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The Landscape of Skilled Service Justification in Skilled Nursing Facilities

Skilled Service Justification in SNFs In the ever-evolving landscape of skilled nursing facilities (SNFs), the stakes have never been higher. With constant advancements in data analytics, regulatory bodies are sharpening their focus on compliance and accountability...

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Ask Proactive – Can we place the room/bed number for a semi-private room on the Enhanced Barrier Precaution sign located outside the resident’s room to notify staff which resident requires PPE for high contact activities or is this a HIPAA violation?

Q: Can we place the room/bed number for a semi-private room on the Enhanced Barrier Precaution sign located outside the resident’s room to notify staff which resident requires PPE for high contact activities or is this a HIPAA violation?     A: CMS addresses...

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Ask Proactive – I have a resident that routinely receives an injection of fluphenazine decanoate every 4 weeks. The injection was not administered during the 7-day observation period, but its a long-lasting medication. Should I code it under N0415A?

Q: I have a resident that routinely receives an injection of fluphenazine decanoate every 4 weeks. The injection was not administered during the 7-day observation period, but its a long-lasting medication. Should I code it under N0415A?     A: Page N-9 of...

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Ask Proactive – We have a resident with a chronic stage IV pressure ulcer who recently had flap surgery to close the wound. Do I continue to code the stage IV on the MDS?

Q: We have a resident with a chronic stage IV pressure ulcer who recently had flap surgery to close the wound. Do I continue to code the stage IV on the MDS?     A: According to the RAI (pg. M-6), if a pressure ulcer is surgically closed with a flap or...

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Ask Proactive – Our social worker attempted to complete the BIMS with a resident, but the resident refused to answer the questions. As a result, the social worker coded all responses in C0200, 0300 and 0400 as “0” with a BIMS Summary Score of “00” at C0500. This seems odd because the resident’s previous BIMS scores have been 14 or15. When I interact with the resident, I don’t observe any cognitive decline, and the staff report no concerns either. Is this BIMS coding correct?

Q: Our social worker attempted to complete the BIMS with a resident, but the resident refused to answer the questions. As a result, the social worker coded all responses in C0200, 0300 and 0400 as “0” with a BIMS Summary Score of “00” at C0500. This seems odd because...

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Ask Proactive – My facility is triggering high for the Quality Measure: Prevalence of Behavior Symptoms Affecting Others, but we don’t have many behavioral issues in our population. Why is this happening?

Q: My facility is triggering high for the Quality Measure: Prevalence of Behavior Symptoms Affecting Others, but we don’t have many behavioral issues in our population. Why is this happening?     A: This measure may trigger if the most recent MDS is coded...

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