News for MDS Experts

Triple Check should not be the first time gaps are found.

A strong MDS process should connect documentation, coding, billing, therapy, nursing, diagnoses, skilled need, and care planning before claims are finalized.

Small process gaps can create bigger operational concerns.

#MDS #SkilledNursing #longtermcare #PDPM #Compliance #QualityMeasures #MDSCONSULTANTS ... See MoreSee Less

The August 2026 Performance Score Reports (PSRs) for the fiscal year (FY) 2027 Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program are now available to download via the Internet Quality Improvement and Evaluation System (iQIES).
The FY 2027 SNF VBP Program year is the first to assess performance on eight quality measures rather than four measures, as part of an expansion of the SNF VBP Program. For the FY 2027 Program year, performance in the SNF VBP Program is based on performance across the following quality measures:
SNF 30-Day All-Cause Readmission Measure (SNFRM)
Skilled Nursing Facility Healthcare-Associated Infections Requiring Hospitalization (SNF HAI)
Discharge to Community—Post-Acute Care Measure for SNFs (DTC PAC SNF)
Number of Hospitalizations per 1,000 Long Stay Resident Days (Long Stay Hospitalization)
Total Nursing Staff Turnover (Nursing Staff Turnover)
Total Nurse Staffing Hours per Resident Day (Total Nurse Staffing)
Discharge Function Score for SNFs (Discharge Function Score)
Percent of Residents Experiencing One or More Falls with Major Injury (Long-Stay) (Falls with Major Injury (Long-Stay))
SNFs may submit requests for corrections to their performance score and ranking up to 30 days following this report being made available, until August 30, 2026.
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🚨On July 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS) for fiscal year (FY) 2027. CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for SNFs annually. This fact sheet discusses the final rule’s provisions.
- 𝗙𝗬 𝟮𝟬𝟮𝟳 𝗙𝗶𝗻𝗮𝗹 𝗨𝗽𝗱𝗮𝘁𝗲𝘀 𝘁𝗼 𝘁𝗵𝗲 𝗦𝗡𝗙 𝗣𝗮𝘆𝗺𝗲𝗻𝘁 𝗥𝗮𝘁𝗲𝘀
CMS finalized updating SNF PPS rates by 2.4%
- 𝗙𝗬 𝟮𝟬𝟮𝟳 𝗙𝗶𝗻𝗮𝗹 𝗨𝗽𝗱𝗮𝘁𝗲𝘀 𝘁𝗼 𝘁𝗵𝗲 𝗦𝗡𝗙 𝗤𝘂𝗮𝗹𝗶𝘁𝘆 𝗥𝗲𝗽𝗼𝗿𝘁𝗶𝗻𝗴 𝗣𝗿𝗼𝗴𝗿𝗮𝗺
Removal of two measures (1) the COVID-19 Vaccination Coverage Among Healthcare Personnel measure, and (2) the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measure
Data Submission Deadline- Revised data submission timeframe from 4.5 months to approximately 45 days, beginning with the FY 2029 SNF QRP
Minimum Data Set (MDS) Data Submission-Finalized requirement for all SNFs to submit MDS data for all SNF residents receiving covered skilled care, regardless of payer
-𝗙𝗬 𝟮𝟬𝟮𝟳 𝗦𝗡𝗙 𝗤𝗥𝗣 𝗥𝗲𝗾𝘂𝗲𝘀𝘁 𝗳𝗼𝗿 𝗜𝗻𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻
CMS received comments on one potential measure topic that might be adopted in future years for the SNF QRP: advanced care planning (ACP)
-𝗙𝗬 𝟮𝟬𝟮𝟳 𝗙𝗶𝗻𝗮𝗹 𝗨𝗽𝗱𝗮𝘁𝗲𝘀 𝘁𝗼 𝘁𝗵𝗲 𝗦𝗡𝗙 𝗩𝗮𝗹𝘂𝗲-𝗕𝗮𝘀𝗲𝗱 𝗣𝘂𝗿𝗰𝗵𝗮𝘀𝗶𝗻𝗴 𝗣𝗿𝗼𝗴𝗿𝗮𝗺
CMS finalized performance standards for the FY 2029 and FY 2030 program years to comply with the program’s statutory notice deadline. CMS will update the “snapshot date” codified at 42 CFR § 413.338(f)(1)(v) for two measures calculated using MDS assessment data to maintain alignment with the newly finalized SNF QRP submission deadlines for MDS assessment data, beginning with FY 2027 data
-𝗥𝗲𝗾𝘂𝗲𝘀𝘁 𝗳𝗼𝗿 𝗜𝗻𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻 𝗼𝗻 𝗨𝗽𝗱𝗮𝘁𝗶𝗻𝗴 𝘁𝗵𝗲 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗗𝗿𝗶𝘃𝗲𝗻 𝗣𝗮𝘆𝗺𝗲𝗻𝘁 𝗠𝗼𝗱𝗲𝗹 𝗣𝗮𝘆𝗺𝗲𝗻𝘁 𝗦𝘆𝘀𝘁𝗲𝗺 𝘁𝗼 𝗔𝗱𝗱𝗿𝗲𝘀𝘀 𝗖𝗮𝘀𝗲-𝗠𝗶𝘅 𝗨𝗽𝗰𝗼𝗱𝗶𝗻𝗴
Request for Information (RFI) focused on potential updates to the Patient Driven Payment Model payment system as part of a broader effort to ensure that payment policy reflects current care practices and changes in the SNF resident population. The RFI also focused on how CMS could address observed case-mix upcoding
cstu.io/7e0d8f
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𝗠𝗲𝗱𝗶𝗰𝗮𝗶𝗱 𝗵𝗮𝘀 𝗯𝗲𝗲𝗻 𝘀𝗲𝗿𝘃𝗶𝗻𝗴 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝗶𝗲𝘀 𝘀𝗶𝗻𝗰𝗲 𝟭𝟵𝟲𝟱—𝗯𝘂𝘁 𝗼𝗻𝗲 𝘁𝗵𝗶𝗻𝗴 𝗵𝗮𝘀 𝗻𝗲𝘃𝗲𝗿 𝗰𝗵𝗮𝗻𝗴𝗲𝗱: D𝗼𝗰𝘂𝗺𝗲𝗻𝘁𝗮𝘁𝗶𝗼𝗻 𝗺𝗮𝘁𝘁𝗲𝗿𝘀.

As reimbursement models, regulations, and quality initiatives continue to evolve, strong clinical documentation remains the foundation for:
• Accurate Medicaid reimbursement
• Case mix integrity
• Regulatory compliance
• Better resident outcomes

Every assessment tells a story. Every note supports the care behind it.

Today, we recognize Medicaid's lasting impact—and the healthcare professionals whose documentation helps ensure quality care is delivered every day.

#Medicaid #LongTermCare #MDS #CaseMix #QualityCare #HealthcareCompliance #SNF #MDSConsultants #DocumentationMatters ... See MoreSee Less

The RBS (Risk Based) survey will be implemented nationwide beginning September 8, 2026. CMS is providing SAs and CMS Locations information related to training and implementation to prepare for the RBS launch in August and September 2026. High Performing Facility Icon: 🏆 CMS will place an icon on Nursing Home Care Compare website identifying facilities that qualify for the RBS which indicates a higher level of performance. The icon will remain on the nursing home’s profile page until the facility is no longer eligible for the RBS.
Ref: QSO-26-14-NH cstu.io/19e18d
Appendix A - RBS Facility Qualifying Criteria
Appendix B - RBS Training Schedule
Appendix C - RBS Facility Disqualifying Criteria
Appendix D - Qualified Facilities and Exclusions Counts and Percents by State
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💡 A physician's order is just the beginning.

A medication order tells us what was prescribed.

The care plan should tell us why, what we're monitoring, what interventions are in place, and how we'll know if the plan is working.

When documentation, care planning, and interdisciplinary communication all tell the same story, the entire team is better equipped to support the resident.
Sometimes the best survey preparation isn't adding more documentation, it's making sure the documentation you already have connects.

What processes has your team found most helpful for keeping everyone on the same page?

#LongTermCare #SkilledNursing #MDS #CarePlanning #QualityMeasures #SurveyReadiness #InterdisciplinaryTeam ... See MoreSee Less

PBJ Employee Linking -Reminders released on Jul 23, 2026.
•Add new employee IDs to the system before linking.
•Link employees as soon as you know about changes.
•It’s okay to link employees before assigning hours.
•Links are active when your file is accepted with no errors.
•Check the employee report to make sure you linked the right people.
•System Employee IDs in QIES will move to iQIES during the transition.
•QIES linking - use the current Federal Fiscal Quarter (Quarter 3) for PBJ link file submissions through August 14, 2026.
•iQIES linking - Quarter 4 submissions start after August 17, 2026. PBJ link file submissions will be accepted in iQIES on August 17, 2026.
•Templates and more information on linking can be found in the downloads section here: cstu.io/c3b596
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The Five-Star rating preview reports for nursing homes will be available in iQIES on July 22, 2026. Nursing Home Care Compare will update with the July Five-Star data on or around July 29, 2026.

Important Note: The Five-Star Helpline (800-839-9290) will be available July 27-31, 2026. For assistance logging into iQIES, please contact the iQIES Service Center via email (iQIES@cms.https://cstu.io/a1ca94) or by phone (800-339-9313).
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👀 Are you seeing the full picture?

Quality Measures are only one piece of the story.

Understanding how iQIES data, Quality Measures, and facility performance work together can help your team identify opportunities before they become survey concerns.

Join us for the final session in our Quality Measures Series as we connect the dots between data, resident outcomes, and performance improvement.

𝗦𝗲𝗲𝗶𝗻𝗴 𝘁𝗵𝗲 𝗙𝘂𝗹𝗹 𝗣𝗶𝗰𝘁𝘂𝗿𝗲: 𝗶𝗤𝗜𝗘𝗦, 𝗤𝗠𝘀, 𝗮𝗻𝗱 𝗦𝗡𝗙 𝗣𝗲𝗿𝗳𝗼𝗿𝗺𝗮𝗻𝗰𝗲

📅 August 4, 2026

Register today at: www.mdsexpert.com/webinars-training/?utm_source=contentstudio.io&utm_medium=referral/

#LongTermCare #SkilledNursing #MDS #QualityMeasures #iQIES #SurveyReadiness #QAPI ... See MoreSee Less