| 11 Steps to Improve Discharge Planning | <p><img src="/Articles/PublishingImages/740%20x%20740/dr-clipboard.jpg" class="ms-rtePosition-2" alt="doctor discharge" style="margin:5px;width:350px;height:350px;" />One aspect of nursing home operations that I have seen that could be
improved is discharge planning. It seems that once a discharge is being
initiated, we do that quickly in an effort to reduce workload. Discharge
planning represents many opportunities that many facilities do not take
advantage of in many different aspects. With that in mind, I would like
to offer or share the following points you may want to consider in your
discharge planning process.<br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">1.</strong> First, your interdisciplinary
team (IDT) should be conducting an IDT discharge meeting with the
resident and their responsible party ahead of the actual discharge date.
A specific date and time should be set ahead of time that everyone can
agree on. I also encouraged the IDT whenever possible to plan discharges
right after breakfast. Keep in mind that the business office bills for
date of admission but does not bill for day of discharge. Many
facilities wait until late into the afternoon to facilitate discharges.
When this happens, you are essentially providing free care throughout
that day. These expenses add up over time and include staff time, food,
supplies, rental equipment, etc. that you will not be able to bill. I
know in some cases this may not be possible, but our IDT would make
every effort to discharge residents after breakfast.<br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">2. </strong>Another
area that I would focus on is keeping a precise record of all rental
durable medical equipment (DME) that you are using to meet patient care
needs. I have seen many instances where accurate records are not
maintained and equipment gets lost or misplaced, which then you become
responsible for. I have walked by many resident rooms several days after
a discharge, and there is rental equipment still left in the room. All
rental equipment should be immediately removed from the room after a
discharge has occurred. From a financial standpoint, you are better off
purchasing this equipment rather than leasing. The lease costs will add
up considerably, and you can avoid this expense by purchasing this
equipment. <br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">3.</strong><span class="ms-rteForeColor-8"> </span>Before the resident leaves the facility, make sure
you have some boxes and plastic bags to pack up their belongings. Your
staff should be using a Resident Belongings Inventory to check off the
resident’s items that were brought in at admission. I would also highly
recommend purchasing a hotel luggage cart to transport the resident’s
belongings to their vehicle. <br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">4. </strong>For skilled nursing admissions, I
would recommend a follow-up call by the IDT within 30 days from the
date of discharge. In some situations where a resident may be struggling
at home and needs more care, you can bring that residents back into
your facility without a qualifying hospital stay and continue their
Medicare benefits unless they have been exhausted. I would also ask the
admission and business office to identify a secondary payer source for
short-term admissions in case their stay is longer than expected. This
should be done prior to or at admission. Your social services director,
therapy director or nurse case manager would be appropriate to follow
up.<br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">5.</strong> If you operate a skilled distinct care unit, it is very
important that long term care residents are not occupying these short
stay rooms. I would also encourage keeping private rooms open for
residents with highly complex care. Again, you do not want to tie up
your private and skilled beds with long term care residents. These beds
need to be available for skilled admissions.<br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">6.</strong> One aspect of
discharge planning that is vital in obtaining timely feedback from
residents who are in the process of being discharged is the completion
of a Resident Discharge Satisfaction Survey. I assign my social services
coordinator to initiate this survey during the IDT discharge meeting
with the resident and their family. This feedback evaluates the
resident’s overall stay and whether they would recommend others to your
facility. It also identifies any issues that could be resolved before
the resident leaves your facility. I would also double check to see that
there are no outstanding grievances that may still be unresolved.
Survey teams will ask to see your grievance logs so this should also be a
facility priority at discharge. This can also be a part of your QAPI
process. <a href="/Articles/Documents/discharge_survey_Trangsrud.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Resident Discharge Satisfaction Survey">Here is one example of a survey.</a> </p><p><strong class="ms-rteFontSize-3 ms-rteForeColor-8">7.
</strong> When your IDT meets to facilitate a discharge, make sure that a timely a
NOMNOC (Notice of Medicare Non-Coverage) is issued and signed by the
resident or responsible party. I have seen many instances where this was
not done and potentially puts the facility in a liable situation. This
means that the claim could be denied and the facility becomes
responsible for the cost of care for that resident for their entire
stay. Make sure you also have a trained back-up to assist with this
process. <br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">8.</strong><span class="ms-rteForeColor-8"> </span>From a marketing standpoint, I used a facility
newsletter to continue building on the relationship with discharged
residents. Facilities make significant efforts up front to build your
census, but keep in mind that many of the residents you discharge could
become repeat customers. It is vitally important to retain that
relationship that everyone has worked so hard to build. An electronic
quarterly newsletter is easy to do. At the time of admission, I would
ask for resident or family email addresses to build a list to use for
your facility communications. If you are looking to use resident
pictures or testimonials for marketing purposes, make sure you get the
required authorizations beforehand. These newsletters can also be sent
to other referral sources such as discharge planners, case managers,
social workers, and physicians. <br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">9.</strong> One thing to keep in mind,
especially with HMO and insurance payors, is that they will try to
discharge a resident too early, especially if they have Medicaid as a
back-up payor. If this happens, be prepared to file appeals on behalf of
the resident, especially if they are still receiving skilled services
during their stay. If you do not appeal, you will be paid at the
Medicaid rate while providing extensive nursing and therapy services.
You will need the resident’s approval to appeal any inappropriate or
early discharge. <br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">10.</strong> To facilitate a safe and appropriate IDT
discharge, I would also recommend a comprehensive discharge checklist to
ensure a smooth transition. Many long term care software programs have
discharge checklists that can be customized to your facility.<br><br><strong class="ms-rteFontSize-3 ms-rteForeColor-8">11.</strong>
Lastly, I would send the resident or responsible party a thank-you
letter for considering and choosing your facility for their care needs.
This is a good way to build more goodwill and further your relationship
with discharged residents and family members. <br><br><em><strong><img src="/Articles/PublishingImages/headshots/Mark-Trangsrud.jpg" alt="Mark Trangsrud" class="ms-rtePosition-2" style="margin:5px;" />Mark Trangsrud </strong>is
a retired skilled nursing home administrator with over 41 years of
experience. He has been licensed in 8 different states as a nursing home
administrator as well as serving on the South Dakota and Colorado
Health Care Association Boards. He can be reached at </em><a href="mailto:Metrangsrud57@msn.com" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="email Mark"><em>Metrangsrud57@msn.com</em></a><em>.</em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;"><br></span></em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<em> magazine includes
information from a variety of sources, such as contributing experts.
The views expressed by external contributors do not necessarily reflect
the views of Provider magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><a href="/About/Pages/Submit-Article.aspx" target="_blank" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em><span style="text-decoration:underline;">Learn how to submit an article.</span></em></a></span></em></p> | 2026-06-04T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/dr-clipboard.jpg" style="BORDER:0px solid;" /> | Caregiving | Improve nursing home discharge planning through better coordination, financial management, resident satisfaction, and follow-up care. |
| Telehealth That Works: Protecting the Progress We Make In Care | <p><strong class="ms-rteForeColor-2">ADVERTORIAL</strong></p><p style="text-align:center;"><img src="/Articles/PublishingImages/2026/iStock-1316204932.jpg" alt="" style="margin:5px;width:500px;height:333px;" /> </p><p>My mother is in long term care (LTC).</p><p>When I show up to work every day, I'm not working from theory. I know what it feels like to trust a facility with someone you love. I know what families are watching for. After more than 30 years in health care, from the emergency department to community-based care to where I sit now, I also know how often the system makes that trust harder to earn than it needs to be.</p><p>The core challenges haven't changed much, even as our technology has improved.</p><p>Coordination of care, collaboration among the providers delivering it, and communication of what's happening and when.</p><p>Three things that sound straightforward until you're managing a resident with several chronic conditions, a multitude of specialists adding orders, and a call light going off at 2 a.m. when there’s no clinician in the building.</p><p>That's the reality most skilled nursing teams are navigating, and it's the reality Lumina Care addresses on a daily basis.</p><h3>When Facilities Require the Most Assistance </h3><p>Overnight hours often leave skilled nursing facilities (SNFs) most exposed. There are fewer staff, clinical support can be limited, and the response we see too often is to transfer the resident to the ER.</p><p>This occurs not because it’s the best clinical decision, but because an overnight provider might not know the resident or have access to their complete medical picture.</p><p>The residents most affected are also the most complex. The average LTC resident is managing five to seven chronic conditions. Many are seeing multiple specialists: cardiology, pulmonology, behavioral health, wound care, etc., each with their own care plan. In rare instances, these care plans are well coordinated and well communicated.</p><p>When there is an acute change overnight, on-site staff do their best to deliver coordinated care, but it’s a challenge. </p><h3>What Telehealth Can Actually Do</h3><p>There are still skeptics, and I understand why. "Telehealth" gets used loosely, and passive remote monitoring (data collection and flashy apps with no real-time clinical response) isn't the same thing as delivering actual care via telehealth.</p><p>This distinction matters.</p><p>Telehealth means a clinician on the other end of a screen who can conduct a visual assessment, respond to an acute need, adjust a care plan, and document directly into an electronic medical record (EMR). It means having someone available when a patient needs clinical care and then sharing the information amongst providers.</p><p>I think about a major winter storm we navigated not long ago. Providers couldn't physically get into facilities, but phone lines were up, Wi-Fi was working, and we were there—remotely.</p><p>We managed acute needs, monitored residents, and kept facility teams from worrying about transfers that would have been a logistical nightmare. Telehealth didn’t replace anyone. It made vital care delivery possible during a weather emergency.  </p><h3>The Outcomes That Earned Our Confidence</h3><p>We're careful about the claims we make. What I can tell you is what we've seen and documented.</p><p>In a SNF partnership with a multi-state operator running our After-Hours Telehealth (AHTH) and Transitional Care Management programs, we saw hospitalization rates among facilities come in under 2 percent. That means 98 percent of patients were safely treated in place.</p><p>For context, the industry average for SNF hospitalizations without this kind of coverage runs around 30 percent.</p><p><br></p><p style="text-align:center;"><img src="/Articles/PublishingImages/2026/Lumina_AHTH_Graph.png" alt="[Chart: Hospitalization Rates with AHTH" style="margin:5px;width:450px;height:450px;" /> </p><p> <br>Those numbers reflect something we've come to believe deeply: continuity across settings is what determines whether the progress a resident makes in a facility holds.</p><p>The transition home isn't the finish line. It's the moment that requires the most coordination, the most follow-through, and frankly, the most investment in everything the clinical team worked so hard to build.</p><h3>What Being Part of the Team Actually Looks Like</h3><p>Every Lumina Care partnership begins with a clinical facility assessment. We sit down with leadership at both the corporate and building levels to understand how we can collaborate to assist in care delivery in each facility. That assessment shapes every care plan we develop, so that when we place an order after hours, it can be fulfilled on site. We understand the facility’s capabilities and verify our plans of care align with capabilities and the resident’s goals of care.</p><p>We also work on the operations side to make sure our clinicians have full visibility across EMRs. The EMR access allows our teams to review existing care plans, specialist notes, prior hospitalizations, and goals of care before interacting with any resident. We enter orders directly and have daily follow-up reports that are delivered to the facility and the primary care provider. This way, we’re confident everyone involved in a resident’s care delivery is in the loop.</p><p>Our Lumina360 dashboard gives facility leaders a real view of their residents. At a glance, they can easily see action items that need attention, simplifying compliance and care management.</p><p>I'm often asked whether we're there to replace anyone. The answer is no, and I mean that plainly. We're an additional set of eyes. We are here to help!</p><p>Lumina Care’s goal is to be an extension of the care team, treat residents in their home when able, help primary care providers with their patients, and assist with safe transitions home. Long term care is full of amazing people. We don’t want to replace the people who know the residents and facilities, we simply want to collaborate to assist in necessary care delivery.</p><h3>The Organizations That Will Lead</h3><p>When I think about where skilled nursing is heading, I keep coming back to something simple: the organizations that will continue to thrive will be the ones willing to ask hard questions about how care is delivered and then act on the answers.</p><p>That's especially true in rural areas, where a facility's ability to offer specialty care can come down to geography as much as resources. Telehealth changes that equation without requiring a complete overhaul of staffing or operations.</p><p>My mother is in long term care. </p><p>The people caring for her are working hard and deserve every tool available to do that well. So does everyone else in care delivery, and Lumina Care is here to help with that!<br><br><em><strong>Laura Geiger</strong> is the Chief Medical Officer at Lumina Care. </em><br><br><em>Lumina Care provides virtual clinical care and operational support to skilled nursing and long term care facilities across the country. Programs include After-Hours Telehealth, Chronic Care Management, Behavioral Health Integration, Collaborative Care Model, Telepsychiatry, Talk Therapy, Transitional Care Management, and the Lumina360 Care Analysis Dashboard.</em><br><br>Learn more at <a href="https://www.luminacare.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Lumina Care">LuminaCare.com</a>.</p> | 2026-06-03T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/telehealth_woman.jpg" width="740" style="BORDER:0px solid;" /> | Caregiving | The biggest challenges in skilled nursing care are not technology gaps, but care coordination, provider collaboration, and communication—especially during overnight hours when staffing and clinical support are limited. |
| Sarah Silva: The Leader with Heart | <p><img src="/Issues/2026/Summer/PublishingImages/Sarah-Silva.jpg" alt="Sarah Silva" class="ms-rtePosition-2" style="margin:5px;" />Sarah Silva was a brand-new face when she walked into a skilled nursing facility (SNF) during her junior year of high school. The daughter of a coal miner and a horticulturist, she had no previous experience in the world of long term and post-acute care. The training program, which allowed students to perform clinicals outside of the classroom, caught her eye. But after spending some time in the SNF, something caught her heart.</p><p>“It wasn’t something I had experienced before,” she says. “In the moment, I just knew that I enjoyed it. I loved getting to know the residents, and it became obvious that it was something I loved. I look at it now and I can say it was life changing.” </p><h3>Enter Assisted Living</h3><p>Silva changed her focus from medical school to being a certified nursing assistant. With continued exposure to skilled nursing, she enjoyed the interaction with residents and the healing that took place, but she realized that the time spent with residents, although meaningful, was short. </p><p>She then heard about a new assisted living building that was being constructed in her local community. Once she went in, she was hooked. </p><p>“It was new and beautiful,” says Silva. “I fell in love with assisted living because I love meeting people where they are. You get to build long-term relationships with the residents, and you are with them every single day. Once I started down that road, I stayed there.”</p><p>Over 20 years later, Silva grew through a number of positions in assisted living, both in Oregon and around the country. Today, she is the chair of the National Center for Assisted Living (NCAL), the assisted living arm of the American Health Care Association (AHCA), where she helps guide priorities for the sector and represents assisted living to national audiences. </p><h3>Going for It</h3><p>Silva’s road to leadership started at home. Her family lived outside of town and had a large garden. One of 11 children, she and her siblings learned the value of hard work from their parents. Everyone had to pitch in to keep things going.</p><p>However, beyond the fundamental lessons of working hard and being prepared, Sarah says it was her mother who modeled one of the most important values to her and her siblings. “If you want something, you have to go for it,” says Silva. “Our mother taught us that. She is the one who went back to school after having been a stay-at-home mom, and she got her degree in horticulture.” </p><p>Her mother was successful in her new career, and soon her success brought the family to Oregon. </p><p>“Seeing her decide in her late 30s and 40s what her dream was, and going after it, that’s something that lives with me and all of my siblings,” says Silva. “Many of us went back to school as adults, and we have an ongoing love of learning. That is one of the things that propelled me.”</p><h3>Doing It All</h3><p>Silva often jokes that she’s worked every role in assisted living, but the truth is, she might have. She started as a caregiver and then became a medication technician, front desk assistant, care coordinator, business office manager, assistant executive director (ED), ED, administrator, and more.</p><p>“That ability to go to that next step at any point in my career was only brought about by having wonderful mentors and the value that was instilled in me and my in siblings to always be learning,” says Silva. “Always be willing to do something, even if you don’t feel like you’re ready for it. Those are the reasons that I’ve managed to go from being a caregiver to being a president.”</p><p>Silva’s most recent role was as president of Arete Living. Today, she is Chief Quality and Strategy Officer at Senior Housing Managers, LLC. The company, which is based in Wilsonville, Ore., owns, operates, develops, and manages senior housing communities.</p><h3>National Leadership</h3><p>As NCAL Board chair, Silva prioritizes amplifying the assisted living profession’s voice. Not only does she focus on carrying out NCAL’s work but also on bringing new voices from across the country to the table to share ideas and best practices.</p><p>“The more that we can pull in a variety of operators, from the small, independently owned, to the medium-sized regional operators, to the large national ones, the better,” she says. “Everyone is participating in the industry and making life better for seniors, and a critical element moving forward is to engage people at all levels.”</p><p>One place where Silva sees that providers are engaged is the AHCA/NCAL National Quality Award Program. And again, Silva’s experience here is vast. Having been an operator who went through the program, she says that going through all the levels changes how providers operate. </p><p>“It was a career-changing portion of my life to go through that with the team, to drill down and change how we think about quality,” she says.</p><table cellspacing="0" class="ms-rteTable-0" align="center" style="width:50%;height:87px;"><tbody><tr class="ms-rteTableEvenRow-0"><td class="ms-rteTableEvenCol-0" style="width:100%;"><div style="background-color:#e1a846;color:black;padding:15px;"><div style="text-align:center;">
<a href="/Video-Resources/ProviderTV/Pages/3-Ways-Assisted-Living-Providers-Can-Lay-the-Groundwork-for-Future-Success.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="3 Ways Assisted Living Providers Can Lay the Groundwork for Future Success" target="_blank"><span class="ms-rteFontSize-4"><strong><img src="/Articles/PublishingImages/2026/Sarah-Silva_play.jpg" class="ms-rteImage-1" alt="Sarah Silva" style="margin:5px;" /><span class="ms-rteFontSize-3">Watch <em>Provider's</em> interview with Sarah Silva</span></strong></span></a></div><p></p>
</div></td></tr></tbody></table><h3>A Quality Champion</h3><p>The Baldrige Performance Excellence Program, on which the National Quality Award Program is based, is a national model for excellence that focuses on all parts of an organization. While providers collect data on clinical measures, such as falls, hospitalizations, rehospitalizations, off-label use of antipsychotic medication, etc., other areas of the program call for action. </p><p>“You look at your life enrichment team and say, ‘What does it look like in this department? How are we ensuring that the programming that we’re offering is inclusive and is meeting the needs of every one of our residents, not just the ones who are social and come out for every activity?’”</p><p>She also points out posing questions for other departments. “It’s taking that mindset of continuous quality improvement and applying it in every aspect of your business to transform the community and building a cohesive team so that everyone is moving in the same direction and has the same goal.”</p><h3>Looking Ahead</h3><p>Silva points to an incoming surge of individuals who are going to need care, roughly four million people over 80 every five years. Although providers are already meeting the demands, Silva says it will be critical to keep resident choice front and center. </p><p>“The generation we are going to continue to care for are people who have spent their entire life advocating for individual choice and to live life on their terms,” says Silva. “For providers, the key is to figure out how to overcome obstacles and ensure that residents get to live this next chapter of life on their own terms, and that it is just as fulfilling and life affirming as every other chapter of their life has been.”</p><p>Silva points out that she has already observed a surge of people who are staying home longer and entering assisted living at a higher acuity than seen in the past. </p><p>“We’ve been presented with a unique challenge of ensuring that we are supporting that resident’s independence as much as possible, while taking care of them,” she says. “The reality is we’re both hospitality and health care, and it’s our job to do both of them equally well.”</p><h3>The Workforce Task</h3><p>The key to meeting this challenge is to attract, retain, and support a large, dedicated workforce, which continues to be its own challenge for assisted living providers. Doubly so, Silva says, as the gap between the number of people who work as caregivers and the number of people who need them will grow. Still, she sees opportunities amid assisted living’s responsibility.</p><p>“There is such a credible hope in the fact that the generation that is entering the workforce wants to do great work,” she says. “They want their work to have meaning, and they want their work to have purpose.” </p><p>“It’s our job to find them. It’s our job to train them. It’s our job to introduce them to our field and to this very purpose-driven work as a career opportunity that isn’t always top of mind.”</p><h3>A Million Good for Every Bad</h3><p>Working in any health care field is not easy. The hours are often long, and many professionals are on call several hours a day. In her over 20 years in the profession, Silva says what keeps her energized is, hands down, the people. “You can’t help but be energized when you are surrounded by people every day that just want to do the right thing,” she says. </p><p>She lights up speaking about a friend, also named Sarah, who is just a phone call away. </p><p>“At any point, if I feel like I am having a bad moment, or there’s something that’s weighing me down, I know she’s just a phone call away,” she says. The profession is filled with people like her.</p><p>“When you’re done talking to them, they will have reminded you why the bad moment is okay, because there are a million more good moments than bad. They’ll say, ‘Okay, but do you want to hear what happened at this community today? Because you’ll love this story.’”</p><p>“Sometimes when you’re in a leadership position, your phone tends to ring with news that something bad has happened, but what keeps me energized is remembering that there’s a million good things for every one of those bad ones.” <br><br><em><strong>Amy Mendoza</strong> is a freelance writer and editor specializing in long term care, health policy, and health care operations.</em></p> | 2026-06-01T04:00:00Z | <img alt="" src="/Issues/2026/Summer/PublishingImages/Sarah-Silva.jpg" style="BORDER:0px solid;" /> | Assisted Living | Silva often jokes that she’s worked every role in assisted living, but the truth is, she might have. She started as a caregiver and then became a medication technician, front desk assistant, care coordinator, business office manager, assistant executive director (ED), ED, administrator, and more. |
| Regulatory Updates Echo AHCA's Better Way | <p style="text-align:center;"><img src="/Issues/2026/Summer/PublishingImages/SF%20reg_2203581622.jpg" alt="" style="margin:5px;" /> </p><p style="text-align:center;"><br></p><p style="text-align:left;">The American Health Care Association (AHCA)’s <a href="/Issues/2025/Summer/Pages/AHCA%27s-Better-Way-to-Support-an-Aging-America.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Better Way agenda" target="_blank">Better Way</a> agenda is based on the principle that America’s aging population unequivocally deserves high quality care. In order to deliver that care, providers need an efficient, effective, transparent, and accountable regulatory system that prioritizes residents and their caregivers. Better Way begins with the premise that oversight is necessary—and that it must be rational. </p><p>Reform takes time, but recent Centers for Medicare and Medicaid Services (CMS) updates show that policymakers are listening to the concerns of long term care providers across the country. Recent rule changes address longstanding inefficiencies and restrictive policies, helping skilled nursing facilities (SNFs) redirect their focus from untangling bureaucratic red tape to caring for their residents. From faster dispute resolution to more accessible civil money penalty funds, here’s what’s changed and what those changes mean for AHCA members.</p><h3>Faster, More Transparent Dispute Resolution</h3><p>CMS’s Informal Dispute Resolution (IDR) process gives facilities the right to appeal citations. For many providers, their appeal has been complicated by the time it takes regulators to complete the process. Some AHCA members have waited close to a year for a decision, all the while facing reputational damage due to the deficiency cited on their record. In addition, they have often received decisions with no clear explanation, leaving them in the dark about the full picture of the alleged deficiency.</p><p><img src="/Issues/2026/Summer/PublishingImages/SF-reg_sum26.jpg" alt="Better Way" class="ms-rtePosition-2" style="margin:5px;width:250px;height:250px;" />This is why the Better Way agenda advocated for IDRs to require timely response from CMS and state health departments, with a written rationale for the regulator’s decision. New CMS guidance, which took effect on April 30, 2026, provides for just that: a decision completed within 60 days of the facility’s request, with a written explanation of the reviewer’s conclusions. </p><p>“We’re encouraged that they provide clarity on that process,” said Holly Harmon, AHCA/NCAL’s senior vice president of quality, regulatory, and clinical services. “We appreciate and advocated for that because understanding the rationale behind a decision is inherent to quality improvement so the right interventions can be applied.”</p><h3>More Efficient Reviews</h3><p>In another helpful update, CMS adjusted its guidance regarding offsite reviews of cited deficiencies, also known as desk reviews. As providers know, when surveyors issue citations to a facility, the facility responds by submitting a plan of correction, after which the surveyor returns to ensure compliance. However, many deficiencies don’t necessarily require onsite observation to ensure compliance, and because of state agencies’ backlogs, those return visits often happen only after considerable delays.</p><p><img src="/Issues/2026/Summer/PublishingImages/Holly-Harmon.jpg" alt="Holly Harmon" class="ms-rtePosition-1" style="margin:5px;width:125px;height:154px;" />It was with these backlogs in mind that AHCA advocated for CMS to allow desk reviews of some deficiencies—a change that would help increase government efficiency while speeding up the review process for providers. In guidance that also took effect on April 30, 2026, CMS allows offsite reviews for less serious deficiencies—D, E, and F without substandard quality of care—and for those that simply don’t require direct observation. “This update helps everyone use their resources more effectively,” said Harmon. “It means that state surveyors can be more effective in performing onsite or offsite follow-up, where indicated.”</p><p>The updates also provide clearer guidance on noncompliance survey timelines. In the past, agency backlogs could result in overlapping survey cycles, with facilities correcting alleged deficiencies only to have new complaint investigations extending the enforcement cycle—even if the facility returned to compliance after the earlier citations. The new framework, for which AHCA advocated, closes the original survey cycle and starts a new one, provided certain conditions are met. </p><p>CMS also updated the Nursing Home Compare Health Inspection Rating, providing a more accurate and timely picture for consumers. Previously, CMS used a facility’s three most recent standard surveys to calculate its star rating. However, starting in July 2025, as a result of ongoing backlogs, the tool refined the calculation to incorporate only the two most recent surveys. </p><h3>Reevaluating Revalidation</h3><p>In December 2025, CMS also announced the indefinite suspension of its January 1, 2026, deadline for the mandatory off-cycle SNF provider enrollment revalidation process. Ownership disclosures are nothing new for nursing homes; however, new reporting requirements drastically expanded the amount of information providers needed to gather, including information from unrelated third parties that have no ownership stake. Meanwhile, the off-cycle revalidation process was a first-time attempt to revalidate all 15,000 nursing homes at the exact same time. As a result, providers and CMS’s data reporting systems were overwhelmed, resulting in the need to suspend the deadline to submit the disclosures. </p><p><img src="/Issues/2026/Summer/PublishingImages/John-Kane.jpg" alt="John Kane" class="ms-rtePosition-1" style="margin:5px;width:125px;height:154px;" />AHCA was a champion of relaying the unrealistic deadline to CMS. “We appreciate CMS’s recognition of the significant challenges that providers faced throughout this unprecedented and extensive revalidation process, and we are grateful they are offering indefinite relief,” said John Kane, senior vice president of reimbursement policy at AHCA/NCAL. “Ultimately, this protects continuity of care for our residents.” Failing to properly submit their revalidation paperwork by the deadline threatened suspension of the facility from the Medicare and Medicaid programs. </p><p>Kane argued that there needs to be a sustainable balance between transparency and administrative burden, something AHCA will continue to advocate to policymakers. “We look forward to continuing to work with CMS on ways we can streamline reporting and focus on the information that is meaningful to residents, families, and stakeholders.”</p><p>While the deadline is suspended, the revalidation process remains as many nursing homes continue to submit their paperwork, and CMS continues to share this information publicly once processed. </p><h3>CMP Reinvestment Updates</h3><p>A vital update to the Civil Money Penalty (CMP) Reinvestment Program was implemented in late 2025, after years of advocacy by AHCA. As Hawley Hunt, AHCA/NCAL senior director, regulatory and quality services, <a href="/Issues/2026/Spring/Pages/Regulatory-Improvements—-and-What-Comes-Next.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Regulatory Improvements—and What Comes Next ">explained</a> in the Spring issue of <em>Provider</em>, the program is designed to let SNFs and other stakeholders access CMP funds for various quality-improvement projects. In 2023, however, CMS removed several reinvestment options, making the program too restrictive for many providers. </p><p>Thanks to CMS’s updates last year, providers can now use CMP funds for a wider variety of purposes, including technological investments, workforce development, and behavioral health services. In addition, whereas the application process used to be prohibitively complex—with different versions for providers in different states—CMS has now improved it to a single form. “We’re grateful to CMS for responding to our concerns about the program,” Harmon said. “We believe that these changes are significant to increase access and use of the available CMP funds in support of quality improvement in nursing homes.”</p><h3>Roadmap for the Future</h3><p>Another encouraging development is the new strategic <a href="https://www.cms.gov/newsroom/blog/optimal-health-all-within-nations-health-long-term-care-systems-ccsq-fy2025-2028-strategic-roadmap" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="CCSQ FY2025–2028 Strategic Roadmap">roadmap</a> released by CMS’s Center for Clinical Standards and Quality (CCSQ) in early March 2026. The plan lays out five strategic goals that CMS CCSQ will advance over the coming years: Prevention, Quality and Safety, Coverage Innovation, Data and Technology, and Burden Reduction. It also <a href="https://www.cms.gov/files/document/optimal-health-all-within-our-nations-health-long-term-care-systems.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Optimal Health for All Within Our Nation’s Health and Long-Term Care Systems">describes</a> programs that align closely with AHCA’s Better Way proposals: risk-based surveys, an accrediting organization pilot, streamlining outdated regulations, simplifying redundant data systems, and updated guidance for evidence-based nutrition standards.</p><p>“We’re encouraged to see a number of changes in the CCSQ roadmap that we believe could bring holistic reform and drive better results and quality,” said Harmon. “CMS specifically states that everyone deserves care that is safe, reliable, and high quality, and AHCA fully agrees.”</p><p>As these updates show, policymakers and providers share a common goal: building a more efficient, rational oversight system that will improve the health and safety of America’s aging population. That objective is at the heart of AHCA’s Better Way agenda, and it will shape the organization’s advocacy in the years to come. </p><p><em><strong>Steve Manning</strong> is a journalist based in New York City.</em><br></p> | 2026-06-01T04:00:00Z | <img alt="" src="/Issues/2026/Summer/PublishingImages/SF-reg_sum26.jpg" style="BORDER:0px solid;" /> | Policy | Recent updates by CMS signal that federal policymakers are receptive to finding a better way when it comes to oversight of skilled nursing facilities. |
| 5 Emergency Preparedness Essentials for Summer | <p style="text-align:center;"><img src="/Articles/PublishingImages/2026/be%20prepared.jpg" alt="be prepared" style="margin:5px;width:433px;height:325px;" /><br></p><p><br></p><p>As temperatures rise and summer storm season gets underway, nursing homes face some of the most critical emergency preparedness challenges in the health care industry. The residents in your care — many of whom rely on medical equipment, climate-controlled environments, and round-the-clock assistance — are among the most vulnerable when disaster strikes. From power outages during heat waves to rapid evacuations ahead of a hurricane, the stakes couldn't be higher. Now is the time for administrators, staff, and care teams to review and strengthen your facility's emergency protocols. </p><p>Here are five essential resources to get you started.</p><p><span style="font-size:11pt;"><strong>1.  </strong><a href="/Articles/Pages/How-Aging-Infrastructure-Threatens-Senior-Care-Emergency-Plans.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="How Aging Infrastructure Threatens Senior Care Emergency Plans"><strong>How Aging Infrastructure Threatens Senior Care Emergency Plan</strong></a></span></p><p><span style="font-size:11pt;">Local infrastructure risks may include aging water systems, deteriorating roads, crumbling bridges, and outdated drainage networks, which could undermine even the most carefully developed emergency plans.<br></span></p><p></p><p><span style="font-size:11pt;"><strong>2.  </strong><a href="/Articles/Pages/Fire-and-Life-Safety-Strategies-for-Senior-Living-Facilities.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Fire and Life Safety Strategies for Long Term Care Facilities "><strong>Fire and Life Safety Strategies for Long Term Care Facilities</strong></a></span></p><p><span style="font-size:11pt;">With an intentional, ongoing commitment to fire and life safety, facilities can overcome these challenges so they are better prepared should an emergency occur.<br></span></p><p><span style="font-size:11pt;"><strong>3.  </strong><a href="/Issues/2022/SeptOct/Pages/Creating-a-Path-to-Emergency-Preparedness.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="Creating a Path to Emergency Preparedness"><strong>Creating a Path to Emergency Preparedness</strong></a></span></p><p><span style="font-size:11pt;">Don’t forget to plan for recovery and restoration. You need
relationships with these types of organizations so you’re not scrambling
later and end up working with companies who take advantage of your
desperation and urgency.<br></span></p><p><span style="font-size:11pt;"><strong>4.  </strong><a href="/Video-Resources/Podcasts/Pages/Emergency-Preparedness-in-Long-Term-Care.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" title="Emergency Preparedness in Long Term Care" target="_blank"><strong>Emergency Preparedness in Long Term Care</strong></a></span></p><p><span style="font-size:11pt;">In this podcast episode, Stan Szpytek discusses emergency
preparedness in long term care facilities. He covers lesser-known
situations that long term care facilities need to prepare for, creating
an all-hazards plan, the importance of communication, training, and
common challenges facilities have when implementing emergency plans. <br></span></p><p><span style="font-size:11pt;"><strong>5.  </strong><a href="/Articles/Pages/The-Complexities-of-Assisted-Living-Fire-Evacuation-Planning.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" title="The Complexities of Assisted Living Fire Evacuation Planning"><strong>The Complexities of Assisted Living Fire Evacuation Planning</strong></a></span></p><p>An assessment of the building design, staffing patterns, and fire protection features should be coupled with an ongoing risk assessment that considers the changing capabilities and needs of the residents.</p><p><br></p><p style="text-align:center;"><a href="https://ahcapublications.org/collections/distaster-emergency-planning" title="Disaster & Emergency Planning" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">More Resources<br><br><img src="/Articles/PublishingImages/Emergency%20Resources.png" alt="" style="margin:5px;width:350px;" /></a><br></p> | 2026-05-26T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/be-prepared.jpg" style="BORDER:0px solid;" /> | Emergency Preparedness | As temperatures rise and summer storm season gets underway, nursing homes face some of the most critical emergency preparedness challenges in the health care industry. |
| A Simple Shift That Helps Facilities Get Ahead of Falls | <p><img src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" alt="fall risk" class="ms-rtePosition-2" style="margin:5px;width:400px;height:400px;" />In the best-run facilities, the teams that consistently stay ahead of falls and functional decline are not necessarily doing more. They are paying attention to something different, and they are paying attention to it earlier.</p><p>The signal they watch is mobility. Not dramatic changes, not formal reassessments triggered by an event, but the quiet shifts that show up in everyday care. A resident who walks a shorter distance to the dining room. A transfer that needs one more cue than it did last week. A patient who skips an activity she normally enjoys. These observations exist in every building. What separates high-performing teams is that they have found a way to bring those observations together before they add up to something larger.</p><p>The good news is that most facilities already have everything they need to do this. It does not require new technology, new documentation, or additional staff time. It requires a small, deliberate change in how existing information gets used.</p><h3>A Ten-Minute Practice That Changes Outcomes</h3><p>The approach is straightforward. Once a week, during an existing clinical or QAPI meeting, the team takes ten minutes to ask one question:<br></p><ul><li>Who moved differently this week?</li></ul><p>That includes residents who:<br></p><ul><li>Walked shorter distances than usual</li><li>Needed more assistance for transfers</li><li>Declined activities they normally attend</li><li>Shifted from walking to wheelchair use</li><li>Fatigued earlier during routine care or therapy</li></ul><p>Each name that comes up gets one assigned action and one named owner, with a defined follow-up timeframe. That’s it. No new forms, no added meetings, no additional burden on an already stretched team.</p><p>The actions themselves are already part of routine care. A therapy screen. A nursing review of pain or sleep or medication side effects. A conversation about environmental barriers. Reinforced carryover between therapy and the floor. What changes is the timing. These conversations happen days earlier, triggered by a pattern rather than an incident.</p><h3>Mobility as an Operational Asset</h3><p>In many facilities, mobility data lives almost entirely within therapy documentation. It is carefully tracked and clinically meaningful, but it rarely surfaces in leadership discussions until something goes wrong. Bringing it into the weekly operational picture, alongside census and case mix, gives leaders an additional layer of insight that is genuinely predictive.</p><p>Functional trajectory drives nearly every outcome that matters: readmission rates, length of stay, discharge success, skin integrity, continence, and family confidence in the care being provided. Teams that monitor mobility trends proactively are better positioned to intervene before any of those outcomes are affected.</p><p>There is also a meaningful benefit for fall prevention culture. When mobility is treated as a clinical signal worth protecting rather than a liability to be minimized, the approach to safety shifts. The goal becomes keeping residents moving safely and for as long as possible, not simply reducing the opportunity for a fall to occur. That distinction matters more than it might seem. Residents who move more, with appropriate support, tend to maintain the strength, balance, and confidence that reduces fall risk over time.</p><h3>Stronger Communication With Families</h3><p>Families often notice when a loved one is moving less, even before they can articulate what has changed. When care teams are already tracking functional mobility as a routine priority, they are prepared for those conversations. They can explain what has been observed, what is being monitored, and what steps are already underway.</p><p>That kind of transparency builds trust in a way that general reassurance cannot. Families feel the difference between a team that is watching and a team that is reacting, and that difference shapes everything from satisfaction scores to family engagement in the care plan.</p><h3>Building on What Already Exists</h3><p>The practical beauty of this approach is that it does not ask facilities to create something new. The information is already there, surfacing every day in therapy notes, nursing observations, and the small interactions between caregivers and residents. The weekly mobility check simply gives that information a consistent path to the people who can act on it.</p><p><span><h3><span><span><img src="/Articles/PublishingImages/2026/Neha-Sabharwal.jpg" alt="Neha Sabharwal" class="ms-rtePosition-2" style="margin:5px;width:125px;height:154px;" /></span></span></h3></span>Facilities that build this habit tend to find that early intervention becomes part of their clinical culture over time. Decline that might once have appeared sudden becomes recognizable earlier. Teams grow more confident in their ability to spot and respond to functional change. And outcomes, measured across falls, readmissions, and discharge success, reflect that confidence.</p><p>The shift is small, but the impact, for residents and for operations alike, is significant.<br><br><em><strong>Neha Sabharwal, PT, DPT,</strong> is director of rehabilitation at Vintage Faire Nursing and Rehabilitation in Modesto, Calif. </em></p><p><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;"></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><a data-outlook-id="f0e4df1e-1ee5-4879-be4a-e6e61a76e0cc" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="text-decoration:none;margin-top:0px;margin-bottom:0px;"><em><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes
information from a variety of sources, such as contributing experts.
The views expressed by external contributors do not necessarily reflect
the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"></span></em></em></a><em><em><a href="/About/Pages/Submit-Article.aspx" title="Submit an article" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em>Learn how to submit an article.</em></a></em></em></span><br></p> | 2026-05-21T04:00:00Z | <img alt="fall risk" src="/Articles/PublishingImages/740%20x%20740/fall_risk.jpg" style="BORDER:0px solid;" /> | Falls;Caregiving | In the best-run facilities, the teams that consistently stay ahead of falls and functional decline are not necessarily doing more. They are paying attention to something different, and they are paying attention to it earlier. |
| Avoiding Common ICD-10-CM Coding Concerns in Long Term Care | <p><img src="/Issues/2023/Winter/PublishingImages/Winter23_caregiving.jpg" class="ms-rtePosition-2" alt="Nurse, calculator, laptop" style="margin:5px;width:350px;height:350px;" />Accurate ICD-10-CM coding in long term care (LTC) is not just a
compliance exercise. It directly affects care planning, quality
reporting, and reimbursement. Yet many facilities continue to struggle
with recurring coding errors. Unlike acute care, the LTC environment
involves prolonged stays and multiple chronic conditions. These
realities make accurate diagnosis coding more challenging and critical.
Diagnoses must be continuously reassessed and coded accurately to
reflect current clinical management rather than admission-only or
historical conditions.</p><p>The most common ICD-10-CM missteps in LTC
are not usually the result of a lack of effort, but rather are due to
documentation gaps, outdated habits, or misunderstandings of coding
conventions and guidelines. Recognizing these patterns is the first step
toward correcting them.</p><h3>1. Failure to Reassess Diagnoses Over Time</h3><p>Perhaps
the most LTC-specific coding challenge lies in failing to reassess
diagnoses as a resident’s condition evolves. Diagnoses appropriate at
admission may no longer apply months later or new conditions may emerge.
Postoperative aftercare codes, resolved infections, or temporary
conditions should not remain on the diagnosis list indefinitely.
Coordination with the physician or nonphysician practitioner (NPP) is
essential to ensure that diagnosis lists are current. </p><h3>2. Overreliance on Unspecified Codes</h3><p>A
frequent issue in LTC coding is continuing to use unspecified diagnosis
codes when greater specificity is available (or should be). ICD-10-CM
allows unspecified codes, but only when the medical record truly lacks
the information needed to assign a more specific code. In LTC, residents
are assessed repeatedly, and their conditions are monitored over time.
For example, continued use of unspecified codes for dementia, chronic
kidney disease (CKD), or diabetes often reflects incomplete
documentation rather than clinical uncertainty. Facilities can rectify
this issue by encouraging physician/NPP documentation on diagnosis to be
as specific as possible (e.g., severity, stage, associated conditions
or complications). Coders should also feel free to query the physician
when documentation is vague, rather than defaulting to unspecified
options.</p><h3>3. Omitting Active Conditions</h3><p>Another common
misstep is failing to code all actively managed conditions. ICD-10-CM
requires reporting diagnoses that affect resident care, including those
that require monitoring, evaluation, treatment, or nursing
interventions. Chronic conditions such as diabetes, heart failure,
chronic obstructive pulmonary disease (COPD), or depression are
sometimes omitted because they are considered “baseline” for the
resident. However, if these conditions influence care planning,
medication management, or monitoring, they should be reported. At the
same time, facilities must avoid the opposite problem: continuing to
code conditions that are no longer active or clinically relevant.
Accurate coding requires a thoughtful review of the entire medical
record, not just copying forward a longstanding problem list. </p><h3>4. Misuse of History Codes</h3><p>Personal
history codes are often misapplied in nursing facilities, particularly
for cancer and cerebrovascular accidents (CVAs). History codes should be
used only when a condition is fully resolved and no longer requires
treatment or monitoring. Residents with residual deficits or ongoing
management require active or sequela codes instead. For example, for a
resident with a history of a CVA with residual speech deficits, a
sequela code should be used versus a personal history code. A query
addressed to the physician/NPP to determine the underlying etiology of a
symptom or condition may be necessary.</p><p>Another issue with
“history of” codes relies on electronic health record (EHR) checkboxes
labeled “history of” versus using the actual “history of” ICD-10-CM code
for a resolved condition. If a code is available for a personal history
of that condition, the active condition code should be resolved in the
EHR. The ICD-10-CM code for history should be added. </p><h3>5. Confusion Between Acute and Chronic Conditions</h3><p>Residents
in LTC frequently experience acute exacerbations of chronic conditions.
Coding errors occur when only the chronic condition is reported or when
the acute component is either missed or miscoded. Conditions such as
acute on chronic heart failure, acute kidney failure superimposed on
CKD, or acute exacerbations of COPD require careful review of
physician/NPP documentation. In many cases, both the acute and chronic
conditions must be coded to fully reflect the resident’s status. When
documentation is unclear, a provider query is needed. </p><h3>6. Incomplete Dementia Coding</h3><p>Dementia
is prevalent in LTC but often coded without the required specificity.
ICD-10-CM classifies dementia by type, severity, and, in some cases,
associated behavioral disturbances. Using unspecified dementia codes
when severity or etiology is documented undermines data accuracy.
Additionally, dementia due to underlying conditions such as Alzheimer’s
disease or other etiologies requires an additional dementia ICD-10-CM
code and correct sequencing. Facilities should encourage providers to
document dementia type, cause, and severity as part of routine
assessments. Coders should ensure the most specific condition is
reported.</p><h3>7. Misunderstanding the “With” Coding Convention</h3><p>The
ICD-10-CM “with” coding convention continues to cause confusion in LTC.
Certain conditions—most notably, hypertension with heart disease or
CKD, and diabetes with various complications—are presumed to be related
based on the presence of the conditions in the medical record, even if
the provider does not explicitly document a causal relationship.</p><p>Facilities
often incorrectly code these conditions separately, rather than using
the appropriate combination code (e.g., using I10, hypertension, with a
separate heart disease code instead of the combination code of I11).
Unless documentation clearly states the conditions are unrelated, coders
should apply as many combination codes as there are conditions (e.g.,
each diabetic complication combination code should be included). When
conditions are not linked by “with” or “in” in the Alphabetic Index or
Tabular List, physician/NPP documentation must clearly establish the
relationship to code them as related. </p><h3>8. Following the Tabular List</h3><p>Accurate
coding also depends on a thorough review of the Tabular List, beginning
at the three-digit category code (e.g., E11 is the three-digit category
code for all Type 2 diabetes codes) and continuing through final code
selection. Coders must follow all instructional notes encountered along
the way, such as Includes, Excludes1 and Excludes2 notes, Code first,
Use additional code, and Code also instructions. These provide mandatory
guidance that can affect code choice and sequencing. Skipping this step
or relying solely on the Alphabetic Index or notes found only at the
final code in the Tabular List increases the risk of incorrect or
incomplete coding. All applicable Tabular List instructions must be
followed to ensure compliant and accurate reporting.<br></p><h3>A Collaborative Approach to Accuracy</h3><p><img src="/Articles/PublishingImages/headshots/JenniferLaBay.jpg" alt="Jennifer LaBay, RN" class="ms-rtePosition-2" style="margin:5px;" />Improving
accuracy with ICD-10-CM coding requires collaboration among
physician/NPPs, nurses, MDS staff, and coders. Support should be
provided with ongoing education and clear processes. When documentation
accurately reflects the resident’s current condition, coding accuracy
follows naturally. The result is stronger compliance, more reliable
quality data, and a clearer picture of the complex care delivered every
day in LTC settings.<br><br><em><strong>Jennifer LaBay,</strong> RN,
RAC-MT, RAC-MTA, QCP, CRC, is curriculum development specialist at the
American Association of Post-Acute Care Nursing (AAPACN).</em></p><p><em><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#212121;">Provider<span class="Apple-converted-space"> </span><em>magazine includes
information from a variety of sources, such as contributing experts.
The views expressed by external contributors do not necessarily reflect
the views of<span class="Apple-converted-space"> </span></em>Provider<em> magazine and AHCA/NCAL.<span class="Apple-converted-space"> </span></em></span><span style="font-family:aptos, sans-serif;font-size:14.6667px;color:#96607d;"><a href="/About/Pages/Submit-Article.aspx" title="https://www.providermagazine.com/About/Pages/Submit-Article.aspx" data-outlook-id="badae440-b0ce-4219-9c08-f7e349a8e3d6" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="color:#96607d;margin-top:0px;margin-bottom:0px;"><em>Learn how to submit an article.</em></a></span></em></p> | 2026-05-19T04:00:00Z | <img alt="" src="/Issues/2023/Winter/PublishingImages/Winter23_caregiving.jpg" style="BORDER:0px solid;" /> | Caregiving;Policy | The most common ICD-10-CM missteps in LTC are not usually the result of a lack of effort, but rather are due to documentation gaps, outdated habits, or misunderstandings of coding conventions and guidelines. |