Navigating the Shift: Reporting Falls with Major Injury to Mitigate Risk and Expand Quality Care

Reporting Falls with Major Injury to Mitigate Risk and Expand Quality Care

On September 18, 2025, the Office of the Inspector General (OIG) CMS published findings on Falls with Major Injury (FMI). The OIG report states 43% of FMI are not reported in accordance with CMS guidelines. RAI/MDS 3.0 manual Section J became effective October 2, 2025, and provides guidance on defining, coding, and reporting FMI.

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About CAC Group

CAC Group is a leading insurance broker and advisor that provides expertise and placement capabilities across the spectrum of insurance and capital markets. The entity comprises CAC Specialty, an industry leading specialty broker, CAC Agency, a P&C, personal lines and employee benefits broker, and CAC Capital, a structured solutions group that specializes in the convergence of insurance and capital markets. Collectively, CAC Group serves large corporations, small-to-medium enterprises as well as individuals. It is an employee-owned company and ranked in the top 40 of all U.S. brokerage firms. For more information, please visit us at www.cacgroup.com.

Media Contact

Allyson Marcus
Senior Vice President, Communications Director
allyson.marcus@cacgroup.com