| Increasing Accessibility for Residents with Low Vision | <p style="text-align:center;"><img src="/Articles/PublishingImages/2025/iStock-1077244500.jpg" alt="" style="margin:5px;width:500px;height:334px;" /></p><p>Across the world, the population is aging rapidly, and with age comes a greater risk of certain health conditions; among these, vision loss is one of the most significant.</p><p>According to the Royal National Institute of Blind People (RNIB), more than half of residents in assisted living or care homes are blind or have low vision. Long term care facilities cannot afford to treat vision loss as a marginal issue.</p><p>Yet, many care facilities can have challenges in offering an accessible experience. Menus, schedules, signage, and paperwork are designed primarily in print formats, leaving residents dependent on staff for even the smallest of tasks. This in turn can lead to other significant issues that impact both residents and care staff alike, including reduced resident independence, increased staff strain, unhappy and disconnected family members, and potentially reduced profits.</p><h3>The Cost of Inaccessible Care Environments</h3><p>When accessibility for blind and low-vision residents is overlooked by a care provider, they face many avoidable challenges. Reading a meal plan, finding a room, or completing paperwork are daily tasks that many residents are very capable of doing. But for others, that independence can be lost as they would require staff interpretation and support even for simple tasks such as these.</p><p>Many care providers often don’t see an issue here, as they are still helping the individual and providing support. However, the problem has implications.</p><p>For residents who are blind or have low vision, they can very quickly feel a loss of independence, frustration, and in some cases, it can even affect their mental well-being.</p><p>For care facilities, spending a minute or two assisting a resident with reading a menu, for example, might not seem like a lot, but dozens of requests a day soon add up and can take away from critical care giving. By providing accessible solutions, this time can also be saved.</p><p>When you consider that 96 percent of assisted living facilities and 99 percent of nursing homes in the United States are experiencing staffing shortages, according to The American Health Care Association, every minute of staff time saved is hugely beneficial.</p><h3>The Benefits of Improving Accessibility </h3><p>Accessibility should never be a box-ticking exercise. It goes far beyond compliance and legislation. When care organizations embed accessibility into the core of their operations, they can benefit from;</p><h4>1.    Reduced strain on staff members.</h4><p>With staffing shortages, hiring a new nurse or caregiver can be challenging and existing staff members often have a full plate. When care is accessible for blind and low-vision individuals, however, what would otherwise be frequent micro interventions (reading menus, accessing schedules, and help with choosing clothes to wear) can now be done independently by the resident.</p><p>This reduces strain on staff by freeing up time and gives them additional capacity to do medication rounds, for example. Reduced strain on staff helps mitigate the costs of labor shortages.</p><h4>2.    Boost in resident satisfaction.</h4><p>When blind and low-vision residents are able to carry out daily tasks with independence, they enjoy a greater quality of life, feel less isolated, and in general are likely to feel happier and more satisfied with the long term care facility they are living in.</p><p>This increase in resident satisfaction can reduce turnover and potentially bring in additional business through word of mouth.</p><h4>3.    Improved family confidence.</h4><p>Putting a loved one in care is an emotional journey for families. Oftentimes, several family members are involved in the process, and the well-being of their loved one is the top priority. When a resident is unhappy, this extends to their family, who, over time, can lose trust and confidence in a facility. On the flip side, when a resident feels confident, independent, and empowered, their family typically feels the same.</p><p>Accessible care means happy residents and a family that has confidence in the facility they have put their trust in. As with the boost in resident satisfaction, this can also help reduce resident turnover and bring in new business.</p><h3>How Technology Can Improve Accessibility</h3><p>When businesses think about accessibility, one of the first things that comes to mind is cost. While implementing accessibility solutions will come with a cost, the long-term benefits outweigh this many times over.</p><p>The truth is, providing accessible care doesn’t need to cost hundreds of thousands or take years to update buildings, thanks to the latest advancements in technology. While there are many physical adjustments to facilities that can also be made to improve accessibility, one of the biggest advancements is AI.</p><p>For blind and low-vision people, AI has been particularly useful. Specific AI software can, for example, interpret menus and activity timetables from a photo and read these aloud to a resident. With forms and paperwork, a blind resident can take a photo, upload it to an AI platform, and get an almost instant, detailed description of what it is.</p><p>AI, when implemented correctly within a care facility, truly enables greater independence for the blind and low-vision community. Care providers who recognize this now will benefit for many years to come, along with their staff and residents.</p><h3>Where to Start?</h3><p>As a care provider wanting to improve accessibility, the first place to start is by conducting a resident and family satisfaction survey. This not only highlights where frustrations currently exist but also signals to families that their voices matter.</p><p>From there, care home managers should take the time to speak directly with blind and low-vision residents in one-on-one conversations. No checklist or policy can replace the insights gained from lived experience, and residents will often suggest simple, inexpensive improvements that make a meaningful difference in their day-to-day lives.</p><p><span><img src="/Articles/PublishingImages/2025/andy%20bailey.png" alt="Andy Bailey" class="ms-rtePosition-2" style="margin:5px;" /></span>With this feedback in hand, the next step is to carry out a thorough accessibility audit. This includes evaluating menus, signage, activity boards, paperwork, and the technology currently in use, alongside the physical environment.</p><p>Finally, facilities should prioritize any quick wins identified from the surveys and audit. This might be something as simple as offering large-print or braille menus or having a strategy for implementing technology solutions.<br><br><em>Andy Bailey is chief marketing officer at Be My Eyes, an accessibility management platform for people who are blind or have low vision. </em><br></p> | 2025-11-04T05:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/AAseniorwoman_ipad.jpg" style="BORDER:0px solid;" /> | Management | According to the Royal National Institute of Blind People, more than half of residents in assisted living or care homes are blind or have low vision. Long term care facilities cannot afford to treat vision loss as a marginal issue. |
| Using Psychological Safety to Build a QAPI Culture | <p><img src="/Articles/PublishingImages/740%20x%20740/healthcare-staff.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:350px;height:350px;" />Quality assurance and performance improvement (QAPI) has the potential for meaningful change as long as it is not reduced to a compliance exercise—documents filed away, minutes recorded, and action items noted. </p><p>The facilities that thrive are those that treat QAPI as a culture, not a checklist. And at the heart of that culture is psychological safety—the belief that every staff member, from the CNA to the administrator, can speak up, share ideas, and challenge processes without fear of punishment.</p><h3>Defining Psychological Safety in QAPI</h3><p>Psychological safety, a concept rooted in organizational behavior research, describes the sense of confidence that one’s voice will be heard and valued. In health care, where hierarchies are deeply ingrained, psychological safety is essential.</p><p>For QAPI teams, psychological safety transforms meetings from routine compliance updates into vibrant problem-solving sessions. It ensures that concerns are raised before they become citations, and that creative solutions are not stifled by fear of reprisal.</p><h3>The Four Dimensions of Psychological Safety</h3><p>To intentionally build psychological safety in QAPI culture, leaders must focus on four dimensions.<br>1. Learner Safety<br>“It’s safe to discover, ask questions, make mistakes, and learn.”<br></p><ul><li>Normalize curiosity by celebrating questions rather than dismissing them.</li><li>Protect new learners with coaching and just-in-time education.</li><li>Reframe mistakes as learning opportunities for system improvement.</li></ul><p>2. Inclusion Safety<br>“It’s safe to belong, regardless of role, title, or background.”<br></p><ul><li>Audit who is at the QAPI table—are CNAs, dietary staff, and housekeeping included?</li><li>Use inclusive language and invite contributions from all disciplines.</li><li>Honor diverse perspectives, recognizing that every role contributes to resident outcomes.</li></ul><p>3. Collaborator Safety<br>“It’s safe to share openly and interact without fear of rejection.”<br></p><ul><li>Facilitate shared decision-making, ensuring no single voice dominates.</li><li>Rotate roles in QAPI meetings to empower frontline staff.</li><li>Encourage peer-to-peer communication and model active listening.</li></ul><p>4. Challenger Safety<br>“It’s safe to speak up, challenge norms, and offer bold ideas.”<br></p><ul><li>Praise constructive pushback and reward curiosity.</li><li>Separate reporting from punishment—focus on transparency over blame.</li><li>Use real-time root cause analysis (RCA) to uncover issues, not to assign fault.</li></ul><p>When all four quadrants are present, staff can move from passive compliance to active engagement in improvement.</p><h3>Practical Strategies to Build Psychological Safety into QAPI</h3><p>Changing culture requires deliberate action. Facilities can begin by implementing these strategies.</p><ul><li>Embed QAPI into Daily Operations</li></ul><p>Culture is built in moments, not meetings. Make QAPI language part of shift huddles, care plan reviews, and daily problem-solving.<br></p><ul><li>Recognizing Contributions Publicly</li></ul><p>Acknowledge staff input during rounds, newsletters, or team huddles. Recognition reinforces the value of participation.<br></p><ul><li>Establish a “QAPI Champion” Role</li></ul><p>Designating staff as champions ensures quality improvement is carried between formal meetings and daily routines.<br></p><ul><li>Train Leaders to Coach, Not Correct</li></ul><p>Leadership tone makes or breaks psychological safety. Coaching builds confidence; criticism silences voices.<br></p><ul><li>Create a QAPI Rhythm Calendar</li></ul><p>Consistent, predictable cycles of data review and performance improvement build trust and engagement.<br></p><ul><li>Incorporate QAPI Into Orientation and Onboarding</li></ul><p>New staff must see QAPI not as leadership’s project, but as the facility’s way of operating.</p><h3>Why Psychological Safety Is the Foundation of Sustainable QAPI</h3><p>QAPI is only as strong as the culture that sustains it. A compliance-driven approach produces binders of data but little change. A culture-driven approach, fueled by psychological safety, produces staff who bring forward problems, propose solutions, and feel ownership in the quality journey.</p><p>The difference is visible:<br></p><ul><li>Staff engagement improves.</li><li>Residents receive more consistent, person-centered care.</li><li>Facilities move from reacting to citations to proactively solving problems.</li><li>Performance improvement plans (PIPs) become living projects rather than paper exercises.</li></ul><p>Ultimately, psychological safety transforms QAPI from a task into a tool of transformation.</p><h3>Final Reflection for Leaders</h3><p><span><span><em><img src="/Articles/PublishingImages/2025/Veronica-Ceasar.jpg" alt="Veronica Ceaser" class="ms-rtePosition-2" style="margin:5px;" /></em></span></span>As you reflect on your facility, ask yourself:<br></p><ul><li>Which quadrant of psychological safety: learner, inclusion, collaborator, challenger is weakest?</li><li>What is one actionable step you can take this month to strengthen it?</li></ul><p>The answers to those questions will determine whether QAPI in your facility remains a compliance exercise or becomes the cultural engine that drives lasting quality improvement.<br><br><em>Veronica Ceaser is a long term care consultant and the founder of GEM Healthcare Consulting. With a background spanning bedside nursing to executive leadership, she specializes in MDS training, quality improvement, and regulatory readiness for skilled nursing teams across the U.S.</em><br></p> | 2025-10-30T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/healthcare-staff.jpg" style="BORDER:0px solid;" /> | Quality Assurance and Performance Improvement;Quality | QAPI has the potential for meaningful change as long as it is not reduced to a compliance exercise—documents filed away, minutes recorded, and action items noted. |
| Improving Section GG Accuracy Through QAPI | <p><img src="/Articles/PublishingImages/2025/iStock-464806966.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:250px;height:249px;" />Accurate data collection and reporting are more important than ever in skilled nursing facilities. Among the challenges is coding section GG of the Minimum Data Set (MDS) that captures usual performance in self-care and mobility tasks. This data also drives care planning, quality reporting, Medicare reimbursement, and, in some states, Medicaid reimbursement, so it has a widespread impact. Thus, addressing and resolving the root cause of any inaccuracies and inconsistencies in a timely way must be a top priority.</p><p>Common issues are incomplete or missing observations, inconsistent input across disciplines, or the lack of an interdisciplinary effort to determine usual performance. The quality assurance and performance improvement (QAPI) process is an effective method for facility teams to identify and address the root causes of these issues.</p><p>QAPI is designed to be a proactive, data-driven framework that goes beyond compliance to focus on measurable and sustainable improvements. This article shows how to include section GG in the QAPI process. It will help ensure improved accuracy of documentation and coding and also establish a lasting system of accountability and collaboration.</p><h3>The Role of Section GG in QAPI</h3><p>Section GG lends itself well to QAPI monitoring because it provides clear, measurable indicators of compliance. Facilities can begin by routinely auditing a sample of assessments each quarter, at least 5 percent of all completed MDS submissions. During these reviews, staff can examine whether each self-care and mobility item was observed, whether the entire 3-day observation window was covered, and whether the input from nurse aides, therapists, nurses, residents, or families was incorporated. The audit should also confirm that discrepancies between disciplines were addressed and resolved before the assessment was finalized.</p><p>The approach just described allows the facility to assign a percentage of compliance for each item, creating a set of key performance indicators (KPIs) to track over time. For example, instead of relying on anecdotal impressions (e.g., “our nurses’ aides aren’t documenting enough”), the facility can use concrete numbers that reveal whether compliance is trending up or down.</p><h3>Understanding the Source of the Issue</h3><p>Once data is collected, the QAPI committee must ask why errors or inconsistencies are occurring. In some cases, the root of the problem may be related to the process. Staff may not complete all episode documentation on each specific self-care or mobility task or they may not recognize that documentation is required throughout the 3-day window. In other situations, the issue relates to training. Staff may not understand the difference between specific tasks or the performance levels used for section GG. Sometimes the problem is inherent in the systems. For example, electronic health records (EHRs) may not provide sufficient prompts or fields for capturing required information, leaving staff to remember the details on their own. Finally, the culture of the facility may be a factor. Completing documentation and focusing on accuracy may be viewed as a siloed MDS issue, rather than a responsibility of the entire collaborative interdisciplinary team.</p><p>Root cause analysis (RCA) should be used to identify the primary cause of the issues identified. Whether through the Five Whys method or a fishbone diagram, facilities can begin to uncover the deeper reasons behind persistent noncompliance. Without identifying the root cause, any efforts to improve section GG documentation risk addressing symptoms rather than causes.</p><p>By applying RCA consistently, facilities can move beyond quick fixes and create sustainable improvements. For example, if training gaps are identified as the primary cause, the focus should be on the process or system used for training to ensure staff clearly understand performance levels and documentation expectations. If workflow barriers or EHR limitations are uncovered, processes can be redesigned or system prompts added to guide staff during the observation window. When the root cause is cultural, believing that section GG is solely the responsibility of the nurse assessment coordinators (NACs), leadership can emphasize the shared accountability of the interdisciplinary team, reinforcing that precise documentation reflects the resident’s true abilities. In each case, addressing the root cause leads to more accurate coding, stronger compliance, and ultimately better resident outcomes.</p><h3>Moving into Action</h3><p>When section GG issues are isolated or minor, the QAPI team may be able to address them through targeted feedback, training, or process adjustment. But if problems are systemic or persistent, it may require a formal Performance Improvement Project (PIP). A PIP provides structure, scope, and accountability, ensuring that the facility moves beyond merely identifying issues to actively solving them.</p><p>For example, if a facility discovers that dashes are used too frequently in GG0130 or GG0170 items, the QAPI team might charter a PIP with the goal of reducing dash use to less than 2 percent of MDS assessments within six months. The project might involve staff training on appropriate coding, daily check-ins during the 3-day assessment window to ensure observations are documented, and routine interdisciplinary reviews before MDS coding. Each step would be monitored through continued audits, with progress shared at QAPI meetings.</p><p>To be effective, the PIP must include measurable goals and a clear plan for monitoring progress. Assigning responsibility is also essential. The NAC, therapy staff, nurse aides, and charge nurses all may have distinct roles to play in the plan that the project should make clear.</p><h3>Sustaining Long Term Improvement</h3><p>Section GG documentation and coding issues are not a one-time effort. Without reinforcement, even well-executed improvement plans can lose momentum. To ensure long-term success, facilities need to include these practices in their daily routines. It could start with staff orientations, to create a positive culture and clear expectations for the importance of section GG documentation. Ongoing monitoring and education should be scheduled and not just hastily organized when problems arise.</p><p>Recognition is another powerful tool to improve a culture focused on accuracy for section GG. When staff meet or exceed compliance goals, celebrating those achievements helps reinforce positive behaviors and encourages a sense of ownership.</p><p>Most importantly, QAPI meetings should continue to review section GG compliance until results are consistently strong. Even then, it is wise to revisit section GG periodically to confirm that gains are maintained and to identify new opportunities for refinement. Facilities should also be prepared to adjust their benchmarks upward over time, fostering a culture of continuous improvement.<br></p><h3>Conclusion</h3><p><img src="/Articles/PublishingImages/740%20x%20740/JessieMcGill.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:175px;height:175px;" />Section GG documentation and coding are foundational to quality care and accurate reporting in nursing facilities. Yet they are also areas where many facilities stumble, whether through incomplete observations, missing documentation, or lack of interdisciplinary collaboration. By integrating section GG into the QAPI framework, facilities will gain tools to measure performance, identify root causes, implement targeted interventions, and sustain long-term improvement.<br><br><em>Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, is senior curriculum development specialist at the American Association of Post-Acute Care Nursing (AAPACN).</em></p><p><em><br></em></p><p style="text-align:center;"><em><span></span></em></p><h4 style="text-align:left;"><em><span><em><img src="/SiteCollectionImages/logos/AAPACN.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:56px;" /></em></span>The American Association of Post-Acute Care Nursing
(AAPACN) represents more than 17,000 long-term and post-acute nurses
and professionals working in more than 5,750 facilities through its
subsidiary associations, the American Association of Nurse Assessment
Coordination (AANAC) and the American Association of Directors of
Nursing Services (AADNS). Learn more at <a href="https://www.aapacn.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><span class="ms-rteThemeForeColor-2-0">AAPACN.org</span></a>.</em></h4><p></p> | 2025-10-21T04:00:00Z | <img alt="" height="739" src="/Articles/PublishingImages/2025/iStock-464806966.jpg" width="740" style="BORDER:0px solid;" /> | Quality Assurance and Performance Improvement;Quality | Common issues are incomplete or missing observations, inconsistent input across disciplines, or the lack of an interdisciplinary effort to determine usual performance. The QAPI process is an effective method for facility teams to identify and address the root causes of these issues. |
| Assisted Living Providers Gain New Perspective of Dementia at NCAL Day | <p><img src="/Articles/PublishingImages/2025/NCALDay.jpg" class="ms-rtePosition-1" alt="" style="margin:5px;width:200px;height:200px;" />Dementia care is at the heart of assisted living. That’s why this year’s National Center for Assisted Living (NCAL) Day attendees—a record of more than 300 assisted living professionals—lined up for the unique opportunity to learn more about what it is like to live with this diagnosis.</p><p>NCAL Day 2025 featured the Dementia Empathy Experience Program (DEEP), an interactive and immersive session that puts participants in the shoes of someone living with dementia. Through hands-on stations and expert-guided insights, they gained a deeper understanding of the cognitive, emotional, and sensory challenges residents face every day.</p><p>“Nearly half of residents in assisted living have Alzheimer’s Disease or other dementia,” said Pam Truscott, NCAL Director of Quality Improvement. “This exercise is meant to help providers better understand the challenges they face with even simple tasks—such as hanging up a jacket—and give them the understanding that empowers teams, strengthens care, and deepens their impact on residents’ lives.”</p><p><span><span><span><span><img src="/Articles/PublishingImages/2025/DEEP.jpg" alt="DEEP" class="ms-rtePosition-2" style="margin:5px;width:400px;height:205px;" /></span></span></span></span>DEEP was one of the multiple sessions offered throughout NCAL Day. The morning keynote speaker, Ralph Peterson, inspired attendees and shared strategies for attracting and retaining employees. Erin Thompson, the closing keynote speaker, helped attendees explore how to overcome common obstacles—mindset, boundaries, and energy mismanagement—to create vibrant, engaged, and purpose-driven communities. </p><p style="text-align:left;"> A multitude of other education sessions were offered throughout the day. Topics included proactive management strategies, technology and improving outcomes, the health and wellness director, population health strategies in assisted living, building trust through data, and value-based care and building networks.</p><p><span><img src="/Articles/PublishingImages/2025/fireside.jpg" alt="firseide chat with NCAL leaders" class="ms-rtePosition-1" style="margin:5px;width:350px;height:197px;" /></span>A highlight of the afternoon was the fireside chat on the future of assisted living. NCAL Executive Director LaShuan Bethea, Director of Policy and Regulatory Affairs Jill Schewe, NCAL’s Truscott, and NCAL Immediate Past Board Chair Gerald Hamilton discussed how the assisted living customer base is changing and how providers can change with it, identified opportunities to strengthen relationships and the impact on improving care, and highlighted how the demands of the profession have changed.</p><p><span><img src="/Articles/PublishingImages/2025/IMG_6688.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:250px;height:188px;" /></span>“There are so many facets of assisted living that are poised to change in the near future—from a growing population who will need our care to how we deliver it,” said Bethea. “I’m excited that we get to have this conversation and engage the providers who are on the front lines of the evolving profession.”</p><p>NCAL Day is an annual education and networking event for professionals in the assisted living industry and is held on the Sunday of Delivering Solutions, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) Convention and Expo. Visit <a href="https://www.ahcancal.org/Assisted-Living/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">www.ncal.org</a> to learn more about the National Center for Assisted Living. </p> | 2025-10-20T04:00:00Z | <img alt="NCAL Day 2025" src="/Articles/PublishingImages/2025/NCALDay.jpg" style="BORDER:0px solid;" /> | Assisted Living;Caregiving | NCAL Day is an annual education and networking event for professionals in the assisted living industry and is held on the Sunday of Delivering Solutions, AHCA/NCAL Convention and Expo. |
| Key Resources for the SNF QRP are Now Available | <p style="text-align:center;"><img src="/Articles/PublishingImages/2025/data_calculator.jpg" alt="" style="margin:5px;width:500px;height:262px;" /><span data-contrast="auto" lang="EN-US" style="font-size:11pt;"></span></p><p style="text-align:center;"><span data-contrast="auto" lang="EN-US" style="font-size:11pt;"><br></span></p><p style="text-align:left;"><span data-contrast="auto" lang="EN-US" style="font-size:11pt;">The
Centers for Medicare and Medicaid Services (CMS) posted several key
resources for the Skilled Nursing Facility Quality Reporting Program
(SNF QRP) for the FY 2027 and FY 2028 program years.</span><span data-ccp-props="{}" style="font-size:11pt;"> </span></p><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US">A revised </span><a href="https://www.cms.gov/files/document/fy2027snfqrpaputableforreportingmeasuresanddata-revised.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">FY 2027</span></span></a><span data-contrast="auto" lang="EN-US"> and the new </span><a href="https://www.cms.gov/files/document/fy2028snfqrpaputableforreportingmeasuresanddata.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">FY 2028</span></span></a><span data-contrast="auto" lang="EN-US">
APU Table for Reporting Measures and Data: These key documents outline
the MDS items used in determining the MDS data reporting threshold for
the applicable fiscal year. Items required for FY 2027 are effective
October 1, 2025. Items require for the FY 2028 are effective October 1,
2026.</span><span data-ccp-props="{}"> </span></li></ul></div><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"></span><a href="https://www.cms.gov/files/document/fy2026snfqrpfaqs.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">FY 2026 SNF QRP Frequently Asked Questions (FAQs):</span></span></a><span data-contrast="auto" lang="EN-US">
This document has been updated to reflect the finalized policies for
the SNF QRP in Fiscal Year (FY) 2026 and includes other useful resources
available to providers.</span><span data-ccp-props="{}"> </span></li></ul></div><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1" role="listitem"><span data-contrast="auto" lang="EN-US"></span><a href="https://www.cms.gov/files/document/snfqrpdatacollectionsubmissiondeadlinesfy2028.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">Data Collection and Final Submission Deadlines for FY 2028</span><span data-ccp-charstyle="Hyperlink">:</span></span></a><span data-contrast="auto" lang="EN-US">
The SNF QRP Data Collection and Final Submission Deadlines have been
updated to provide the data collection time frames and final submission
deadlines for the FY 2028 SNF QRP.</span><span data-ccp-props="{}"> </span></li></ul></div><div><span data-contrast="auto" lang="EN-US">Questions about the SNF QRP or the above resources may be directed to </span><a href="mailto:regulatory@ahca.org" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">regulatory@ahca.org</span></span></a><span data-contrast="auto" lang="EN-US">. </span></div> | 2025-09-30T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/data_calculator.jpg" style="BORDER:0px solid;" /> | CMS | CMS posted several key resources for the Skilled Nursing Facility Quality Reporting Program for the FY 2027 and FY 2028 program years. |
| How Long Term Care Trend Tracker Gives Providers the Data They Need | <p><img src="/SiteCollectionImages/logos/LTCTT.png" class="ms-rtePosition-2" alt="" style="margin:5px;width:300px;height:300px;" />As long term care providers navigate a complex web of economic and policy pressures, from historic labor shortages to ballooning operational costs, their survival increasingly depends on quality data. The challenge is not quite as simple as going and looking up the data they need, however, it’s also a matter of organizing and transforming that data into actionable insights.</p><p>Enter <a href="https://www.ahcancal.org/Data-and-Research/LTC-Trend-Tracker/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Long Term Care (LTC) Trend Tracker</a><sup>TM</sup>.</p><p>Launched in 2013, LTC Trend Tracker is a powerful web-based platform for AHCA/NCAL members. In short, it’s a one-stop-shop for providers, consolidating mammoth quantities of information into a single, user-friendly interface. AHCA/NCAL receives data from user uploads and government agencies such as the Centers for Medicare and Medicaid Services (CMS), cleans it up, and provides it to member organizations for free.</p><p>As KeShawn Franklin, a project manager at AHCA/NCAL, explained, the tool solves a common problem for providers: “People just aren’t aware of where to go to find the data they need,” she said. “When they do find out where to go, they have more opportunities to make better-informed decisions about their operations.”<br></p><h3>Tailored Tools for Every Provider</h3><p>For skilled nursing facilities (SNFs), LTC Trend Tracker provides a centralized data hub at the click of a button. For assisted living communities, which are regulated at the state level, it provides a system for providers to upload their own data and generate detailed reports across a variety of metrics. Once users log in, they can use the system platform to zoom in to their own operations at a granular level, or zoom out to a bird’s eye view, comparing their own organization against peers and competitors at the local, regional, and national levels. Every provider’s data is private and secure—users can only see their own information, while other organizations’ data are reported in aggregate. </p><p>LTC Trend Tracker is a valuable tool for small, independent providers as well as large corporations that operate across multiple regions. At <a href="https://johnclarkeseniorliving.org/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">John Clarke Senior Living,</a> a nonprofit SNF in Rhode Island with 60 beds, CEO Joan Woods described the Trend Tracker as “indispensable.” “I don’t think I could do strategic planning without it,” she said.</p><p>Meanwhile at <a href="https://www.areteliving.com/" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Areté Living,</a> whose portfolio includes assisted and independent living as well as memory care facilities in nine states, Director of Quality and Compliance Jennifer Svoboda offered a similar perspective.</p><p>“Areté Living has been a user of LTC Trend Tracker for many years,” she said. “The ability to track and compare performance both against our peers and within our own teams allows us to identify when metrics fall outside of standards and develop action plans for continuous improvement.”</p><p>LTC Trend Tracker makes complex data clear, legible, and actionable. When users log in, their dashboard provides an instant snapshot of their performance in key metrics, as compared to their peers. (These metrics include staffing, survey citations, hospitalizations, and average Medicare rates.) They can use the tool to generate reports based on these metrics, and then use these reports for planning, marketing, collaborating with partner organizations or policymakers—whatever they need.</p><p>Woods, for instance, distributes customized reports to her board members and department heads at John Clarke ahead of strategic planning sessions. “One of the things we learned is that getting this information out prior to the strategic planning session is important, so that people have time to digest,” she said. “I give my staff the opportunity to come back and ask for information presented in a different way, so that we're getting the best data that we use to make strategic decisions about where we're going to go.”</p><p>She also finds the tool essential in her work with legislators. “We try to have our congressional delegation in here as much as we can, so having that data and information available is really important,” she explained. “It’s invaluable to be able to say, ‘Here’s how we’re doing compared to…’ or ‘This is how our whole community is doing.’ To be able to show your delegation that information, that's important to them. That gets their interest.” </p><p>Equally important to her is the quarterly Top-Line publication, which includes progress reports on each member facility’s Five-Star Performance, Quality Initiative, and Quality Award status. “It's a very simple, condensed way to demonstrate how well we're doing,” she said. “I always roll that into my quality assurance meetings and board meetings. If you’ve got investors, it’s a great way to show your investors how well you’re doing.”</p><h3>From Raw Data to Actionable Insights</h3><p>Although LTC Trend Tracker asks a little more of assisted living providers, who have to manually upload their own data into the system, the resource is no less valuable for the effort. “By analyzing the data from Trend Tracker, we have a clearer, data-driven foundation for our strategic planning process,” said Svoboda at Areté Living. “With Trend Tracker, we can pinpoint areas that need focused attention and resources. Additionally, analyzing trends in our data helps us identify areas where we are meeting expectations, making progress, or falling short of our goals.”</p><p>By transforming raw data into specific, customizable reports, LTC Trend Tracker gives administrators a vital edge when it comes to monitoring performance and ensuring accountability. “Leaders can quickly access key quality metrics, allowing for timely interventions when metrics are not within the company standard,” Svoboda added. “Being able to benchmark against peers is critical to understanding market position and identifying areas of excellence and areas of needed improvement. Outside comparisons allow us to be further accountable for how we are doing in the context of the market.”</p><p>In 2024, at the request of assisted living providers, LTC Trend Tracker <a href="https://www.ahcancal.org/News-and-Communications/Blog/Pages/LTC-Trend-Tracker-Launches-New-Measures-for-Assisted-Living.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">added a new measure</a> tracking falls and falls with injury. Svoboda said that this is an especially valuable metric for her organization, though she stressed that all the quality metrics are important. “This measure is important because major injury can have a profound impact on the quality of life of our residents,” she explained. “It is a powerful indicator of clinical effectiveness and our ability to provide proactive and comprehensive care.”<br></p><h3>Leveraging Predictive Powers</h3><p>Users can also avail themselves of LTC Trend Tracker’s predictive tools. The <a href="https://www.ahcancal.org/Data-and-Research/LTC-Trend-Tracker/Documents/Five%20Star%20Quality%20Measure%20Rating%20Predictor%20Tool.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Five-Star Quality Measure Predictor Tool,</a> for instance, allows buildings to input hypothetical improvements to individual quality measures and predict how those changes would affect their Five-Star rating. Then there’s the <a href="https://www.ahcancal.org/Data-and-Research/LTC-Trend-Tracker/Documents/LTCTT%20SNF%20VBP%20Predictor%20Tool%20Help%20Doc_FINAL.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">SNF Value Based Purchasing (SNF VBP) Predictor Tool,</a> which allows providers to see their predicted Medicare reimbursement and, therefore, plan for its potential effects. “The value-based purchasing tool is fabulous,” Woods enthused.</p><p>From a practical standpoint, LTC Trend Tracker is straightforward to use, with AHCA/NCAL providing detailed guides and virtual training. Franklin’s team routinely adds new features, like the recent <a href="https://www.ahcancal.org/Data-and-Research/LTC-Trend-Tracker/Documents/How%20to%20Access%20the%20Provider%20Network%20Data%20Dashboard.pdf" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Provider Network Data Dashboard,</a> and engages in quarterly feedback sessions with a work group of member-users. “Most of the feedback has been positive,” she said. “Just the fact that they can log into one place and be able to access different types of reports has definitely been the highlight of this particular data tool.”</p><p>Looking to the future, Franklin said that there are significant enhancements—including a major user interface upgrade—planned throughout the next year. On the provider side, both Woods and Svoboda encouraged their peers to make use of the tool. </p><p>“To understand how you stand up against other organizations—community-, state-, county-, nation-, whatever-wide—is really important,” Woods said. “As an independent owner of a small business, not-for-profit organization, I don't have the benefit of being able to compare myself to other members of a corporation. So, this is extraordinarily valuable to me.”</p><p>“It allows for a data-driven approach to addressing clinical and operational challenges,” Svoboda agreed. “While there is some comparative data out there, specifically for assisted living, LTC Trend Tracker provides the ability to compare against peers. LTC Trend Tracker is a valuable, approved resource, not available anywhere else.”</p><p><em>Steve Manning is a journalist based in New York City.</em><br></p> | 2025-09-30T04:00:00Z | <img alt="" src="/SiteCollectionImages/logos/LTCTT.png" style="BORDER:0px solid;" /> | Caregiving | LTC Trend Tracker is a powerful web-based platform for AHCA/NCAL members. It’s a one-stop-shop for providers, consolidating mammoth quantities of information into a single, user-friendly interface. |
| CMS Releases the FY26 Mission and Priority Document | <p><span data-contrast="auto" lang="EN-US"><img src="/Articles/PublishingImages/740%20x%20740/blog_debt.jpg" class="ms-rtePosition-2" alt="" style="margin:5px;width:250px;height:250px;" />The Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year (FY) 2026 </span><a href="https://www.cms.gov/files/document/admin-info-25-11-all.pdf" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">Mission and Priority Document (MPD)</span></span></a><span data-contrast="auto" lang="EN-US">,
which is issued annually to direct and prioritize the agency’s work for
the year. The document reflects regulatory changes, budget adjustments,
new initiatives, and statutory requirements. It outlines survey,
certification, enforcement, and Medicare funding allocations for states,
while also providing background information on certified provider and
supplier types, as well as accreditation and deeming surveys. Survey
activities must be scheduled and conducted according to the priority
tier structure set forth in the MPD. These four tiers reflect statutory
mandates and program emphasis, with Tier 1 representing the highest
priority and Tier 4 representing the lowest.</span><span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":6,"335551620":6,"335559685":0,"335559737":0,"335559738":0,"335559739":160,"335559740":278}"> </span></p><p><span data-contrast="auto" lang="EN-US">Survey
activity remains central to CMS oversight, and the agency continues to
emphasize a tiered survey prioritization structure to ensure resources
are focused where they are most needed. </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1" role="listitem"><p><span data-contrast="auto" lang="EN-US">Under
Tier 1, nursing homes must receive a standard recertification survey no
later than every 15.9 months, with a national goal of maintaining a
12.9-month average between surveys. States are also required to conduct
at least 10 percent of surveys “off-hours,” with at least half of those
completed on weekends. Special Focus Facilities (SFFs) must be surveyed
at least once every 186 days. </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p></li></ul></div><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1" role="listitem"><p><span data-contrast="auto" lang="EN-US">Tier
2 requires states to maintain the 12.9-month average for nursing home
recertification and prioritizes initial certifications if applications
have been pending for more than 150 days without a deeming option, or
when CMS determines there is an access-to-care issue. </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p></li></ul></div><div><ul role="list"><li aria-setsize="-1" data-leveltext="" data-font="Symbol" data-listid="8" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1" role="listitem"><p><span data-contrast="auto" lang="EN-US">Tier 3 applies to Medicaid-only nursing homes and other initial certifications not included in Tiers 1 or 2.</span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p></li></ul></div><p><span data-contrast="auto" lang="EN-US">For
Intermediate Care Facilities for Individuals with Intellectual
Disabilities (ICFs/IID), CMS has reinforced similar expectations. These
facilities must also adhere to the 15.9-month maximum interval between
surveys, with a statewide average of 12.9 months or less. Initial
certifications for ICFs/IID fall under Tier 3 and are scheduled based on
state priority.</span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><p><span data-contrast="auto" lang="EN-US">CMS
continues to strengthen regulatory compliance and quality improvement
efforts. The agency is reinforcing timely survey practices, particularly
for Special Focus Facilities.  </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><p><span data-contrast="auto" lang="EN-US">In
addition to survey requirements, CMS discussed new initiatives designed
to modernize oversight and address ongoing staffing challenges. </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><p><span data-contrast="auto" lang="EN-US">One
of the most significant is the continuation of Risk-Based Survey (RBS)
testing, a pilot program that focuses resources on higher-performing
nursing homes. Facilities that consistently demonstrate strong quality
performance may receive a more targeted survey, which is intended to
improve efficiency while still ensuring compliance with health and
safety standards. </span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><p><span data-contrast="auto" lang="EN-US">Another
major initiative is the Nursing Home Staffing Campaign, supported by a
$75 million investment. According to the memo, this campaign aims to
raise awareness of career opportunities in nursing homes, provide
tuition reimbursement and stipends, and work with states to expand Nurse
Aide Training and Competency Evaluation Programs (NATCEPs). By reducing
barriers to workforce entry, CMS hopes to expand the pipeline of
certified nurse aides available to nursing homes.</span><span data-ccp-props="{"335551550":6,"335551620":6}"> </span></p><p><span data-contrast="auto" lang="EN-US">Questions about this memo can be sent to </span><a href="mailto:regulatory@ahca.org" target="_blank" rel="noreferrer noopener" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083"><span data-contrast="none" lang="EN-US"><span data-ccp-charstyle="Hyperlink">regulatory@ahca.org</span></span></a><span data-contrast="auto" lang="EN-US">.</span><span data-ccp-props="{}"> </span></p> | 2025-09-29T04:00:00Z | <img alt="" src="/Articles/PublishingImages/740%20x%20740/blog_debt.jpg" style="BORDER:0px solid;" /> | CMS;Policy | CMS released the FY 2026 MPD, which outlines survey, certification, enforcement, and Medicare funding allocations for states, while also providing background information on certified provider and supplier types, as well as accreditation and deeming surveys. |