News / Blog
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The latest news, events, blogs and more…
Ask Proactive – Can a resident requiring the CDC updated “Enhanced Barrier Precautions” be coded in Section O0100M for Isolation or Quarantine?
Q: Can a resident requiring the CDC updated “Enhanced Barrier Precautions” be coded in Section O0100M for Isolation or Quarantine? A: No. The CDC updated Enhanced Barrier Precautions (EBP) do not meet the RAI requirements for coding Isolation or Quarantine on the MDS...
Proactive Summary – FY 2023 SNF Final Payment Rule
On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY)...
QAPI Efficacy: From Plan to Sustained Improvement
Nursing homes are required to develop, implement, and maintain an effective, comprehensive, and data-driven Quality Assurance & Performance Improvement (QAPI) program to improve the quality of life and quality of care delivered to residents. Establishing an...
Ask Proactive – I have a resident who was discharged (unplanned) and remained in the hospital for 15 days before returning to my facility. A Quarterly MDS assessment fell due during the time they were out of the facility and my software is showing it as late or missed. What should I do?
Q: I have a resident who was discharged (unplanned) and remained in the hospital for 15 days before returning to my facility. A Quarterly MDS assessment fell due during the time they were out of the facility and my software is showing it as late or missed. What should...
Risk Management Strategies for the DON
The word “Risk” is referenced in the CMS State Operations Manual - Appendix PP 524 times. Clearly Risk Management is a critical area of focus for the Director of Nursing and the nursing department. According to the article Clinical Areas of Liability: Risk Management...
Update: SNF Qualifying Hospital Stay (QHS), Benefit Period Waivers and Medical Review Preparedness
Effective July 15, 2022, HHS Secretary extended the PHE, the new expiration date being October 13, 2022. CMS continues to recognize that disruptions arising from a PHE can affect coverage under the SNF benefit: Prevent a patient from having the 3-day inpatient QHS...
Detecting the Root Cause of Infection Events
Federal regulations require the facility Infection Preventionist (IP) to be a participant on the facility’s Quality Assessment and Assurance (QAA) committee and report on the Infection Prevention and Control Program (IPCP) and on incidents (e.g., healthcare-associated...
Ask Proactive – What happens in the MDS department when a building is being purchased by a new company? A colleague mentioned that since it’s a new NPI number, we may need to complete a discharge and entry on every patient. Is this true?
Q: What happens in the MDS department when a building is being purchased by a new company? A colleague mentioned that since it’s a new NPI number, we may need to complete a discharge and entry on every patient. Is this true? A: There are two types of change in...
Detecting the Root Cause of Infection Events
Federal regulations require the facility Infection Preventionist (IP) to be a participant on the facility’s Quality Assessment and Assurance (QAA) committee and report on the Infection Prevention and Control Program (IPCP) and on...
July 2022 Important New Revisions to 5 Star Methodology Expected to Penalize Up to 16% of Providers
For facilities that have relied upon the strength of their staffing rating to drive the overall Five Star rating, the new guidance effective with the July 2022 refresh is estimated to negatively impact 10-16% of providers, according to a July 11 McKnight’s report...
Avoiding Top 10 Deficiencies: F677 – ADL Care Provided for Dependent Residents
F677 ADL care provided for dependent residents is one of the top 10 areas cited for deficient practice in the nation. This regulation states that a resident who is unable to carry out activities of daily living should receive the necessary services to maintain good...
Quick List of Significant Revisions to LTC Surveyor Guidance Effective October 24th
On June 29, 2022, CMS issued QSO-22-19-NH, announcing the release of new Interpretive Guidance for Phase 3 requirements, which went into effect November 28, 2019, and revisions to Phase 2 guidance. Surveyors will begin using this guidance to identify noncompliance on...
Ask Proactive – We have had multiple outbreaks of COVID in recent weeks. There has been confusion when coding isolation. Can we code isolation if we have two positive residents sharing a room?
Q: We have had multiple outbreaks of COVID in recent weeks. There has been confusion when coding isolation. Can we code isolation if we have two positive residents sharing a room? A: Coding isolation requires specific criteria. One of these characteristics is if the...
Antibiotic Stewardship
Improving the use of antibiotics in healthcare to protect patients and reduce the threat of antibiotic resistance is a national priority. Antibiotics are among the most frequently prescribed medications in nursing homes, with up to 70% of residents in a nursing home...
Perfecting the Care Planning Process: CAAs
The Care Areas Assessment (CAA) process is the framework for decision-making after the MDS assessment has been completed, and serves as the link between the MDS and the Care Plan. The CAA process helps the interdisciplinary team evaluate the resident holistically, and...