Ep 36: Inside the 2025 MDS Updates with Jane Schoof: What Clinicians Need to Know
Release Date: 11/24/2025
Ep 36: Inside the 2025 MDS Updates with Jane Schoof: What Clinicians Need to Know
Heart-to-Heart with HealthCap
In this episode of Heart to Heart with HealthCap, Angie Szumlinski sits down with Jane Schoof, Director of Utilization at Atrium Living Centers, to discuss the most significant changes to the MDS 3.0 RAI Manual (v1.20.1), focusing on falls and injuries. Together, they review how CMS has redefined what constitutes a fall, including incidents caused by “overwhelming external forces,” and explain what should now be coded as an intercepted fall. The discussion sheds light on how these updates are designed to close reporting gaps between hospital claims and MDS coding, improve accuracy, and...
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EP 35 PBJ: Staying Compliant and Survey Ready with Melanie Flachs
Heart-to-Heart with HealthCap
Payroll-Based Journal (PBJ) reporting isn’t always top of mind—until it is. In this episode of Heart to Heart with HealthCap, Angie Szumlinski is joined by Melanie Flachs of The Peplinski Group, a seasoned nurse and long-term care leader, to discuss what every senior living operator should know about PBJ, RN coverage, and the real-time tracking that can make or break your star rating. From decoding F-tags and identifying common coding pitfalls to practical strategies for weekend coverage, Melanie shares how her communities stay survey-ready through intentional staffing processes, strong...
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Ep 34 Understanding MDS with Robin Hillier (Part 2)
Heart-to-Heart with HealthCap
In Part 2 of our deep dive into the MDS process, Heart-to-Heart with HealthCap welcomes back MDS expert to unpack the most recent updates to the Minimum Data Set (MDS) as of October 1, 2023. Angie Szumlinski and Robin explore critical coding changes, penalties tied to incomplete assessments, challenges with Section GG, and how interdisciplinary teams can improve accuracy and resident outcomes. From quality measures to schizophrenia audits, this episode is packed with practical insights for senior living professionals navigating today's MDS landscape. Robin has also created a to support your...
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Ep 33 Understanding MDS with Robin Hillier (Part 1)
Heart-to-Heart with HealthCap
In this episode of Heart-to-Heart with HealthCap, Angie Szumlinski is joined by MDS expert for Part 1 of our two-part deep dive into the MDS process. Robin shares how the MDS is used across care delivery, compliance, and reimbursement—and why coding accuracy and interdisciplinary collaboration are more critical than ever. Whether you're new to MDS or need a refresher, this episode offers foundational insights you won’t want to miss. Robin has also created a f to support your learning!
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Ep. 32 Navigating CMS Schizophrenia Audits: Lessons Learned & Best Practices
Heart-to-Heart with HealthCap
In this episode of Heart to Heart with HealthCap, Angie Szumlinski chats with Gwynn Ryder, Vice President of Operations for Aspire Health in Ohio, about the challenges and lessons learned from navigating CMS Schizophrenia Minimum Data Set Audits. They discuss the intricate process of compliance, the impact on star ratings, and how one missed detail can ripple into significant consequences for senior living communities. Gwen shares practical advice, insights on improving internal processes, and the importance of proactive quality assurance to stay ahead of audits. Tune in for a deep dive into a...
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Ep. 31 - Fall 2023 Vaccine Recommendations with Dr. David Gifford
Heart-to-Heart with HealthCap
In this engaging podcast episode, Angie Szumlinski, Director of Risk Management at HealthCap and a seasoned expert in the field, engages in a captivating conversation with Dr. David Gifford, Chief Medical Officer at AHCA/NCAL. Together, they delve into the realm of respiratory viruses, shedding light on the latest insights and recommendations concerning their vaccines. From the ever-present RSV to the perennial concern of influenza and the ongoing challenges posed by COVID, the vulnerability of our senior living residents to these respiratory viruses is a paramount concern. Join us as we...
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Ep 30 Bivalent Vaccine Hesitancy
Heart-to-Heart with HealthCap
In this episode Angie Szumlinski, HealthCap Director of Risk Managment and Cathy Hamblen, HealthCap Risk Manager talk with Chad Worz, PharmD, BCGP, FASCP, Chief Executive at the about vaccine hesitancy and strategies for improving bivalent COVID-19 vaccine rates in senior living.
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Ep 29: Residents with Restricted Diets - Enjoying the Holidays
Heart-to-Heart with HealthCap
During the holidays, many residents and families of residents on a restricted diet would like permission to deviate from the diet to enjoy traditional "holiday" foods. Will a dietary waiver protect you if a negative outcome occurs as a result of such a deviation? Angie Szumlinski, HealthCap Director of Risk Managment, talks with Mary McMurry, Litigation Manager at about this and other topics to keep your residents safe and you protected.
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Ep 28: Ready or Not! Phase 3 is Coming October 24th
Heart-to-Heart with HealthCap
CMS will begin surveying against Phase 3 of Requirements of Participation for Nursing Homes on October 24, 2022. With around 180 pages of guidance, revisions, and updates affecting 52 F-tags, many providers are feeling anxious about the new guidance. Angie Szumlinski, Director of Risk Management for HealthCap talks with Crystal Bowens, the Associate VP of Regulatory Services for AHCA/NCAL about the updates, and what providers can do to prepare. Crystal reminds us that AHCA/NCAL members can always reach out to them at for specific questions.
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Ep 27: Arbitration Agreements - Why and How
Heart-to-Heart with HealthCap
Christina Nechiporchik, Associate General Counsel for HealthCap talks with John Hessburg, Senior Partner at the law firm of Kitch where he leads the Post Acute Practice group. Also included in the conversation is Drew Flichak, Chief Administrative Officer and Corporate Compliance Office at Vivage Senior Living. Listen as they talk about why we should be talking about arbitration agreements after CMS issued revised Surveyor Guidance on June 29, 2022. In addition, they discuss the best practices for implementing arbitration agreements in your facilities while remaining in compliance.
info_outlineIn this episode of Heart to Heart with HealthCap, Angie Szumlinski sits down with Jane Schoof, Director of Utilization at Atrium Living Centers, to discuss the most significant changes to the MDS 3.0 RAI Manual (v1.20.1), focusing on falls and injuries. Together, they review how CMS has redefined what constitutes a fall, including incidents caused by “overwhelming external forces,” and explain what should now be coded as an intercepted fall. The discussion sheds light on how these updates are designed to close reporting gaps between hospital claims and MDS coding, improve accuracy, and strengthen resident care.
Jane also provides insight into the revised definitions of major injury and injury except major, sharing how clinicians can apply clinical judgment, documentation, and teamwork to code consistently. The conversation emphasizes the importance of clearly documenting every fall, whether it occurs in therapy or during routine care, to ensure coding accuracy and regulatory compliance.
To help you implement these new standards, HealthCap has created two companion resources: the Comprehensive Reference Guide: Understanding the 2025 MDS 3.0 Changes and the Falls and Injuries Quick Reference Handout. Both documents offer examples, practical tips, and operational insights to help your community align its coding and training practices with the 2025 updates.