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Every Stars Among Us Award begins the same way: with someone taking the time to nominate a deserving person or program.

On August 17, U.S. District Court Judge Nancy Brasel issued an Order dismissing the lawsuit that LeadingAge Minnesota, along with our Long-Term Care Imperative (LTCI) partner, filed in March 2026 challenging the Nursing Home Workforce Standards Board (NHWSB).

After months of delay due to late submission by DHS of the State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS), nursing home rate notices for January 1, 2026 are about to be posted to the nursing facility provider portal.

In a rapidly evolving turn of events, a Ramsey County judge ruled on 8/10/2026 that the “Right to Repair” ballot initiative should be included on the November ballot in Saint Paul’s general election.

In response to discussions with LeadingAge Minnesota, The Department of Public Safety (DPS) has created an additional topic on their Alcohol & Gambling Enforcement (AGE) website intended to give clarity to apartment buildings.

The work of building a strong assisted living operation does not end when the license is issued. Whether an organization is preparing to welcome its first resident or has served residents for years, the same challenge remains: turning complex regulatory requirements into policies, training, documentation and everyday practices that work together.

Section GG has become one of the most influential sections of the Minimum Data Set (MDS), yet it remains one of the most misunderstood. While many clinicians recognize its importance for Medicare reimbursement, Section GG extends far beyond payment. Accurate coding directly impacts Quality Measures, Value-Based Purchasing, Five-Star performance, state Medicaid case-mix systems, discharge planning, and the resident's overall clinical story.

Despite its significance, many skilled nursing facilities continue to experience inconsistent GG coding—not because staff lack clinical knowledge, but because processes, communication, and education often fail to keep pace with evolving expectations. The encouraging news is that most of the opportunities for improvement are operational and can be addressed through standardized workflows and interdisciplinary collaboration.

Coding Usual Performance, Not Best or Worst

One of the most common challenges is determining the resident's usual performance. Section GG requires facilities to code the resident's typical level of function during the assessment period, not the resident's best or worst performance. A resident recovering from surgery or a stroke may require substantial assistance one day and only supervision the next. Selecting the highest or lowest level of function instead of identifying the resident's usual performance can significantly alter reimbursement and quality outcomes.

Observation, Not Assumption

Another frequent opportunity involves relying on assumptions rather than observation. Staff may unintentionally code what they believe a resident is capable of doing instead of what actually occurred. Section GG should always reflect observed performance supported by interdisciplinary documentation from nursing, therapy, and certified nursing assistants. Every member of the care team contributes valuable information that helps paint an accurate picture of the resident's functional abilities.

Selecting the Correct Level of Assistance

Facilities also continue to struggle with selecting the correct level of helper assistance. Distinguishing between setup assistance, supervision, partial assistance, substantial assistance, and dependent can be challenging without ongoing education. These distinctions may appear minor, but even a one-level difference can affect quality metrics and reimbursement. Routine competency training using real resident scenarios helps improve consistency and confidence among staff responsible for documenting functional performance.

Appropriate Use of "Not Attempted" Codes

The use of "Not Attempted" codes presents another opportunity for improvement. Codes such as 07, 09, 10, and 88 should only be used when the specific RAI Manual definitions are met and supported by documentation. These codes should never become the default option simply because an activity was not observed during a shift. Clear documentation explaining why an activity was not attempted is essential to support accurate coding and withstand audit scrutiny.

Communication Across Disciplines

Perhaps the greatest opportunity lies in improving communication across disciplines. Section GG should never be viewed as solely a therapy responsibility or an MDS responsibility. The highest-performing organizations recognize that accurate functional coding depends on collaboration between nursing, therapy, restorative nursing, MDS coordinators, and clinical leadership. When each discipline contributes its observations, the resulting GG coding more accurately reflects the resident's true functional status.

The Value of Daily Clinical Meetings

Daily Medicare or PDPM clinical meetings have proven to be one of the most effective strategies for improving GG accuracy. These brief interdisciplinary discussions allow the team to review recent functional changes, identify documentation gaps, confirm usual performance, and ensure coding decisions align with the resident's clinical presentation before the assessment is finalized. Addressing questions concurrently is significantly more effective than attempting to reconstruct the resident's performance days later.

Regular Auditing as a Bridge

Regular auditing is another valuable tool for bridging the gap. Reviewing completed GG coding alongside supporting documentation often reveals patterns that can be addressed through targeted education. Rather than viewing audits as compliance exercises, successful organizations use them as opportunities to coach staff, strengthen documentation practices, and improve consistency across departments.

The Benefits of Getting It Right

The benefits of accurate Section GG coding extend well beyond regulatory compliance. Facilities that prioritize functional accuracy often experience more appropriate Medicare reimbursement, stronger state Medicaid case-mix classifications where applicable, improved Quality Measure performance, better Value-Based Purchasing outcomes, and stronger Five-Star ratings. Equally important, accurate coding supports safer discharge planning by ensuring care teams clearly understand the resident's functional abilities and ongoing needs.

Telling the Resident's Story

At its core, Section GG is about telling the resident's story accurately. Every transfer, every walk to the bathroom, every meal completed independently, and every improvement achieved through skilled care contributes to that story. When documentation and coding truly reflect the resident's usual performance, facilities are rewarded with more accurate reimbursement, stronger publicly reported outcomes, and greater confidence during audits.

Bridging the gap in Section GG does not require coding residents higher or lower—it requires coding them correctly. By investing in interdisciplinary collaboration, standardized processes, concurrent reviews, and continuous education, skilled nursing facilities can transform Section GG from a documentation requirement into a powerful driver of clinical excellence, financial stewardship, and quality outcomes.

When organizations focus on coding accuracy instead of simply coding completion, everyone benefits. Residents receive care that reflects their true functional needs, clinicians gain confidence in the assessment process, leadership obtains more reliable quality data, and facilities are better positioned to thrive in an increasingly outcome-driven healthcare environment. In today's skilled nursing landscape, accurate Section GG coding isn't just best practice, it's a strategic advantage.

On August 13, 2026, the Centers for Medicare and Medicaid Services (CMS) released the surveyor resources for the newly implemented Risk Based Survey (RBS) process.

The CDC is shutting down SimpleReport. The Minnesota Department of Health requires assisted living organizations to transition to alternative electronic tools to report positive point-of-care test results within one working day.

LeadingAge Minnesota is sharing that William Levine, Data & Membership Coordinator, is taking the next step in his professional career and has accepted a data analyst position with another organization and will therefore be moving on from the association.

The agenda will be published and registration will open in the coming week for LeadingAge Minnesota’s October District Meetings. This fall, we’re adding something new to the district meeting format based directly on member feedback.

As you consider who to nominate for a 2027 Stars Among Us Award, don't overlook everyday excellence. Not every star seeks the spotlight, and some of the people most deserving of recognition are the least likely to ask for it.

Learning and professional development can take many forms, and LeadingAge Minnesota’s education partners offer additional opportunities for professionals to grow and explore new areas of expertise. One of those partners, Saint Mary’s University of Minnesota, offers graduate programs that help professionals build specialized knowledge and skills for the next step in their careers.

St. Francis Health Services of Morris, Inc. (CEO, Carol Raw) and Benedictine (CEO, Jerry Carley) have signed a non-binding Letter of Intent to explore an affiliation between the two Catholic, nonprofit organizations in which Benedictine would become the sole corporate member of SFHS. If the membership substitution occurs, Duluth Benedictine Ministries would, subject to its own agreement, become the Catholic sponsor of SFHS.

LeadingAge Minnesota member Vivie has announced the appointment of Mike Fryar as its new chief revenue officer. In this newly created executive role, Fryar will lead efforts to align marketing, sales and growth strategies across the organization's expanding continuum of services. Read the full press release below to learn more about Fryar's background and Vivie's vision for this new leadership position.