Question: Can Isolation be coded for methicillin-resistant staphylococcus aureus (MRSA) on a wound? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: No, the RAI User’s Manual specifically states that isolation cannot be coded for a wound infection. See page O-8 (bold text added for emphasis): Code only when the …
SNF QRP Data Collection and Final Submission Deadlines The SNF QRP Data Collection and Final Submission Deadlines have been updated to provide the data collection time frames and final submission deadlines for the FY 2028 SNF QRP. From https://www.cms.gov/medicare/quality/snf-quality-reporting-program/submission-deadlines SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient …
SNF QRP Data Elements Used for Reporting Assessment-Based QMs and Standardized Patient Assessment Data Elements Affecting FY 2027 APU Determination and Data Collection and Final Submission Deadlines for FY 2027 posted The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview of Data Elements Used for Reporting Assessment-Based Quality Measures …
This file can be used by NACs to determine how ICD-10-CM codes entered on the MDS “map” to PDPM payment components. https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/patient-driven-model
Question: If an open area is found on day four after admission, is that still present on admission (7-day look-back period)? The definition of “present on admission” is “as close to admission as possible.” Answer from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: I do not think this would …
Question: A long-term resident went out to the hospital and returned on a skilled stay using his Managed Care plan. He has both a 5-Day and Annual scheduled for the same day, but at separate times. Do both of these get coded as “the first assessment” in A0310E? Answer from …
Question: For section GG, the nurse aides use a mechanical lift transfer with two-person assist for transfers four times, but physical therapy transfers with one person and maximal assist once. Part of the dependent definition is “helper does all the effort” – but this was not true for all transfers—would …
The nurse assessment coordinator (NAC) plays an essential role in capturing a resident’s cognitive status by coordinating and coding the Staff Assessment for Mental Status in the Minimum Data Set (MDS). The Brief Interview for Mental Status (BIMS) remains the preferred approach. But in certain situations, staff observations must be …
The strict coding criteria for O0110M1, Isolation or quarantine for active infectious disease, requires precise documentation to support the MDS. AAPACN’s new Documentation Template: Isolation for Active Infectious Disease tool can help nurse assessment coordinators (NACs) educate nurses on the key areas of required documentation for residents in isolation. Want …
The Centers for Medicare & Medicaid Services (CMS) recently released the final version of the RAI User’s Manual, version 1.20.1, which goes into effect Oct. 1, 2025. While the draft version has been available for several months, CMS made several additional changes, including a new definition for falls and major injury, …
