The latest news, events, blogs and more…
F699 Trauma-Informed Care
F699 Trauma-informed Care is one of the many areas with changes to the LTC Survey process effective October 24th -- is your facility prepared? According to SAMHSA - Substance Abuse and Mental Health Services Administration seventy percent of adults in the United...
Ask Proactive – How much is the ALJ Appeal Amount in Controversy for 2023?
Q: How much is the ALJ Appeal Amount in Controversy for 2023? A: The amount in controversy (AIC) threshold amount for Medicare ALJ appeals will continue to be $180.00 for CY2023 and the AIC for Judicial Review will increase to $1850.00 Learn more Angie Hamer,...
Ask Proactive – What are some of the most significant changes to the new RoP Interpretive Guidance for Abuse, Neglect & Exploitation?
Q: What are some of the most significant changes to the new RoP Interpretive Guidance for Abuse, Neglect & Exploitation? A: Some of the most significant changes to the new RoP Interpretive Guidance (IG) for Abuse, Neglect...
LTC Infection Prevention & Control Outbreak Management—Start Here!
Infection surveillance is critical in long term care. It enables the effective Infection Preventionist to monitor facility trends and act proactively in response to potential outbreaks. CMS states that The facility must establish a system for surveillance based upon...
F895 Compliance and Ethics Programs
Revised long term care surveyor guidance for F895 Compliance and Ethics Programs was released June 29, 2022. CMS will begin enforcing F895 on October 24, 2022 and has released specific surveyor guidance and updates to Appendix PP to guide preparations. Effective...
Ask Proactive – MDS Section I—ICD.10 Diagnosis Code Error
Q: I’ve noticed when reviewing resident diagnoses for MDS Section I that several of the diagnoses are suddenly showing an error message. How do I correct this? A: CMS has revised several ICD-10 codes for the 2023 fiscal year....
Updated COVID-19 Guidance-Key Takeaways
Over the past week, CMS and CDC issued updated guidance related to COVID-19. On September 23, 2022, CMS updated the QSO memos 20-38-NH related to nursing home testing requirements and 20-39-NH related to nursing home visitation. Key changes/additions to the CMS...
Ask Proactive – The Medicare and Medicaid Services (CMS) updated the surveyor guidance found in Appendix PP of the State Operations Manual on June 29, 2022. Surveyors will use critical element (CE) pathways to aid in the investigation of many of the federal tags. When will the new guidance begin?
Q: The Medicare and Medicaid Services (CMS) updated the surveyor guidance found in Appendix PP of the State Operations Manual on June 29, 2022. Surveyors will use critical element (CE) pathways to aid in the investigation of many of the federal tags. When will the new...
F686 Pressure Ulcers—Where Facilities Go Wrong
In Appendix PP of the State Operations Manual, Tag F686 for Treatment/Services to Prevent/Heal Pressure Ulcers outlines the following requirements: 483.25(b)(1) Pressure ulcers. Based on the comprehensive assessment of a resident, the facility must ensure that—(i) A...
Percent of Residents Who Made Improvements in Function
Q: Percent of Residents Who Made Improvements in Function – My facility generally performs very well in this Quality Measure but we have recently seen fewer residents triggering and a decline in our percentage. Most of our short-term residents are discharging to the...
New Requirements Binding Arbitration Agreements
On July 18, 2019, CMS finalized new requirements related to binding arbitration agreements that went into effect on September 16, 2019. The requirements prohibit LTC facilities from requiring residents to sign binding arbitration agreements as a condition of admission...
Staff Development Checkup: F880 Infection Prevention and Control Training Essentials
Staff must be informed and competent in following proper infection control practices. Systems for educating team members and for ensuring that they understand and apply the information properly while performing their job duties is essential. In 2022, 4027 facilities...
MDS Completion: Death During Therapeutic Leave
Q: I have a resident who went home this past week to spend a few hours with family. While on her therapeutic leave she expired. Do I complete a Discharge Return Not Anticipated assessment or death in facility? A: A Death in Facility assessment would be completed. RAI...
Ask Proactive – Our therapy contract company recently notified us that their therapy staff will no longer be able to help cover nurse aide / CNA responsibilities. We don’t agree with this. The regulation did not change and there hasn’t been recent activity with waiver updates. Please help.
Q: Our therapy contract company recently notified us that their therapy staff will no longer be able to help cover nurse aide / CNA responsibilities. We don’t agree with this. The regulation did not change and there hasn’t been recent activity with waiver updates....
LTC Requirements of Participation Update: Admission, Transfer and Discharge Rights
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, as well as revisions to Phase 2 guidance. Surveyors will begin using this guidance to identify...