated video tutorial to assist providers with guidance application and interview strategies for the cognitive assessment known as the Brief Interview for Mental Status (BIMS) found in the MDS 3.0 RAI v1.18.11, effective October 1, 2023. This video tutorial …

OSA Crash Course: Keys to Navigating this Medicaid-Only Payment Assessment

In a number of Medicaid case-mix states, the MDS v1.18.11 item sets won’t be the only MDS item sets that are implemented on Oct. 1, 2023—a fact that should temper some excitement about certain MDS items, such as section G (Functional Status), “going away,” suggests Scott Heichel, RN, RAC-MT, RAC-CTA, …

How Will October 2023 MDS Changes Impact PDPM and Medicare Payment?

Many changes are coming to the Minimum Data Set (MDS) effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Resident Assessment Instrument (RAI) User’s Manual version 1.18.11 in April with a final manual expected in August. Several of the MDS …

Medicare Managed Care Basics: Critical Intel for the DNS

Data from the Centers for Medicare & Medicaid Services (CMS) shows that, as of January 2023, half of all Medicare beneficiaries are now enrolled in a Medicare Advantage plan, according to a recent Kaiser Family Foundation report. Additional CMS data released in June 2023 indicates that although the number of …

Restorative Nursing Payment and Documentation Issues: Keys to Success

Restorative nursing can impact fee-for-service Medicare Part A payment in the Behavioral Symptoms and Cognitive Performance category and the Reduced Physical Function category of the nursing component in the Patient-Driven Payment Model (PDPM), says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC, director of education for Hansen, Hunter & Co. …

MLN Publication: SNF Three-Day Qualifying Hospital Stay and Medicare Billing Rules

Skilled Nursing Facility 3-Day Rule Billing Format Fact Sheet ICN: MLN9730256 Publication Description: Learn communication of coverage, claims processing edits, and financial responsibility. https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/snf3dayrule-mln9730256.pdf