MASTER-level citations, current as of the version date. Facilities may append payer-specific requirements (MAC LCDs, ADR criteria, local notification parameters) as overlays without altering the MASTER version.
CMS Medicare Benefit Policy Manual (Pub. 100-02), Chapter 8 — Coverage of Extended Care (SNF) Services Under Hospital Insurance. Skilled coverage, the covered-services list, the daily-basis requirement, the practical-matter test, and the benefit period.
CMS Medicare Program Integrity Manual (Pub. 100-08) — medical review / ADR standards applied to Part A SNF review.
42 CFR Part 483 — Requirements for Long-Term Care Facilities, with State Operations Manual Appendix PP (F580 notification; F641 accuracy; F658 professional standards; F684 quality of care; F726 competency; the domain F-tags cross-linked from each reference module).
CMS MDS 3.0 RAI User’s Manual, v1.20.1, effective October 1, 2025 — Sections O, N, GG, M, J, K, I and the supportive-documentation expectation.
SNF PPS / PDPM — the Part A case-mix model; verify the current fiscal-year SNF PPS final rule at time of use.
Jimmo v. Sebelius — the maintenance-coverage standard: skilled coverage does not require improvement.
Usage note. Every model note and smart phrase is a structured example to be edited to reflect what was actually delivered and the resident’s specific orders. Documentation must reflect the real day; do not copy unchanged. Coverage amounts, staffing rules, and qualifying-stay waivers change — verify against the current source. CHAP/MAC items are facility-fill.
