News / Blog
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The latest news, events, blogs and more…
Ask Proactive – One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met and were discussing a primary diagnosis. Therapy believes we should use Z47.1 Aftercare following joint replacement surgery but some of the available hospital documentation uses S72.141A Displaced intertrochanteric fracture of right femur, initial encounter for closed fracture. Which is the correct code?
Q: One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met and were discussing a primary diagnosis. Therapy believes we should use Z47.1 Aftercare following joint...
Ask Proactive – We have a patient who has achieved ambulation in the hallways at supervision level using a walker. Our new case manager is insistent that we discharge as soon as possible, or our services could be denied by Medicare. The patient wants to return to PLOF, independent ambulation, so her therapists do not feel a discharge is appropriate at this time. Would this claim be at risk for denial?
Q: We have a patient who has achieved ambulation in the hallways at supervision level using a walker. Our new case manager is insistent that we discharge as soon as possible, or our services could be denied by Medicare. The patient wants to return to PLOF, independent...
Avoiding the Most Commonly Cited Medication Errors
Recent CASPER data for Fiscal Year 2024 ranks deficiency F760, "Residents are Free of Significant Medication Errors," as 25th and F759, "Free of Medication Error Rate of 5% or More," as 27th. Let’s examine examples of these deficiencies along with an action plan based...
Ask Proactive – What are the best practices to prevent a deficiency, especially an Immediate Jeopardy, related to CPR?
Q: What are the best practices to prevent a deficiency, especially an Immediate Jeopardy, related to CPR? A: One of the most critical components in preventing a deficiency related to CPR is communication. The facility must ensure that the resident’s...
Minimum Staffing Rule’s Facility Assessment Mandate
On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule. This final rule mandates the following minimum...
Retiring Nurse Leaders—What’s your Plan?
Recently, a poll was posted inquiring about upcoming retirement plans for MDS Coordinators and Directors of Nursing. The poll was posted in a closed Facebook forum, The MDS Coordinators Discussion Group, hosted by Jim Kilburn which represents over 19,000 post-acute...
Ask Proactive – What steps should be taken when a resident chooses not to comply with diet or fluid restrictions?
Q: What steps should be taken when a resident chooses not to comply with diet or fluid restrictions? A: According to the State Operations Manual (SOM), under F553 ‘The Right to Participate in Planning Care,’ a resident has the right to select or refuse...
Strengthening Nursing Home Oversight: A Review of Proposed Changes to Enforcement
In the realm of healthcare, especially within nursing facilities, ensuring compliance with regulations is paramount to safeguarding the well-being of residents. Recently, the Centers for Medicare & Medicaid Services (CMS) proposed significant revisions to...
Ask Proactive – Is it best practice to have witnesses write their own statements for incidents or investigations or to write these statements for them?
Q: Is it best practice to have witnesses write their own statements for incidents or investigations or to write these statements for them? A: Deciding whether to have witnesses write their own statements or not is going to depend on your specific state...
ICD.10 Corrections Issued Impacting PDPM
CMS issued corrections to the FY 2024 SNF PPS Final Rule PDPM ICD-10 Mapping. The document, which was issued and effective April 10, 2024, makes corrections to technical errors that are applicable beginning 10/1/2023. This correction document can be accessed at the...
Ask Proactive – I hear so much talk about drug diversion in healthcare, how would I know if it was happening in my facility?
Q: I hear so much talk about drug diversion in healthcare, how would I know if it was happening in my facility? A: Healthcare professionals and institutions must remain vigilant for signs of drug diversion to safeguard patients and facilitate appropriate...
Infection Control Highlight: Managing UTIs in Long-Term Care Facilities
Infection control is a critical aspect of healthcare, especially in long-term care (LTC) facilities where residents are more vulnerable to infections like urinary tract infections (UTIs). UTIs are a common and often recurring issue in this setting, requiring vigilant...
Ask Proactive – I have a resident that was admitted Medicare part A on the 11th, discharged to the hospital on 13th and is returning today (22nd). Is her admission MDS due earlier because of the 04/11 admission date?
Q: I have a resident that was admitted Medicare part A on the 11th, discharged to the hospital on 13th and is returning today (22nd). Is her admission MDS due earlier because of the 04/11 admission date? A: The admission assessment should be reinitiated...
Auditor Insights: Easy Fixes to Skilled Charting Shortcomings
Audits are on the rise! Skilled nursing facilities (SNFs) are at an all-time high when it comes to active medical review. From the SNF 5 Claim Probe and Educate and individual Medicare Advantage reviews, to recovery audit contractors (RACs) and Supplemental Medical...
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...