LTC Clarified: Weekly News, Insights & Connections

As part of the Patient Driven Payment Model, the Non-Therapy Ancillary (NTA) component can represent a significant portion of a resident's Medicare Part A reimbursement, particularly during the first three days of the stay when the NTA component receives a 3.0 variable per diem adjustment. NTA component accuracy relies on effective systems to identify, document, and code the complex medical conditions and extensive services that impact the NTA score. Are you leaving NTA points on the table?

A strong foundation in the Medicare Basics is essential to compliance with SNF Medicare program requirements and accurate reimbursement for each Medicare resident’s Part A stay. The course will provide an overview of the Medicare benefit period rules, the technical and skilled coverage criteria, the beneficiary notice requirements, and documentation requirements to support coverage and reimbursement under the Patient Driven Payment Model. Learn More

Q: Surveyors are on-site and are possibly going to issue an IJ--what actions should we take before the IJ is cited?

This 5-week intensive series offers long-term care professionals an in-depth understanding of the regulatory requirements and process involved when an Immediate Jeopardy (IJ) has been cited. Tips and strategies will be shared for writing an IJ Removal Plan and subsequent PoC, and for preparing for the IJ removal and revisit surveys that will follow. Learn More

SEPTEMBER: Check out upcoming webinars in September!

OCTOBER: Check out upcoming webinars in October!

Our experienced mock survey team identifies potential risks related to facility systems, procedures and processes of care to guide corrective actions. The mock survey process includes all 9 mandatory tasks, a review of all additional areas triggered for review through the initial pool process, and a detailed report of findings to guide any needed plan of correction. Learn More

In the News

RAI Manual for FY2027

The Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual for FY 2027 is scheduled to be released by CMS) on September 17, 2026. The FY 2027 ICD-10-CM/PCS code updates are effective October 1, 2026, and will be used for discharges and encounters from that date through September 30, 2027. The RAI Manual for FY 2027 will incorporate these updates, along with any other regulatory or coding changes for the 2027 reporting period. The updated RAI manual will be posted to Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual | CMS

SNF PEPPER Now Available for Download

On September 15, 2026, CMS announced the release of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for Skilled Nursing Facilities (SNFs), along with the supporting User Guide. PEPPER data aims to support providers in evaluating their billing practices to identify areas that require auditing or monitoring, recognize under or overcoding risks, and monitor length of stay trends. Visit the CBR/PEPPER website for more information.

CDC Updates Respiratory Virus Guidance for Health Care Personnel

CDC issued updated guidance establishing a more consistent approach for health care personnel with COVID-19, influenza, RSV, and other common respiratory viruses. HCP with infection may return to work as early as day 4 when at least three days have passed since symptom onset, they have been fever-free for 24 hours without medication, symptoms are improving, and they feel well enough to work; source control should continue through at least day 7. Asymptomatic HCP with an exposure generally do not require work restriction but should use source control and monitor for symptoms. LTC providers should review employee health, infection prevention, and return-to-work policies to ensure they reflect the new CDC recommendations.

Contact Proactive LTC CareConnect for same-day access to seasoned clinical experts providing guidance to stabiliaze situations, reduce risk and move forward with confidence.