The importance of accurate coding of section GG, Functional Abilities, continues to grow as this data is used in care planning, Quality Measures, reimbursement, and regulatory compliance. The Centers for Medicare & Medicaid Services (CMS) released the final RAI User’s Manual, v1.20.1, in late August. It includes several clarifications for …
MDS section R (Health-Related Social Needs) is officially no more. The big news for nurse assessment coordinators (NACs) in the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Final Rule for Fiscal Year (FY) 2026, released on July 31, 2025, and published on Aug. 4, is …
The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for the fiscal year (FY) 2026 Skilled Nursing Facility Prospective Payment System (SNF PPS), addressing several key recommendations submitted by the American Association of Post-Acute Care Nursing (AAPACN). AAPACN provided detailed input on rate setting, ICD-10 code mapping, …
Since the implementation of the Patient-Driven Payment Model (PDPM), nursing facilities have had to take a more nuanced approach to how a resident’s needs are assessed and documented. As discussed in part 1 of this series, Medicare payment, as well as Medicaid payment in many states, is determined using PDPM …
Summer usually is a time for nursing home residents to experience social outdoor activities and meals. It could mean attending barbecues, picnics, parades, outdoor concerts, or baseball games, gardening or birdwatching, doing outdoor crafts, or even just taking the air on the patio or another outside space. However, summer fun …
The Centers for Medicare & Medicaid Services (CMS) did not propose any changes to the previously adopted quality measure (QM) sets for either the Skilled Nursing Facility Quality Reporting Program (SNF QRP) or the Skilled Nursing Facility Value-Based Purchasing program (SNF VBP) in the Medicare Skilled Nursing Facility Prospective Payment …
Falls remain one of the most persistent and expensive challenges in long-term and post-acute care (LTPAC) settings. For the director of nursing services (DNS), the responsibility to decrease fall risk while maintaining resident dignity and autonomy is a delicate balance. Conventional approaches, such as checklists, environmental modifications, and routine assessments, …
Written by Kristine Martinez, BSN, RN, RAC-CT, RAC-CTA, QCP, DNS-CT, MDS Consultants Often, section K on the minimum data set (MDS), along with the associated care area assessments (CAAs) and care planning are delegated to the dietitian to manage. However, when reviewing a comprehensive MDS, it becomes clear that section …
The American Association of Post-Acute Care Nursing (AAPACN) surveys nurse assessment coordinators (NACs) every other year on aspects of their work, salary, and time. The 2025 AAPACN NAC Work Study and Salary Report offers valuable insights into the challenges NACs face that can help with staff retention. The study also …
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), …
