We are joined by Dee Shaffer, a dually Missouri & Kansas licensed admin.  What works for her facility to navigate the complex world of Medicare & Medicaid.  

Why did this trigger when I answered the late loss ADL's as not attempted due to medical condition?  Wait, this resident only declined in one area, why did this also trigger?  

What can I do about this long stay QM flag?  What are the exclusions?  How can I get my provider to stop using these?

Why is this pressure sore from December listed on my January QM report?  

Do you know what the entry/admission function score is?  It is part of the Discharge Function Score.  Tune in now!

Let's talk about section I diagnosis coding. How do we not get into trouble?

Are we getting a section R?  What about all the therapy question changes?

What do we do about unplanned discharges?  How are we supposed to have information?  What if the discharge was a PPS & OBRA discharge combined, what is that time frame?

When should these be signed?  Before the ARD?  After?  Staff interview question specifics??

What category does Covid fall into?  Dementia does not below in the neuro categories. 

Do not find yourself having a one on one with the OIG!  Who decides if the MDS person purposely miscoded an assessment?

I have my ADL charting in the notes, is that good enough?  Make sure you are using the ARD and two previous days for your ADL assessments!

When should isolation be coded?  What are the constituents of an MDRO?

Can I summarize?  Is an impaired BIMS enough documentation to mark the resident impaired?

What questions in section GG are used here?  Are these included in the 5-star rating?

Does changing physicians prompt a sig change?  My resident is leaving the facility after a major decline.  Do I complete a sig change?

What?  13 pages on CMS.gov?  We break this down to a very easy subset.  SNF QRP FY2026 APU Table for Reporting Assessme...

Does walking figure into the nursing CMI?  What about HIV or cancer?  We briefly cover the entire MDS to reveal what sections play into this calculation.  Tune in!

Is schizophrenia non-traumatic brain dysfunction or medically complex?  What category do I choose for this fall with a fracture and subsequent hip replacement?

Wait, my resident is NPO, how do I code eating?  My other resident has never ate by mouth?

Adding a section R?  What does that mean?  What will be in it?

Is this weight loss coded on the last MDS real?  Wait, my resident lost weight at 4 months but is back to normal.  Do I code this?  

The most common erroneously coded QM is a UTI.  Are you coding it wrongly too on the MDS?  How did the RAI change the coding in relation to sepsis last October?

We answer a few more of your questions and drop the new bombshell from Myers & Stauffer!!

What do we include?  What should we never do?  What is a leading query?