The latest news, events, blogs and more…
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...
Ask Proactive – We recently received a letter from our MAC informing us of findings on the Comparative Billing Report (CBR) of SNF Short-Stays for PT / PT and NTA services. Our facility triggered greater than the 90th percentile as compared to our state and jurisdiction related to claims with PT/OT Short-Stays (0-20 days LOS). Wondering if we need to complete a self-audit? Have you seen this? What should be our next steps?
Q: We recently received a letter from our MAC informing us of findings on the Comparative Billing Report (CBR) of SNF Short-Stays for PT / PT and NTA services. Our facility triggered greater than the 90th percentile as compared to our state and jurisdiction related to...
Ask Proactive – Unacceptable Primary Diagnoses
Q: Our Medicare Part A claim was rejected due to “principal diagnosis is an unacceptable diagnosis. Correct and resubmit/rekey”. The principal diagnosis coded on the Medicare claim and in section I0020B of the Medicare 5-day MDS is B95.62 (MRSA infection as the cause...
How will a Recession Impact Your Facility?
As most facilities continue to focus efforts on recovering from the impact of the pandemic, the potential of an economic recession threatens to present the next major provider challenge. With increasing inflation, climbing interest rates, stock market declines,...
Becoming a Dynamic DON
Fulfilling the Director of Nursing (DON) role in a skilled nursing facility is not an easy challenge. In addition to an extensive list of formal responsibilities and job duties, those who are truly successful in the role have tremendous grit, a sense of purpose, and a...
Ask Proactive – I’m a new DON at a skilled nursing facility and the team meeting procedures don’t appear to help the facility manage the resident or team’s needs. What items should I be sure we cover to make these meetings both efficient and effective for the team?
Q: I’m a new DON at a skilled nursing facility and the team meeting procedures don’t appear to help the facility manage the resident or team’s needs. What items should I be sure we cover to make these meetings both efficient and effective for the team?I A: Ensuring...
Ask Proactive – If someone uses a lift for transfers, how should I code G0300E, Surface-to-Surface Transfer (Transfer between bed and chair or wheelchair)?
Q: If someone uses a lift for transfers, how should I code G0300E, Surface-to-Surface Transfer (Transfer between bed and chair or wheelchair)? A: The RAI Manual states “If a lift device (a mechanical device that is completely operated by another person) is used, and...