The latest news, events, blogs and more…
Clinical Meetings: Is Your Team Hitting the Mark?
With staff pressed on every side, ensuring clinical meetings are an effective use of time and resources is essential. Strong meeting processes can facilitate key objectives are met related to clinical quality, MDS assessment accuracy, risk management, and...
Ask Proactive – Under F761, what needs to be included on the label of multi-dose products that are pulled from the E-kit, brought from home or brought from the hospital?
Q: Under F761, what needs to be included on the label of multi-dose products that are pulled from the E-kit, brought from home or brought from the hospital? A: Multi-use products should be labeled with: The original manufacturer’s or pharmacy-applied label indicating...
PDPM Isolation and Supportive Documentation
Under the Patient Driven Payment Model (PDPM), resident characteristics are used to classify Medicare residents into payment groups. One of these characteristics is isolation due to an active infection. Being coded for infection isolation can have a significant impact...
Survey Ready! Staff Development & Competency Essentials
As states are working to catch up on annual recertification surveys across the nation, now is a good time to review and update your education calendar for the upcoming year. During annual surveys in 2022, surveyors will be paying additional attention to compliance...
Ask Proactive – I have a resident who was skilled under Part A services who was discharged but remained in the facility. They were subsequently picked up under Part A services again. Would the interrupted stay rules apply to this situation?
Q: I have a resident who was skilled under Part A services who was discharged but remained in the facility. They were subsequently picked up under Part A services again. Would the interrupted stay rules apply to this situation? A: Possibly, but timing matters. An...
Avoiding F656 Care Planning Deficiencies
F656 Develop/implement comprehensive care plans is the #5 most cited deficiency nationally. This week’s blog examines what you need to know about the regulatory requirements related to F656 and how to avoid issues commonly cited by surveyors. There are five standard...
Ask Proactive – Let’s say I have a resident fall with injury on January 1st. How many days have to pass before it will drop off and not count against us as far as our 5-star rating?
Q: Let's say I have a resident fall with injury on January 1st. How many days have to pass before it will drop off and not count against us as far as our 5-star rating? A: The fall with major injury will be included in the QM % for the quarter if it was coded on a MDS...
Ask Proactive – I conducted the pain interview with a resident recently and they stated that they have ‘almost constant’ pain and rated it as ‘moderate’. I reviewed the chart and the resident has PRN analgesic available, but never requests it, and the Q shift Pain monitoring on the MAR indicates no pain during the look back period. How should I address this on the MDS?
Q: I conducted the pain interview with a resident recently and they stated that they have ‘almost constant’ pain and rated it as ‘moderate’. I reviewed the chart and the resident has PRN analgesic available, but never requests it, and the Q shift Pain monitoring on...
Medicare Compliance: Avoiding Common Errors on SNF Certification/Recertification
According to the most recent Comprehensive Error Rate Testing (CERT) report released by the Centers for Medicare & Medicaid Services (CMS), $2.7 billion in improper payments were projected for Skilled Nursing Facility (SNF) services for 2021. Inadequate...
Ask Proactive – A Medicare patient was admitted to our SNF in the morning and went home AMA later that same afternoon. What MDS assessments need to be completed?
Q: A Medicare patient was admitted to our SNF in the morning and went home AMA later that same afternoon. What MDS assessments need to be completed? A: The Entry record and the unplanned discharge return not anticipated are required to be completed. In addition,...
Responding to an Allegation of Abuse
There are few things that can wake up a nursing home administrator faster than a phone call in the middle of the night from their facility reporting an allegation of abuse. Federal regulations require nursing facilities to promptly report any allegation of abuse,...
Avoiding the #4 Top Citation – F689 Free of Accident Hazards/Supervision/Devices
F689 is the fourth most cited deficiency in standard surveys and the first most cited in complaint surveys so far during the 2022 Fiscal Year according to CASPER data as of 4/17/22. F689 has been cited a total of 2,010 times during standard and complaint surveys 7%...
Ask Proactive – Can you please clarify if we can skill our patient returning to the facility following a 3 day qualifying stay at a psychiatric hospital? We have a new RAI Nurse who is hesitant to skill.
Q: Can you please clarify if we can skill our patient returning to the facility following a 3-day qualifying stay at a psychiatric hospital? We have a new RAI Nurse who is hesitant to skill. A: CMS speaks to skilled days following a psych stay in Chapter 8 of the...
Growing MDS Experts On Your Team
With staffing challenges and ongoing industry changes looming, it can be difficult to maintain a focus on MDS accuracy despite the considerable implications for care planning, QMs and reimbursement. Some facilities have needed to rely on their MDS Coordinator(s) to...
2022 5-Star Rating System Changes
Effective with the April 2022 Five-Star refresh, CMS is now implementing the planned, regular increases to the Quality Measure (QM) rating thresholds, that were originally announced to begin in 2019 but were delayed due to the public health emergency. With the April...