News for MDS Experts

The OIG (Office of Inspector General) announced this new work plan on 7/15/2026 and this review will determine Medicare payments for routine home care provided to hospice beneficiaries in nursing homes, estimate potential cost savings from reducing the payment to address the inefficiency in the payment structure, and examine practices of hospices with a high percentage of their beneficiaries in nursing homes.
oig.hhs.gov/reports/work-plan/browse-work-plan-projects/the-fixed-daily-rates-that-medicare-pays-... ... See MoreSee Less

The SNF Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on the compare tool on cstu.io/850704 and the Provider Data Catalog (PDC) during the October 2026 refresh. 𝗣𝗿𝗼𝘃𝗶𝗱𝗲𝗿𝘀 𝗵𝗮𝘃𝗲 𝘂𝗻𝘁𝗶𝗹 𝗔𝘂𝗴𝘂𝘀𝘁 𝟭𝟰, 𝟮𝟬𝟮𝟲, 𝘁𝗼 𝗿𝗲𝘃𝗶𝗲𝘄 𝘁𝗵𝗲𝗶𝗿 𝗽𝗲𝗿𝗳𝗼𝗿𝗺𝗮𝗻𝗰𝗲 𝗱𝗮𝘁𝗮. Access reports through iQIES in My Reports.
Provider Preview Reports for the October 2026 refresh include:
Assessment-based measures based on quality assessment data submitted by SNFs from Quarter 1, 2025 through Quarter 4, 2025.
The COVID-19 Vaccine: Percent of Residents Who Are Up to Date measure based on data from Quarter 4, 2025.
The Centers for Disease Control and Prevention (CDC) Influenza Vaccination Coverage Among Healthcare Personnel measure based on data from Quarter 4, 2025 through Quarter 1, 2026.
The CDC COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure based on data from Quarter 4, 2025.
The Discharge to Community and Potentially Preventable 30-Day Post-Discharge Readmission measures based on data from Quarter 4, 2023 through Quarter 3, 2025.
The Medicare Spending Per Beneficiary measure based on data from Quarter 4, 2022 to Quarter 3, 2024. Due to delays in the availability of CMS claims data, this measure will not be updated in October 2026 as scheduled. Updated provider measure scores (Quarter 4, 2023 through Quarter 3, 2025) will be released with the January 2027 Care Compare refresh.
The SNF Healthcare-Associated Infections (HAI) measure based on data from Quarter 4, 2024 through Quarter 3, 2025.
www.cms.gov/medicare/quality/snf-quality-reporting-program/public-reporting ... See MoreSee Less

The OIG (Office of Inspector General) will be conducting a nationwide analysis to determine the extent of antipsychotic drug use among Medicare beneficiaries in nursing homes, including the extent to which those beneficiaries had a dementia diagnosis. The work plan was announced on 6/29/26.
oig.hhs.gov/reports/work-plan/browse-work-plan-projects/nationwide-analysis-of-antipsychotic-drug... ... See MoreSee Less

Every MDS matters. Every Quality Measure counts. Every ⭐⭐⭐⭐⭐tells a story.

Join MDS Consultants on July 21 for Part 5 of our Quality Measures Series and discover how Quality Measures influence Five-Star Ratings, reimbursement, and survey success.

Whether you're an Administrator, DON, MDS Coordinator, or part of the interdisciplinary team, this session will provide practical insights you can put into practice immediately.
✨ Better understanding.
✨ Better outcomes.
✨ Better ratings.

#FiveStar #QualityMeasures #MDS #SNF #LongTermCare #HealthcareEducation #MDSConsultants ... See MoreSee Less

On August 17, 2026, the Centers for Medicare & Medicaid Services (CMS) will launch the Internet Quality Improvement and Evaluation System (iQIES) functionality for Payroll-Based Journal (PBJ) data submission and reports. 𝗛𝗲𝗿𝗲’𝘀 𝘄𝗵𝗮𝘁 𝘆𝗼𝘂 𝗻𝗲𝗲𝗱 𝘁𝗼 𝗸𝗻𝗼𝘄 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗲 𝘁𝗿𝗮𝗻𝘀𝗶𝘁𝗶𝗼𝗻.
-You must register for PBJ roles in iQIES before you can submit data.
-PBJ submissions for Fiscal Quarter 3 must be submitted in QIES only through August 14, 2026. After August 14, 2026, at 11:59 PM ET, QIES will no longer accept PBJ records.
-PBJ submissions for Fiscal Quarter 4 start August 17, 2026, and must be submitted only in iQIES. Fiscal Quarter 4 submissions will not be accepted between July 1, 2026 and August 16, 2026, in QIES or iQIES.
-Beginning August 17, 2026, users will be allowed to access and run PBJ reports in iQIES. See the list of reports including the CASPER and iQIES reports for comparison.
qtso.cms.gov/news-and-updates/what-expect-pbj-data-submission-and-reporting-iqies ... See MoreSee Less

CMS is implementing an increase to the Quality Measure (QM) rating thresholds, increasing each rating threshold by one-half of the average improvement in QM scores (QSO 19-08-NH). For the July 2026 refresh, the average improvement was determined from the period of January 2025 – April 2026.
𝘕𝘰𝘵𝘦 𝘵𝘩𝘦 𝘱𝘰𝘪𝘯𝘵 𝘵𝘩𝘳𝘦𝘴𝘩𝘰𝘭𝘥𝘴 𝘧𝘰𝘳 𝘪𝘯𝘥𝘪𝘷𝘪𝘥𝘶𝘢𝘭 𝘘𝘔𝘴 𝘥𝘪𝘥 𝘯𝘰𝘵 𝘤𝘩𝘢𝘯𝘨𝘦.
www.cms.gov/medicare/health-safety-standards/certification-compliance/five-star-quality-rating-sy...
www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/us... ... See MoreSee Less

The June 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.
www.cms.gov/files/document/appendix-b-june-2026-pdf.pdf
www.cms.gov/files/document/changes-appendix-b-june-2026-pdf.pdf ... See MoreSee Less

Facilities may need MDS support before there is a crisis.

Common signs include assessment backlogs, MDS Coordinator vacancy or turnover, PDPM coding concerns, Triple Check inconsistencies, care plans not matching MDS coding, Quality Measure concerns, or new and overwhelmed MDS staff.

A second set of eyes can help identify gaps before they become harder to fix.

#MDS #skillednursing #longtermcare #PDPM #compliance #QualityMeasures #MDSCONSULTANTS ... See MoreSee Less

Happy Fourth of July!

Today, we celebrate the freedoms we enjoy and honor those who have served and continue to serve our country.
From all of us at MDS Consultants, we wish you, your families, and your residents a safe, happy, and relaxing Independence Day.

Thank you to the healthcare professionals working through the holiday to provide exceptional care. Your dedication does not go unnoticed.

Have a wonderful Fourth of July!
❤️🤍💙

#FourthOfJuly #IndependenceDay #longtermcare #skillednursing #HealthcareHeroes #MDSCONSULTANTS #ThankYouHealthcareProfessionals ... See MoreSee Less