In today’s skilled nursing environment, Section GG has become one of the most influential components of the Minimum Data Set.
In today’s skilled nursing environment, Section GG has become one of the most influential components of the Minimum Data Set. Although some operators still view GG as “just another coding requirement,” its effects extend far beyond documentation. Accurate GG coding reflects true resident progress, drives reimbursement, influences quality measures, supports compliance, and strengthens your facility’s reputation. To succeed in an increasingly outcome driven landscape, every skilled nursing facility must establish strong processes to ensure consistent and accurate GG coding.
Why GG Accuracy Is Critical
Reimbursement Under PDPM
GG coding directly contributes to case mix group assignment for multiple PDPM components. Errors in coding, whether through overstatement or understatement, can result in missed reimbursement as well as potential audit scrutiny. For facilities operating within narrow margins, GG accuracy plays a measurable role in financial stability.
Quality Measures and Five Star Ratings
CMS functional outcome measures such as improvement in mobility and self care rely heavily on GG data. If staff undercode a resident’s abilities or fail to capture true usual performance, the facility’s outcomes may appear worse than they actually are. This can negatively impact Five Star Quality Measure ratings and overall public reporting.
Survey Readiness and Compliance
Surveyors now pay increased attention to alignment between care plans, therapy documentation, and MDS coding. Discrepancies or inaccuracies in Section GG raise immediate concerns and may lead to citations under F Tags such as F656, which covers development and implementation of comprehensive care plans, and F657, which addresses care plan timing and revision.
Common Pitfalls in GG Coding
Even with strong intentions, skilled nursing facilities frequently encounter similar challenges when coding Section GG. These issues can directly harm reimbursement accuracy, reduce quality measure performance, and increase compliance exposure.
Relying Solely on Therapy Evaluations
Using only therapy documentation without input from nursing or other direct care staff often results in an incomplete understanding of the resident’s usual performance.
Coding Extremes Instead of Usual Performance
Coding a resident’s best or worst performance rather than their typical functional level distorts both baseline and outcome measures.
Missing Observation Windows
Delays in evaluating resident function, especially during the critical first three days of admission, often lead to incomplete or rushed GG coding.
Lack of Interdisciplinary Communication
Without consistent collaboration between MDS, nursing, and therapy staff, documentation discrepancies are more likely to occur, increasing compliance risk.
Addressing these pitfalls requires intentional workflow design, timely reviews, and a facility wide commitment to interdisciplinary communication.
Best Practices for Leaders
Create an Interdisciplinary System
GG data must be collected collaboratively. Input from nursing assistants, therapy professionals, and nurses ensures that documentation accurately reflects the resident’s abilities.
Build in Audits and Education
Regular audits comparing GG entries with supporting documentation can identify systemic issues. Ongoing staff education reduces repeat errors and strengthens overall coding accuracy.
Use Early Huddles for New Admissions
A brief team review on Day Four helps reconcile GG coding for new residents. This ensures that typical performance is captured accurately before the assessment is locked.
Tie GG Data to QAPI
Functional outcomes are both regulatory requirements and indicators of care quality. Embedding GG review processes into QAPI allows leaders to track trends, benchmark outcomes, and demonstrate ongoing improvement.
The Bottom Line
Section GG is far more than a coding exercise. It is a strategic lever that drives financial performance, improves quality outcomes, and supports compliance. Skilled nursing facilities that prioritize accurate GG coding are better positioned to protect revenue, strengthen Five Star ratings, and reduce survey risk.
