News for MDS Experts

For Post Acute Care Facilities, the ICD-10-CM files include updates for FY 2026. Use these codes for discharges occurring from April 1, 2026 – September 30, 2026, and for patient encounters occurring from April 1, 2026– September 30, 2026.
cstu.io/65488e
cstu.io/19017e
cstu.io/44a838
cstu.io/63e3b8
cstu.io/23b356 ... See MoreSee Less

🚨CMS updated the start date to the Skilled Nursing Facility Data Validation Process to begin 𝗺𝗶𝗱-𝗝𝗮𝗻𝘂𝗮𝗿𝘆 𝟮𝟬𝟮𝟲. This audit process was originally scheduled to start in the fall of 2025. Skilled Nursing Facility Data Validation Process: Frequently Asked Questions (FAQs) are updated for December 2025. SNFs are notified of selection through their Internet Quality Improvement and Evaluation System (iQIES) MDS 3.0 Provider Preview Reports folder.
cstu.io/9e0496
cstu.io/02b950 ... See MoreSee Less

🌟 Happy Friday from MDS Consultants! 🌟

As we wrap up another productive week supporting skilled nursing facilities nationwide, we’re grateful for the hardworking teams delivering quality care every day.
Here’s to rest, recovery, and readying ourselves for the week ahead.

#LTCStrong #FridayFeeling #MDSConsultants #SkilledNursingSupport ... See MoreSee Less

𝗙𝘂𝗻 𝗙𝗮𝗰𝘁: 𝗗𝗶𝗱 𝗬𝗼𝘂 𝗞𝗻𝗼𝘄...?

Before hospitals and health systems jumped on the digital bandwagon, nursing homes were already leading the way in clinical data collection.

That’s right, with the introduction of the Minimum Data Set (MDS) in the early ‘90s, nursing homes became early adopters of standardized, federally mandated digital assessments.

This was before EHRs were even common in most hospitals.

𝗧𝗵𝗲 𝗠𝗗𝗦 𝗯𝗲𝗰𝗮𝗺𝗲 𝘁𝗵𝗲 𝗳𝗼𝘂𝗻𝗱𝗮𝘁𝗶𝗼𝗻 𝗳𝗼𝗿:
- PDPM
- Quality Measures (QMs)
- Five-Star Ratings
- Survey risk indicators
- Resident-centered care planning
- And, of course… Medicare reimbursement 💰

So next time someone underestimates long-term care facilities, remind them:

“𝗪𝗲 𝘄𝗲𝗿𝗲 𝗱𝗼𝗶𝗻𝗴 𝗱𝗮𝘁𝗮-𝗱𝗿𝗶𝘃𝗲𝗻 𝗰𝗮𝗿𝗲 𝗯𝗲𝗳𝗼𝗿𝗲 𝗶𝘁 𝘄𝗮𝘀 𝗰𝗼𝗼𝗹.” 😎

#MDSConsultants #LongTermCare #SkilledNursing #MDS #PDPM #QualityCare #NursingHomeHeroes #ClinicalAssessment #DataMatters #FunFactFriday ... See MoreSee Less

Learn how to avoid improper payments. See the SNF Billing Reference educational tool to find out when to bill your patient's prescription drugs to Part A, instead of their Part D drug plan. The Office of the Inspector General found that Medicare Part D improperly paid for drugs during Part A skilled nursing facility (SNF) stays. Drugs prescribed for a Part D-enrolled patient aren’t covered by Part D if Part A or B can pay for them.
cstu.io/9a2ce3
cstu.io/0ba513
cstu.io/f158ae ... See MoreSee Less

🚨January 1 Revalidation Deadline Indefinitely Suspended-Enrolled skilled nursing facilities (SNFs) should continue collecting data on ownership, managerial, and related party information and submit their revalidation. However, there is no submission deadline until further notice.
cstu.io/024102
cstu.io/d2e25e ... See MoreSee Less

𝗙𝗿𝗶𝗱𝗮𝘆 𝗥𝗲𝗳𝗹𝗲𝗰𝘁𝗶𝗼𝗻

In the world of long-term care, every interview has a person behind it—and we never forget that.

💡 Whether we’re reviewing Section GG or planning an education session, we do it with compassion, clarity, and coffee (lots of coffee).

Happy Friday from the MDS Consultants crew!

Here’s to rest, reflection, and recharging for another week of doing the work that matters.

#LTCVoice #MDSConsultants #FridayThoughts #LTCLeaders #BehindTheMDS ... See MoreSee Less

The November update of Appendix B to the MDS 3.0 RAI User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, and CMS locations and contacts.
cstu.io/5743cf
cstu.io/8f0333 ... See MoreSee Less

OIG data analysis identified Medicare Part B payments made to optometrists for high-level evaluation and management (E/M) services not usually billed by optometrists. For 2021 through 2023 (audit period), Medicare paid $4.7 million to 200 optometrists for E/M services for moderate to highly complex subsequent nursing facility care. The top 15 optometrists accounted for 72 percent of those payments. This audit examined whether the 15 optometrists complied with Medicare requirements when billing for services at nursing facilities. CMS reimbursed selected optometrists for Part B services that were not billed in accordance with Medicare requirements. All 225 of the enrollees we sampled had associated claim lines of service that did not meet Medicare documentation or coding requirements. OIG recommends that CMS recover the portion of the $3 million in estimated overpayments that are within the 4-year reopening period and develop system edits to prevent the incorrect billing of services.
cstu.io/64fff9 ... See MoreSee Less