On-Demand Webinar: No Script, No Limits: Open Q&A with AAPACN Nurse Experts-Recording: AAPACN Webinar 04/23/2026: No Script, No Limits: Open Q&A with AAPACN Nurse Experts

Video Transcription

Video Summary

This webinar was a live Q&A hosted by APACN nurses and curriculum specialists focused on MDS coding, quality measures, and CMS guidance. The presenters first reviewed CMS clarifications on long-stay antipsychotic exclusions, including how changes in Medicare enrollment, Medicaid status, and hospice elections affect whether a resident is included or excluded from the measure.<br /><br />Much of the session addressed coding challenges in the MDS manual. Topics included Section I diagnosis documentation, emphasizing that facilities must follow the more restrictive REI guidance even when provider documentation may support a diagnosis. They also discussed IV fluids in Section K, clarifying how hospital-based fluids are captured, and reviewed Section J coding for pathological fractures, which should not be counted as major injury falls if clearly documented by a physician.<br /><br />Several questions focused on Section GG and documenting ADL performance accurately. The presenters stressed that usual performance, not best or worst, should guide coding, and that facilities should use real-time monitoring, staff education, and correction notes when documentation is inaccurate. They also discussed the importance of allowing residents to do as much as possible independently and identifying root causes when staff over-assist.<br /><br />Other topics included swallowing and eating items in Section K, setup assistance for meals, modified diets, Section M coding for fungal toes, data validation audits in iQIES, Medicare and Medicare Advantage coverage questions, and how surveyors may use photography during surveys. The session closed with encouragement for facilities to submit questions through official APACN and CMS channels.

Keywords

MDS coding

CMS guidance

quality measures

Section GG

Section I diagnosis

Section K IV fluids

Section J fractures

ADL documentation

long-stay antipsychotic exclusions

iQIES audits