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Top Tips to Improve Skilled Documentation
Quite often, we receive questions related to whether or not a patient can be “skilled.” Perhaps a resident has a new onset cardiac condition, is receiving wound care, or is not making progress in therapy and will be transitioning to a restorative nursing program. In...
Ask Proactive – Who is qualified to provide Restorative Aide training?
Q: Who is qualified to provide Restorative Aide training? A: Recommend that a therapist or nurse performs the training. It would be best practice to have the therapist provide the training or have the therapist train the nurse, and then the nurse trains the...
2022 Staff Development Planning
As we move into a new year, it’s a great time to review and update your 2022 education plan. According to QSO-22-02-ALL issued last month, during annual surveys in 2022, surveyors will be paying additional attention to compliance with the requirements for F-726...
Ask Proactive – What happens if a patient receives more than 25 percent of their therapy in a concurrent/group setting?
Q: What happens if a patient receives more than 25 percent of their therapy in a concurrent/group setting? A: The provider will receive a warning edit on the validation report that will inform them that they have exceeded the 25% limit. The edit will state:...
Survey Management: Drafting Effective Plans of Correction
42 CFR §488.401 defines a Plan of Correction (PoC) as a plan developed by the facility and approved by CMS or the survey agency that describes the actions the facility will take to correct deficiencies and specifies the date by which those deficiencies will be...
Standards of Care: Indwelling Catheter Use
Overview of F690 F690 indicates that an indwelling catheter should not be inserted unless clinically indicated and removal should occur as soon as possible. Providers and nursing staff should assess risks to avoid complications, such as CAUTI (Catheter Associated...
Ask Proactive – Our facility has had a couple claims come back with incorrect ICD 10 codes (i.e. Depression F32.9, cough r05 and low back pain m54.5). I notice that they have new digits added. Is there a resource to find new ICD-10 code changes?
Q: Our facility has had a couple claims come back with incorrect ICD 10 codes (i.e. Depression F32.9, cough r05 and low back pain m54.5). I notice that they have new digits added. Is there a resource to find new ICD-10 code changes? A: Each year, in October,...
Standards of Care: Incontinence
Urinary incontinence is a common symptom among residents of long-term care facilities but is frequently left untreated, resulting in a high incidence of falls among other problems. Incontinence is one of the leading reasons for placement of older adults into...
Ask Proactive – We have a current patient receiving rehabilitation following a stroke. Her family signed her out for their Thanksgiving holiday meal, but kept her out overnight and didn’t return until the following evening. Her family is already asking how long they can have her out for attending their Christmas celebrations. We’re questioning if she can remain skilled if her family is able to care for her outside our SNF.
Q: We have a current patient receiving rehabilitation following a stroke. Her family signed her out for their Thanksgiving holiday meal, but kept her out overnight and didn’t return until the following evening. Her family is already asking how long they can have her...
Ask Proactive – How does a death impact the MDS assessment schedule? We had a resident that was here under Medicare A and the ARD for the PPS 5-day and Admission assessment was scheduled for the 8th day of the stay. She, unfortunately, passed away on the ARD. Do I still need to complete the 5-day/Admission?
Q: How does a death impact the MDS assessment schedule? We had a resident that was here under Medicare A and the ARD for the PPS 5-day and Admission assessment was scheduled for the 8th day of the stay. She, unfortunately, passed away on the ARD. Do I still need to...
Regulatory Update: COVID-19 Survey Activities & Increased Oversight in Nursing Homes
On Nov. 12, 2021, CMS issued a memo regarding changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes. Key changes to the survey process announced in this memo include: CMS is rescinding the requirement to conduct focused infection control (FIC)...
Vaccine Mandate Policy Consideration Checklist
As your team prepares to comply with the vaccine mandate in response to CMS’ Interim Final Rule, consider this checklist to assess whether your vaccination policy addresses all requirements. Access the checklist… COVID-19 Vaccine Mandate Policy Checklist Does...
OIG Updates the Health Care Fraud Self-Disclosure Protocol
The Department of Health and Human Services Office of Inspector General released an update to the Health Care Fraud Self-Disclosure Protocol (SDP). The SDP can be used by health care providers, suppliers, or other individuals or entities subject to Civil Monetary...
Ask Proactive – What services can be included as respiratory therapy on the MDS in Section O?
Q: What services can be included as respiratory therapy on the MDS in Section O? A: The RAI manual defines Respiratory therapy (on page A-19 of Appendix A) as the following: Services that are provided by a qualified professional (defined as respiratory...
Ask Proactive – How should the SNF count total volume, mode, and type of therapy in section O of the MDS for purposes of the discharge assessment when a patient’s stay included one or more interrupted stays?
Q: How should the SNF count total volume, mode, and type of therapy in section O of the MDS for purposes of the discharge assessment when a patient’s stay included one or more interrupted stays? A: SNFs should report the therapies furnished since the beginning...