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Minimum Staffing Final Rule
*Content in this post was corrected on 4/24/2024 at 11:11 Central Time. The HPRD of direct nurse aide care was changed from .45 to 2.45* On Monday, April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) unveiled a comprehensive 329-page final rule...
Ask Proactive – We just had an annual survey and received three F-Tags level D in SNF area. One of those was Infection Control. Should I anticipate a civil money penalty due to the Infection tag?
Q: We just had an annual survey and received three F-Tags level D in SNF area. One of those was Infection Control. Should I anticipate a civil money penalty due to the Infection tag? A: You will only receive the enhanced enforcement penalties if you...
Top MDS Coding Misses and What It’s Costing Your Facility
While MDS Coordinators consistently strive for accuracy, complying with the intricate coding instructions and details in the Resident Assessment Instrument User Manual, in addition to state-specific coding instructions is challenging. Unfortunately, MDS coding errors...
Ask Proactive – We just had an annual survey and received three F-Tags level D in SNF area. One of those was Infection Control. Should I anticipate a civil money penalty due to the Infection tag?
Q: We just had an annual survey and received three F-Tags level D in SNF area. One of those was Infection Control. Should I anticipate a civil money penalty due to the Infection tag? A: You will only receive the enhanced enforcement penalties if you...
Strategies for Achieving Restorative Nursing Excellence
Skilled nursing facilities (SNFs) and nursing facilities (NFs) play a crucial role in supporting individuals with chronic illnesses, disabilities, or those needing extended care services. Among the essential programs within these facilities is the Restorative Nursing...
After the Survey: Tips On Writing an Effective Plan of Correction
Let’s delve into what a Plan of Correction (PoC) entails. According to, 42 CFR §488.401 a PoC is a plan developed by the facility and approved by either CMS or the survey agency. It outlines the actions the facility will take to rectify deficiencies and specifies the...
Ask Proactive – Is concussion related to fall considered a fall with major injury that would be coded in section JJ1900C of the MDS?
Q: Is concussion related to fall considered a fall with major injury that would be coded In section JJ1900C of the MDS? A: The RAI Manual defines a fall with major injury as follows: Major injury: includes bone fractures, joint dislocations, closed head...
Ask Proactive – I had a resident admitted to our SNF under skilled care who has been diagnosed with HIV/AIDS, but the NTA points are not generating in the HIPPS code. Can you please explain why this is happening and what corrective action should be taken to ensure reimbursement is accurate?
Q: I had a resident admitted to our SNF under skilled care who has been diagnosed with HIV/AIDS, but the NTA points are not generating in the HIPPS code. Can you please explain why this is happening and what corrective action should be taken to ensure reimbursement is...
Managing Elopement Risk in Nursing Homes
Managing elopement risk is crucial for ensuring the safety and well-being of residents in nursing homes, particularly those with cognitive impairments. Elopement, defined as when a resident leaves the premises or a safe area without the facility’s knowledge and...
Ask Proactive – To ensure resident safety with beds and bedrails, how often should bed inspections be conducted and what should be checked?
Q: To ensure resident safety with beds and bedrails, how often should bed inspections be conducted and what should be checked? A: As part of the preventive maintenance program, bed inspections should be conducted a minimum of every six months, and this...
Top Survey Tags FY2024 & How to Avoid Them
According to CASPER Standard Survey data (3/17/24), over 25 thousand deficiencies have been cited thus far this fiscal year (FY), spanning 215 distinct F-tags. This article aims to scrutinize the primary deficiencies across five regulatory groups/facility departments...
Keys to Managing Survey in Process
Navigating the intricacies of the survey process can seem difficult. However, with the right strategies, mindset, and preparedness plan your facility can emerge stronger and better equipped for success than ever before. In this week’s blog, we delve into the key...
Ask Proactive – When coding IV fluids “while not a resident” in section K of the MDS for a resident who does not have a dehydration diagnosis what documentation would support that the IVFs were administered for nutrition/hydration?
Q: When coding IV fluids “while not a resident” in section K of the MDS for a resident who does not have a dehydration diagnosis what documentation would support that the IVFs were administered for nutrition/hydration? A: The key to supporting the coding...
Ask Proactive – How does oral care impact the risk of death in a nursing home?
Q: How does oral care impact the risk of death in a nursing home? A: Aspiration pneumonia is a leading cause of death in nursing homes. Aspiration pneumonia occurs when a non-air substance (e.g. food, liquid, saliva) and bacteria from the mouth is...
DON Success: Delegation of Duties
As the acuity and complexity of long-term care residents has increased, the responsibilities of the Director of Nursing (DON) have also escalated significantly. The duties of the DON are not just clinical in nature, they also involve regulatory, reimbursement, and...