The latest news, events, blogs and more…
Overcoming Behavioral Care Planning Pitfalls
Behavioral health can be one of the most complex aspects of long term care. Thoughtful and personalized care planning is key to both proactive preventative strategies and an effective response to challenging behaviors. This week’s blog breaks down the critical...
Ask Proactive – Did the ICD-10 codes for Dementia recently change?
Q: Did the ICD-10 codes for Dementia recently change? A: Yes, the FY 2023 ICD-10 updates (effective 10/01/22) include updated codes that provide greater specificity based on severity and behavioral symptoms present. The ICD-10-CM now classifies dementia on the...
ABCs of an Effective Skilled Nursing Note
According to the Patient-Driven Payment Model (PDPM), skilled nursing facilities (SNFs) are required to have documentation in the medical record that will allow a medical reviewer, in the case of an additional documentation request (ADR), to determine that Medicare...
Ask Proactive – We do not currently have an MDS Coordinator and it will be some time before the new one can start. Who can complete the MDS; does it have to be a nurse?
Q: We do not currently have an MDS Coordinator and it will be some time before the new one can start. Who can complete the MDS; does it have to be a nurse? A: Each facility self-determines its policies and procedures for patient documentation practices and...
Tips for Successful IDR/IIDR
The IDR process gives nursing homes one informal opportunity to dispute cited deficiencies after any survey of Federal requirements for participation. Facilities are also provided the opportunity to request and participate in an Independent IDR if CMS imposes civil...
After the Survey: Developing a Plan of Correction
A plan of correction (POC) is a plan developed by the facility and approved by CMS or the state survey agency that clearly describes the actions the facility will take to correct deficiencies cited during a survey and specifies the date by which those deficiencies...
Ask Proactive – I have a Medicare Part A resident that went home for a visit and stayed overnight. Do I need to complete MDS assessments for an interrupted stay?
Q: I have a Medicare Part A resident that went home for a visit and stayed overnight. Do I need to complete MDS assessments for an interrupted stay? A: Unless your State has a different policy, a Leave of Absence (LOA) which includes a temporary home visit of...
Cleaning and Disinfection for the Infection Preventionist
A recent study found that over 90% of high-touch surfaces in Long Term Care facilities were contaminated with potential sources of infectious disease spread. (American Journal of Infection Control) Handrails, equipment controls, and patient beds were 4 times more...
Ask Proactive – SNF Certification/Recertification
Q: We recently received the outcome of our TPE audit. The MAC denied even with our delayed certifications for the skilled stays. We thought this was an accepted process if the SNF certification / recertifications were late. How can we dispute the determination? ...
Ask Proactive – Your obligation to report concerns
Q: I am a floor nurse and have a concern about a coworker’s practices at work. When I am on the medication cart that she normally works, I find many medications that still have blisters packs that are full, and unopened inhalers, eye drops, etc. She and I are friends...
Survey Ready! F895 LTC Compliance and Ethics Program Requirements
Oversight, Outbreaks, Overpayments…Oh My! It seems the LTC industry has no shortage of potential pitfalls knocking at the door. October 24, 2022 has come and gone, with the long-awaited phase 3 surveyor interpretive guidance now in effect for LTC providers. This...
Ask Proactive – Does the ABN Have to be Issued When Therapy Ends?
Q: When someone is still on Med A benefits and the therapy team reduces or ends one type of therapy but not all types, does the ABN need to be given each time? A: The notices aren’t required when therapy reduces or ends services, but rather when the SNF...
Revisions to Special Focus Facility (SFF) Program
On Oct. 21, 2022, CMS issued QSO-23-01-NH, announcing revisions to the Special Focus Facility (SFF) program with an emphasis on improving the quality of care that residents living in SFF receive. The changes to the program aim to address facilities that remain in the...
Survey Enforcement Remedies: Directed In-Service Training
Q: My facility just completed our annual survey and is in denial of payment until a Directed In-Service training is completed. What is a Directed In-Service training and how do we ensure compliance? A: Directed In-service training is one of the enforcement...
Avoiding Deficiencies at F758 – Psychotropic Drugs
The prevalence of psychotropic drugs in nursing homes has increased in recent years in part due to the worsening of emotional and behavioral disorders exacerbated by the restrictive measures of the COVID-19 pandemic.[1] Consequently, F758 Psychotropic Drugs is one of...