LTC Clarified: Weekly News, Insights & Connections

Unreported Falls in Nursing Homes:

OIG Study Findings

In September 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released a concerning report related to a study with findings indicating that falls with major injury were significantly underreported by skilled nursing facilities. Let's review their findings and potential implications for providers...

Join us November 5-7 for 15 contact hours of live virtual MDS orientation training with expert trainers over 3 interactive training days, with break out groups and coding practice. Extensive resource manual and opportunities for Q&A provided in this MDS orientation that introduces critical clinical assessment, care planning and MDS concepts impacting facility reimbursement, quality measures, and regulatory compliance. Learn more & register here.

Q: I have a resident with an in-house acquired Stage 2 pressure injury. He went out to the hospital for three days and upon return, it was documented as Stage 4. How should this be coded on the MDS?

This workshop will focus on the key areas that will guide the Social Service staff to meet the needs of the residents as well as enhancing their quality of life. Presented by Janine Lehman. Learn more and register here.

NOVEMBER: Check out these upcoming November webinars!

Our expert mock survey team helps to identify and correct potential compliance gaps before they become deficiencies. Harvest the benefits of a Proactive approach-- schedule your mock survey today.

Proactive Home Health Consulting

Home Health News: Ins & Outs of Medicare Certification for Your Home Health Agency

Becoming a Medicare-certified home health agency (HHA) opens the door to serving a wider range of patients and securing reimbursement for covered home health services. However, the path to certification requires traversing a structured process with specific federal and state requirements. Let’s review the steps to obtaining Medicare certification for your home health agency.

Access up-to-date policies & procedures, tools & resources, workshops & NAB approved on-demand training all in one affordable subscription. Learn more here.

Reminder on SNF Data Validation Notice Letters in iQIES

CMS recently announced the implementation of an MDS validation process to assess the accuracy of data as it relates to the SNF quality reporting (SNF QRP) and Value Based Purchasing (VBP) programs. The SNF Validation Program is an audit-driven initiative which focuses on assessing the accuracy of the MDS data used in calculating the quality measures. Beginning this fall (FY2026) CMS will select a random sample of up to 1,500 SNFs to participate in the program each fiscal year—requiring selected SNFs to provide documentation for validation for up to 10 residents. Any SNF who submitted at least one MDS assessment through IQIES during both the preceding fiscal year and current calendar year may be eligible for selection, but a facility may only be selected for review once per fiscal year. SNFs will be notified of their selection through their IQIES provider preview reports folder. The notification letter will provide Instructions for submitting the requested documentation, the resident sample list and contact information for the medical review contractor. For more information about the process, see the FAQs here.