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MDS Version 1.19.11 Effective October 1, 2024

The Centers for Medicare and Medicaid Services (CMS) will revise the MDS assessment tool
for data collection effective October 1, 2024.

The revised Resident Assessment Instrument
Manual has been posted to the CMS website and includes the revised data collection tool.
These are currently a DRAFT. The DRAFT Minimum Data Set Resident Assessment
Instrument Manual version 1.19.11 can be reviewed at Minimum Data Set 3.0 Resident
Assessment Instrument User’s Manual v1.19.1 (

The changes in the draft RAI Manual include:

  • Guidance to support the addition of the following new items:
          – N0415K: Anticonvulsant
          – O0350: Resident's COVID-19 vaccination is up to date.
  • The removal of Discharge Goals in items GG0130: Self-Care and GG0170: Mobility.
  • Additional clarifications were added to Chapter 5, Submission and Correction of the
    MDS Assessments, regarding situations where an erroneous PPS assessment is
    combined with an OBRA-required assessment (e.g., for a Medicare Advantage stay). In
    this situation, a Manual Deletion Request is required, followed by the completion and
    submission of a new stand-alone OBRA MDS assessment.

Specifics regarding all of the changes can be found in the included chapter/section change
tables at the end of the draft Manual.

2024 Spring Conference Agenda Released

2024 Convention Agenda – Revised 01.11.2024 – 2Join us for 4 days of great programming, networking with your peers and colleagues, and fun events at our 36th annual conference! Back by popular demand …. CMS representatives, DOH representatives, and a host of industry experts who will provide update to date information on the regulatory environment, legal considerations, and clinical best practice standards.

April 2 – 12:45 – 6:00PM     Break-Out Sessions – Attend the session(s) of your choice!

April 3 – 8:15AM – 1:30PM  Educational Sessions  /           3:00-5:00PM Expanded Exhibitor Hours with wine, beers, games, and door prizes

April 4 – 8:15AM – 3:30PM  Educational Sessions /            6:00-10:00PMParty with Chris Woodward and Shindiggin’

April 5 – 8:30AM – 12:00N  Half – Day with sessions from PA DOH and OLTL 


Proposed Federal Staffing Mandate

The Centers for Medicare and Medicaid Services (CMS) issued the proposed federal staffing mandate for nursing homes in early September in the Federal register with a 60 day comment period. The staffing mandate includes a different timeline for implementation for urban and rural nursing homes and the full mandate is proposed to be implemented over a three-year period. The proposed staffing mandate in the Federal register can be reviewed in the attachment for information and potential comment.

Minimum Staffing Standards

Optional State Assessment (OSA)

Effective October 1, 2023 when the revised MDS version 1.18.11 is implemented, Pennsylvania will begin using the Optional State Assessment (OSA) for payment purposes. The payment connection is for the determination of the Resource Utilization Groups (RUGs) which will continue to be used for the calculation of the Medicaid Case Mix Index (CMI) for Medicaid reimbursement. CMS will no longer support the RUG classifications after September 30, 2023 but Pennsylvania has not obtained legislative approval to switch from RUGs to PDPM for Medicaid CMI calculation.


The OSA will be completed as a stand alone assessment in correlation with all PPS and OBRA assessments except discharge assessments. It will be submitted with these assessments and must have the same assessment reference date (ARD) as the assessment it is being completed with. The OSA manual can be found on the CMS MDS webpage and in the attachment.


Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual | CMS

Resident Assessment Instrument (RAI) Manual

The final version of the revised Resident Assessment Instrument (RAI) Manual has been issued by the Centers for Medicare and Medicaid Services (CMS). The manual, as well as the final version of the MDS assessment tools (all types of assessments) are available on the CMS website or can be accessed and downloaded on this website. Whether you are the assessment nurse or the assessment nurses report to you as the nurse leader at your nursing home, it is good to have this information as a reference.


For the nurse leader knowing the items that are included in the revised MDS assessment version 1.18.11 provides you the opportunity to know what should be included in medical record documentation as support for the MDS assessment item coding. If the nurses are completing the pain interview with the residents, it is critical for them to know the questions to ask and how they should be incorporated into the person-centered care plan.


Both the revised RAI Manual and the revised MDS assessment tools can be found at this CMS page.


Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual | CMS


RAI Manual

Centers for Medicare & Medicaid Services (CMS) Issues Federal Staffing Mandate

On September 1, 2023, CMS issued a press release regarding the highly anticipated federal staffing mandates for nursing homes. The staffing mandates were initially discussed by President Joseph Biden in a state of the union address. Nursing home providers have been awaiting the announcement for some time. The proposed rule consists of three core staffing proposals that are staggered across a period of time. There is a 60-day comment period from the issue of the Federal Register outlining the staffing mandate proposal and several other items that impact nursing home providers. The Federal Register with the federal staffing mandate proposal is attached, along with the CMS press release from September 1 for your review.

CMS 3442-P

Revised MDS Assessment version 1.18.11 – Effective October 1, 2023

The Centers for Medicare and Medicaid Services (CMS) has revised the MDS assessment used for the coding of resident data representative of care and services. This data is also used for the quality measures reports which impact the Five Star Quality Rating and for reimbursement for both skilled services through the Patient Driven Payment Model (PDPM) and Medicaid as part of the quarterly Case Mix Index (CMI) score. The MDS assessment data elements are also utilized to correlate to the person centered care plan. The revised MDS and all related item sets are now available on the CMS website and on the PANAC website at Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual | CMS and News | PANAC (


Additionally, CMS will no longer support the RUG classifications effective September 30, 2023. Pennsylvania will continue to utilize the RUG classifications for the Medicaid CMI quarterly reports for reimbursement. Thus Pennsylvania will begin using the Optional State Assessment (OSA) to collect data required to achieve the RUG classifications. The OSA will collect data in addition to the required OBRA MDS assessments. The OSA data set can also be found and reviewed on the CMS website.

Pennsylvania State Regulations Revised – Effective Date July 1, 2023

The Pennsylvania state regulations have been revised for the first time in many years. These revisions include a stepped adjustment to required staffing mandates. The revised staffing mandates include both a PPD adjustment as well as inclusion of ratio requirements for RN, LPN and CNA staffing. Both must be achieved for compliance. Several updates were also made to update definitions to current terms and to align with federal and/or OAPSA definitions.


The revised state regulations, an education power point reviewing the regulations, regulation guidelines and FAQs regarding the revised regulations can be found on the PA state Department of Health website at Regulations (

Inaugural Quality Symposium

Quality Symposium

Join us for our first ever Quality Symposium focused solely on practice standards for high risk / high volume care areas necessary to provide quality care and produce quality outcomes.

Virtual Platform – July 12 – 13

Session Topics Include:
*Pressure Ulcer/Injury Prevention and Management
*Care Planning
* Trauma Informed Care
* Medication Management
* Pulmonary Assessment
* SBAR Use
* Incontinence Management
* Accident Prevention

CMS Revises Guidelines for COVID testing and Nursing Home Visitation

CMS issued memos on May 8, 2023 regarding guidance for visitation in nursing homes and COVID-19 testing in nursing homes. The memos are Ref: QSO-20-39-NH (nursing home visitation) and Ref: QSO-20-38-NH (nursing home COVID-19 testing). Previous memos regarding these nursing home topics issued in 2020 during the pandemic have been either revised or expired as of the end of the Public Health Emergency declaration on May 11, 2023.


Please go to the CMS site to retrieve the memos for additional information.

Federal Trade Commission Proposes Non-Compete Rule

Federal Trade Commission Proposed Rule on Non-Compete Clauses

Background On January 5, 2023, the Federal Trade Commission released a Notice of Proposed Rulemaking (NPRM) to prohibit employers from imposing noncompete clauses on workers. True to their name, non-competes block people from working for a competing employer, or starting a competing business, after their employment ends. Evidence shows that noncompete clauses bind about one in five American workers, approximately 30 million people. By preventing workers across the labor force from pursuing better opportunities that offer higher pay or better working conditions, and by preventing employers from hiring qualified workers bound by these contracts, non-competes hurt workers and harm competition.

Proposed Rule on Noncompete Clauses

Based on concerns about these harms to workers and to competition, the FTC has proposed a rule concerning non-competes.

  • The rule would provide that noncompete clauses are an unfair method of competition. As a result, the rule would ban employers from entering noncompete clauses with their workers, including independent contractors.
  • The rule would require employers to rescind existing noncompete clauses with workers and actively inform their employees that the contracts are no longer in effect.
  • In the proposed rule, for which the agency invites comment, the FTC estimates that the rule would: o Increase workers’ earnings by nearly $300 billion per year o Save consumers up to $148 billion annually on health care costs o Double the number of companies founded by a former worker in the same industry
  • The proposed rule seeks public comment on a number of topics, in particular: o Whether franchisees should be covered by the rule o Whether senior executives should be exempted from the rule, or subject to a rebuttable presumption rather than a ban o Whether low- and high-wage workers should be treated differently under the rule

We Invite You To Be Part Of Our History!

Join our elite group of sponsors of our 35th Annual PADONA Conference and be part of our 35th year celebration!
We are grateful to the following business partners for their generous support of our conference!

      Phoebe Pharmacy – Conference Bag Sponsor

         Jewish Healthcare Foundation – Partial Virtual Conference Sponsor

            Affinity Health Services – Party Band Sponsor 

                Pelican Insurance –Wednesday and Thursday Afternoon Coffeee Sponsor

                   CHR Consulting Services – Party Door Prize Sponsor 

                      Premier Therapy – Registration Sponsor 

                        PointClickCare – Partial Clinical Track Sponsor 

                           Eshyft – Lanyard Sponsor 

                              Diamond Pharmacy – Hand Sanitizer Sponsor 

                                 General Healthcare Resources – Educational Session Gift Card Giveaways

                                    Brockie Pharmatech – Celebration Party Food Station


Remaining Conference Sponsorships 02.24.2023
All Sponsorships Include:



2023 Scholarship Program

PADONA is a non-profit organization committed to serving nurse professionals working in long-term care.  We commit to you by providing resources that promote higher education and additional learning opportunities to assist you as you care for Pennsylvania’s seniors.  Each year, we offer three different types of nursing education scholarships for members in pursuit of additional education.  

Primary PADONA members can apply for OR recommend an applicant for an educational scholarship for any one of the following opportunities:

  1. Scholarship Award towards a nursing degree;
  2. Scholarship Award toward annual convention attendance; and/or
  3. Scholarship Award toward our annual Leadership Development Course.


Applicants must:

  • be a Primary Member of the Pennsylvania Association Directors of Nursing Administration (PADONA) for two consecutive years.


  • be recommended by a Primary Member of the Pennsylvania Association Directors of Nursing Administration (PADONA) who has been a member for two consecutive years. 
  • be a staff member or a family member of a Primary Member.   


  • have a Pennsylvania permanent address and be enrolled on a part time or full time basis in one of following programs:

          An NLN accredited LPN program.

          An NLN accredited diploma or associate RN program.

          An NLN accredited BSN program.

          An NLN accredited program leading to a master’s degree in nursing or nursing management.

          An NLN accredited program leading to a doctoral degree in nursing or nursing management.

          Other; or

  • Apply for a scholarship to attend the annual spring conference; or
  • Apply for a scholarship to attend the annual Leadership Development Program


Check out the link to our application and scholarship submission criteria on our website.   You can also visit our scholarship page on the website at Scholarship – PADONA – Pennsylvania Association of Directors of Nursing Administration for additional information.

Applications must be submitted by January 31, 2023 to the PADONA Board of Directors.  Please email applications and supporting documentation to Candace Jones at or fax to 856-780-5149.


Centers for Disease Control and Prevention (CDC) Updates “Up to Date” Definition for COVID-19 Vaccines

Centers for Disease Control and Prevention (CDC) Updates “Up to Date” Definition for COVID-19 Vaccines

The Centers for Disease Control and Prevention (CDC) released a statement in November on their website under the COVID-19 information that updates the definition of being “up to date” with vaccines. This information is directly from the CDC website.

When Are You Up to Date?

You are up to date with your COVID-19 vaccines if you have completed a COVID-19 vaccine primary series and received the most recent booster dose recommended for you by CDC.

COVID-19 vaccine recommendations are based on three things:

  1. Your age
  2. The vaccine you first received, and
  3. The length of time since your last dose

People who are moderately or severely immunocompromised have different recommendations for COVID-19 vaccines.

You are still up to date if you receive all COVID-19 vaccine doses recommended for you and then become ill with COVID-19. You do not need to be immediately revaccinated or receive an additional booster.

Pennsylvania State Regulations for Long Term Care Revised

Pennsylvania State Regulations for Long Term Care Revised

The Pennsylvania state regulations for Long Term Care providers have been revised and have been approved by the Independent regulatory review Commission. Pennsylvania state regulations were last revised by the department of health in 1997. Since that time there have been several revisions and updates to the federal regulations. These revised regulations provide an opportunity to reflect on the increased acuity of long term care residents with the intentions to improve resident quality of care, increase consistency between federal and state regulations, increase the efficiency of the state survey process, eliminate confusion in the application of standards and provide clarification for staffing minimums and ratios.

The revised state regulations are effective July 1, 2023 and can be found at: under nursing homes and then clicking on regulations.

Have a Question?

Call or email us with any questions you might have.

President/Board Chair
Candace McMullen
(814) 617-1435

Directed in Service & Continuing Education
Sophie Campbell
(724) 601-7873

LuAnn White
(814) 599-3717

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Whether you are interested in becoming a member, exhibitor, sponsor, scholarship recipient, etc, we will answer all of your questions. Lets schedule your free consultation.

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