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Tags Posts tagged with "patient assessment instrument"

patient assessment instrument

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The Centers for Medicare and Medicaid Services (CMS) recently published an errata document to the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) Manual, Version 4.2, related to the coding of items J1750, J1800, and J1900. This errata document was issued to update guidance related to the Falls with Major Injury (FMI) measure in the IRF Quality Reporting Program (QRP), which is effective on January 1, 2026. Specifically, the guidance related to item J1900 Number of Falls Since Admission item has revisions to the definition of Injury (except Major) and Major Injury.

CMS also released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held in May 2025. The report provides an overview of the measure, a high-level summary of the key features of the re-specified measure, a description of the methodology used to construct the FMI measure, and an overview of measure testing results. Additional guidance and related updates to the IRF-PAI Manual, Quality Measure Calculations and Reporting User’s Manual, and public reporting timelines will be provided at a future date. The report is available in the Downloads section on the IRF QRP Measures Information web page.

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The Centers for Medicare and Medicaid Services (CMS) has published the draft inpatient rehabilitation facility patient assessment instrument (IRF-PAI) version 4.4. This version of the IRF-PAI becomes effective on October 1, 2026.

This draft version has the following modifications from the current IRF-PAI Version 4.2:

  • IRF-PAI Item 8. Gender – has been moved to IRF-PAI Item A0810. Sex.
  • IRF-PAI Item 14. Admission Class – has been removed.
  • Transportation Item A1250 – has been modified into Transportation Item A1255 with new item verbiage and response options and is only to be collected at admission. Transportation item A1250 has been removed from the discharge assessment.
  • Item O0350. Patient’s COVID-19 vaccination is up to date – has been removed from the discharge assessment.

As finalized in the fiscal year (FY) 2026 Final Rule, draft version 4.4 also removes the Section R Social Needs items. The four items removed were social determinants of health (SDoH) data elements related to living situation, food, and utilities, which were previously scheduled to be implemented October 1, 2026.

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The Centers for Medicare and Medicaid Services (CMS) published and released a summary report from a recent inpatient rehabilitation facility (IRF) listening session that focused on revising the transmission schedule for the inpatient rehabilitation facility Patient Assessment Instrument (IRF-PAI).

The summary highlights the discussion about potential changes to the IRF-PAI transmission schedule for unplanned discharges as well as changes in payer source, providing the rationale for this discussion, and questions posed during the listening session. The listening session also discussed opportunities to improve the assessment and data collection for pediatric patients.

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The Centers for Medicare and Medicaid Services (CMS) has released the June 2024 inpatient rehabilitation facility patient assessment instrument (IRF-PAI) quarterly question and answer (Q&A) document. The document is located at the bottom of the IRF-PAI web page under “downloads.” It consolidates June 2020 to June 2024 quarterly Q&A’s in order to provide all IRF providers the benefit of the clarifications to existing guidance. The Q&A’s included are based on questions received through the IRF Quality Reporting Program (QRP) help desk. A Q&A on completing IRF-PAI items for pediatric patients is included on pages 2 and 3. CMS acknowledges concerns about coding certain assessment items for pediatric patients, but instructs providers to code each item based on the guidance regardless of the patient’s age.

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