LTC Clarified: Weekly News, Insights & Connections

Falls remain one of the most persistent and costly challenges in skilled nursing facilities. Yet despite ongoing prevention efforts, many facilities find themselves stuck in a cycle of repeated incidents without measurable improvement. The difference between average outcomes and high-performing facilities often comes down to one thing: how effectively fall data is analyzed and translated into action.

Proactive provides the systems, structure and support you need to reduce falls and Falls with Major Injury. Learn more about adding Proactive to your Fall Prevention team!

Navigate the Quality Measures (QMs) that define SNF performance with practical strategies to improve outcomes, strengthen compliance, and protect reimbursement. Participants will develop a clear understanding of how key measures are defined, coded, and calculated—and how day-to-day clinical practice translates into overall facility performance. Learn more and register here.

Q: I am a Director of Nursing Services (DNS) juggling many responsibilities. What is the best way to support and oversee the MDS department?

APRIL: Check out these upcoming April webinars!

5 Star Cut Point Tables Updated

Updates to the 5 Star Cut Point Tables and Full Statement of Deficiencies are available here.

CMS MDS 3.0 QM User's Manual v 18.0 Errata – Long-Stay Antipsychotic Measure Update

An errata change table document to the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v18.0 is now available. This document is related to the clarification of details for the Long-Stay Antipsychotic measure in Chapter 1, Section 6. This errata is being issued to clarify guidance related to the respecification of the Long-Stay Antipsychotic measure effective January 1, 2026. The supplemental files referenced in the manual, including the HCPCS codes, hospice exclusion codes, diagnosis exclusion ICD-10 codes, and the NDC codes have also been updated. The errata documents, including the updated manual, errata change tables, and associated files can be found in the Downloads section on the NHQI Quality Measures webpage. 

Special Focus Facility Listing March 2026

The Special Focus Facility List and Candidate List was updated

• SFF Posting With Candidate List March 2026 (PDF)
• SFF List Archive March 2026 (ZIP)

SNF Consolidated Billing (CB) Enforcement HCPCS Codes Quarterly Update

Transmittal # R13684CP issued March 26, 2026 provides updates to the lists of HCPCS codes that are subject to the consolidated billing provision of the SNF Prospective Payment System (PPS). Changes to Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes and Medicare Physician Fee Schedule designations will be used to revise Common Working File (CWF) edits to allow MACs to make appropriate payments in accordance with policy for SNF consolidated billing in chapter 6, section 20.6. For additional information see  R13684CP and MM14427 - HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement: July 2026 Quarterly Update

Electronic Signature Standards

Implementation specifications from the recent Administrative Simplification Adoption of Standards for Health Care Claims Attachments Transaction and Electronic Signatures Final Rule are outlined in the HL7 Digital Signatures Guide apply to claims submission information—including both solicited and unsolicited attachments to the health plan as finalized in CMS-0053-F.  May 26, 2026 is the effective date and May 26, 2028 is the compliance date for the final rule.  

Electronic Sigature standards established in the final rule do not apply to non-claims related electronic signatures for physician orders for items for services, provider enrollment/credentialling (e.g. CMS 855), 1500 forms or beneficiary signatures. The rule does not modify existing requirements for these signatures.

Learn more 

Make progress with 2026 goals and wish-list projects on a Proactive Annual Partner Plan which provides an allotment of consulting support hours delivered by seasoned LTC experts at a fraction of the cost of hiring new staff. Support is lead by a designated consultant, and can be provided as a combination of onsite and remote assistance with services billed in 12 flat monthly installments. Plans start as low as 8 hours per month with facility customized work plans that provide just-right support for survey-readiness, QM improvement, key clinical programs, reimbursement accuracy and crisis management. Add the Proactive team to your roster and achieve the outcomes you’ve been working toward! Contact us to learn more.