Falls with Major Injury: New CMS Guidance, Coding Clarity, and QAPI Strategies for SNFs
About this episode
The episode discusses updated CMS guidance on Falls with Major Injury, focusing on MDS coding and strategies for improving resident safety.
In this LTC NAC Chat podcast episode, Sarah Becker, RN, Director of Clinical Reimbursement for Proactive LTC Consulting, and Christine Twombly, RN, RAC-MT, RAC-MTA, CQP, CRC, break down the updated CMS guidance on Falls with Major Injury and what it means for MDS coding, Quality Measures, survey outcomes, and resident safety. Together, they simplify complex regulatory changes, clarify key definitions — including intercepted falls and pathological versus traumatic fractures — and walk through real-world examples to support accurate coding and interdisciplinary collaboration. The discussion also highlights the impact of these changes on Quality Measures and recent OIG findings on underreporting, along with practical strategies for improving compliance and reducing risk. To close, the team shares how strong QAPI processes can transform fall prevention efforts through trend analysis, individualized care planning, and system-wide improvement.
Topics covered
- Falls with Major Injury
- CMS Guidance
- MDS Coding
- Quality Measures
- Resident Safety
- QAPI Strategies
Keywords
- regulatory changes
- interdisciplinary collaboration
- compliance
- risk reduction
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