The PDPM Nursing category. A Primer for MCRA and MCD

Traditionally, the PDPM nursing category has been underutilized in its representation of resident unique characteristics. With the elimination of section G in MDS 3.0 v1.18.11 in October 2023, states are moving away from RUG based case mix index rate adjustments to PDPM based systems that generally incorporate only the PDPM nursing category in that calculation.…...

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Georgia Transition to PDPM for Medicaid CMI

Download course materials here. Georgia has transitioned to PDPM for Medicaid CMI and rate calculations. This training will help providers get up to speed with regard to this transition along with practical steps they can take to ensure that their PDPM generated CMI is an accurate reflection of the resident’s unique clinical mix. Version 2…...

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SNF QRP Measures a deep dive

The SNF Quality Reporting program, or SNF QRP, Continues to grow in it’s importance and influence on skilled nursing facilities. With the FY 22024 final rule firmly establishing SNF QRP expansion, providers should be aware of the scope and variety of measures that reporting requirements that could impact their PPS payment rates. This presentation will…...

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Kentucky Transition to PDPM for Medicaid CMI

Kentucky has transitioned to PDPM for Medicaid CMI and rate calculations. This training will help providers get up to speed with regard to this transition along with practical steps they can take to ensure that their PDPM generated CMI is an accurate reflection of the resident’s unique clinical mix.  Course materials are available here....

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Tennessee Transition to PDPM for Medicaid CMI

Tennessee has transitioned to PDPM for Medicaid CMI and rate calculations. This training will help providers get up to speed with regard to this transition along with practical steps they can take to ensure that their PDPM generated CMI is an accurate reflection of the resident’s unique clinical mix.  Course materials are here....

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Get to know Your Confidential Feedback Reports

More than half of the FY 2024 SNF PPS Final Rule was dedicated to the SNG QRP and VBP programs. A significant component of both of these programs now spotlights Social Risk Factors and Health Equity. The VBP program has a health equity bonus structure and CMS recently released Health Equity confidential feedback reports for…...

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Significant Change in Status: Updates to the Quality Measures, Staffing and 5-star Without Section G

With section G’s removal from MDS 3.0 v1.18.11, the residual implications are far reaching. On Sept. 20th. CMS released QSO-23-21-NH describing these significant changes. Along with this memo, CMS released updated versions of the 5-Star User’s guide and the Quality Measures User’s Manual detailing the specific technical specifications to the quality measures and staffing star…...

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SNF Value Based Purchasing FY 2024, a Deeper Dive

CMS has upped the game when it comes to SNF Value-Based Purchasing. By 2028 there will be 8 measures that facilities will have to perform well on in order to retain some or all of the 2% withhold. Providers will need to understand measures as well as the scoring method and health equity adjustment. This…...

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Insiders Summer Education Series MDS 3.0 v1.18.11 Appendix A

MDS 3.0 and the Final RAI Manual revisions have been posted. There have been revision to Appendix A. This program will help providers understand these revisions as well as consider ways to operationalize the updates. Course materials. Enjoy!...

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Insiders Summer Education Series MDS 3.0 v1.18.11 CATs and CAAs

MDS 3.0 and the Final RAI Manual revisions have been posted. There have been changes and or revision to the CATs and CAAs. This program will help providers understand the changes and revisions as well as consider ways to operationalize the updates. Course materials. Enjoy! (Note: if you say CAA, you kind of sound like…...

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