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), …
Question: A resident elected hospice on July 9, 2025. What is the required completion date for the Significant Change in Status Assessment (SCSA), and what steps should be taken if the resident passes away before the assessment is completed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: …
Question: Is aspirin coded as an antiplatelet in N0415I? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The RAI User’s Manual includes aspirin as an antiplatelet medication on page N-9: “N0415I1. Antiplatelet: Check if an antiplatelet medication (e.g., aspirin/extended release, dipyridamole, clopidogrel) was taken by the resident at any …
Question: How do we code interviews that were not complete when a Medicare resident has an unplanned discharge to the hospital? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: If the interviews were not completed, you would need to answer the gateway question that ‘Yes’ the resident interview should …
When completing any Minimum Data Set (MDS) assessment, accurate coding of A0310E is critical. This item is completed on OBRA (Omnibus Budget Reconciliation Act), scheduled PPS (Prospective Payment System), and OBRA discharge assessments. It asks, “Is this assessment the first assessment since the most recent admission/entry or reentry?” How this …
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 …
Question: If a resident initiates his/her discharge for the following day and the facility was able to organize home care, equipment, etc., is this considered a planned or unplanned discharge? Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA: There is a distinct difference between being able to prepare for a …
Question: The RAI User’s Manual guidance for mechanically altered diet mentions “soft solids.” Would that include solids that are naturally soft or solids that we would “soften”? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The diet needs to be mechanically altered to facilitate eating/swallowing in order to code …
In this LTC NAC Chat podcast episode, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, senior curriculum development specialist with AAPACN, discuss the MDS changes coming this fall and what we know right now. Additional Resource:
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N0415 (High-Risk Drug Classes: Use and Indication) is much more than just paperwork. This MDS item impacts resident care through the care area triggers (CATs) and the care area assessments (CAAs), as well as facility performance across the Skilled Nursing Facility Quality Reporting Program (SNF QRP), the Skilled Nursing Facility …
