Skilled nursing facility toolkit 2026

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  1. Click ‘Get Form’ to open the skilled nursing facility toolkit in the editor.
  2. Begin with the Executive Summary section, which provides an overview of care coordination best practices. Familiarize yourself with the key points that will guide your understanding of the toolkit.
  3. Move to Section 1.0 on Readmission Prevention. Here, you will find various tools such as the Resident Rehospitalization Tip Sheet and Top 10 Things to Know about SNF Readmissions Measure. Fill out any relevant fields based on your facility's data.
  4. In Section 2.0, focus on Reducing Adverse Drug Events. Utilize the provided resources for medications like Warfarin and opioids, ensuring you document any necessary patient education strategies.
  5. Proceed to Section 3.0 for Readmission Tools. Use the SNF Transfer Checklist and other forms to assess patient needs and ensure all documentation is complete before admission.
  6. Finally, review Sections 4.0 and 5.0 for Patient Education Tools and Teach-Back methodologies, ensuring that all educational materials are tailored for effective communication with patients.

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A skilled nursing facility is a temporary residence for patients undergoing medically necessary rehabilitation treatment, while a nursing home is more of a permanent residence for people in need of 24/7 care. These services may be under the same physical roof.
Overview. The Minimum Data Set (MDS) is a standardized assessment tool that measures health status in nursing home residents. MDS assessments are completed every 3 months (or more often, depending on circumstances) on nearly all residents of nursing homes in the United States.
Under PDPM, payment is determined by factoring in a combination of six payment components. Five of the components are case-mix adjusted and include a physical therapy component, an occupational therapy component, a speech-language pathology component, a nontherapy ancillary services component, and a nursing component.
What To Bring: Health insurance cards. Advance directives and any other pertinent records (Durable Power of Attorney, Guardianship papers) Emergency contact information. Three to five sets of loose, comfortable clothes that are easy to get into and remove. One pair of comfortable walking shoes. Undergarments.

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