Leadership Strategy Is the Difference Between Accident Prevention and F689 Citations
Insights from Colleen Toebe, MSN, CWCN, RAC-MTA, RAC-MT, DNS MT – Vice President of Clinical Services As I work with nursing home leaders across the country, one thing is clear: accident prevention is no longer just a clinical priority. It is a leadership, quality, risk management, and survey readiness priority.For Nursing Home Administrators and Directors...
Navigating the New Antipsychotic Quality Measure: Compliance, Coding, and Five-Star Impact
The January 2026 CMS revisions to the Long-Stay Antipsychotic Quality Measure—now incorporating Medicare Fee-for-Service, Medicaid, and Medicare Advantage claims—create a more expansive and sensitive methodology that can trigger the measure even when antipsychotics were not administered during the MDS look-back period. This shift, combined with CMS concerns around underreporting and inaccurate diagnosis coding, places heightened pressure...
Section GG: Where Clinical Accuracy Meets Financial Performance
Insights from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC – Director of Reimbursement and Education, Pathway Health As skilled leaders recognize, the Minimum Data Set (MDS) is foundational to reimbursement accuracy—and Section GG sits at the center of that process. Section GG captures a resident’s functional performance at admission and discharge and directly...
Hot Topic: Responding to the Latest CMS Special Focus Facility (SFF) Program Update – Falls
Insights from Nancy Foss, RN, BSN, Director of Regulatory and Consulting Services – Pathway Health Recent breaking news from CMS (QSO) signals an important shift in survey and quality priorities: falls—particularly falls with major injury—are moving to the forefront of regulatory scrutiny, with direct implications for survey outcomes, enforcement actions, and Special Focus Facility (SFF) oversight....
ARD: A Leadership Imperative for Accurate Reimbursement and Compliance
Selecting the Assessment Reference Date (ARD) for the Medicare 5-Day and Interim Payment Assessment (IPA) is one of the most consequential decisions in the MDS process. Yet, it is often treated as a routine task rather than a strategic one. In today’s complex reimbursement environment, ARD selection directly influences payment accuracy, compliance integrity, and an...
Survey-Ready, Every Day: A Playbook for SNF Administrators & DONs
Insights from: Lisa Thomson, BA, LNHA, HSE, CIMT, Chief Operating Officer, Pathway Health There’s nothing better than the quiet confidence a team feels when surveyors arrive. That confidence isn’t accidental—it’s built through clear habits, simple tools, and steady coaching. From my seat as a leader, survey readiness is less about “gearing up” and more about...
Navigating the Risks of the CMS Special Focus Facility Watchlist: A Call to Proactive Leadership
For nursing facility providers, few notifications carry the weight and consequence of being added to the CMS Special Focus Facility (SFF) Watchlist. It’s not merely a regulatory designation—it’s a public signal that a facility has persistently failed to meet federal standards of care. The implications are immediate, far-reaching, and often devastating. Understanding the SFF Watchlist...
Resources & Expertise to Meet Your Needs
As a professional management and consulting organization serving clients in the long-term care and post-acute care industry, Pathway Health stays up-to-date on the latest clinical, regulatory, quality, and reimbursement trends to keep our clients on the path to success. Our solutions serve multiple markets within this industry, providing facilities with the tools and resources they...
Impacted F-tags: F605 Right to Be Free from Chemical Restraints, F757 Drug Regimen is Free from Unnecessary Drugs, F841 Responsibilities of Medical Director, F758 Free from Unnecessary and Psychotropic Medications / PRN Use (was removed)
Today, we’re discussing important updates from the Centers for Medicare & Medicaid Services (CMS) that will significantly impact nursing home operations. CMS has issued revisions to the Long-Term Care (LTC) surveyor guidance, detailed in memorandum QSO-25-14-NH, effective April 28, 2025. Among these updates, the changes related to chemical restraints and unnecessary psychotropic medication are particularly...
Admission, Transfer, Discharge Changes Effective April 28, 2025. F 620 – Admission Agreement
Today, we’re exploring important updates from the Centers for Medicare & Medicaid Services (CMS) that will significantly impact nursing home operations. CMS has issued revisions to the Long-Term Care (LTC) surveyor guidance, detailed in memorandum QSO-25-14-NH, effective April 28, 2025 [1] [2]. Among these updates, the changes to admission, transfer, and discharge processes are particularly...
