News / Blog
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Nutrition, Hydration and Weight Loss
Maintaining adequate nutritional/hydration status and prevention of weight loss in LTC residents can be challenging. According to AMDA data, 50-60% of LTC residents experience weight changes and 12% are chronically undernourished (based on BMI). Learn more about the...
Long Stay Quality Measures: System Strategies and Tips for Accuracy
Quality Measures (QMs), have set the standards for SNF/LTC QA focus. QM ratings objectively assess the quality of care a skilled nursing facility provides compared to peers and play a key role in the facility selection process for the resident, their family,...
Ask Proactive – What changes were made to the 5-Star Rating System in the October update to the 5-Star Technical Users’ Guide?
Q: What changes were made to the 5-Star Rating System in the October update to the 5-Star Technical Users’ Guide? A: The 5-Star Users’ Guide was updated on 10/27/2021 with minor revisions made to the Quality Measure Rating. The changes include: The "Rate of...
Ask Proactive – We’re in the process of updating our patient discharge survey. With anticipated new CMS quality measures based on the patient or family’s interpretation of the quality of care received, what questions do you recommend including?
Q: We’re in the process of updating our patient discharge survey. With anticipated new CMS quality measures based on the patient or family’s interpretation of the quality of care received, what questions do you recommend including? A: The SNF FY2022 Proposed...
COVID Litigation
As the COVID-19 pandemic swept through the nation in early 2020, one fact that became clear to us all was that the elderly population, especially those residing in nursing facilities, were disproportionately impacted. Around 140,000 residents and staff of nursing...
Ask Proactive – I know that the 48-hour Baseline Care plan must be completed within 48 hours, but what is required to be addressed in this care plan?
Q: I know that the 48-hour Baseline Care plan must be completed within 48 hours, but what is required to be addressed in this care plan? A: In Appendix PP of the State Operations Manual, F 655 Baseline Care Plan has the following requirements: “The facility...
Ensuring CMI Accuracy: Don’t Miss Out on These Easy Fixes
Are your processes achieving accurate CMI reimbursement for the care that your staff delivers? The case mix index is intended to reflect the type of residents being treated and the level of care required. Therefore, it is important to ensure that procedures are in...
Hospice & End of Life Services in Nursing Homes
Caring for patients nearing the end of life or in the advanced stage of a serious illness should address needs in the areas of physical comfort and practical life tasks, as well as spiritual and emotional needs. This blog overviews Hospice and Palliative Care services...
Ask Proactive – If a new admission was diagnosed and treated for a UTI prior to admission, but there is not sufficient documentation to determine that UTI criteria (McGeer’s) was met, do I code it in Section I?
Q: If a new admission was diagnosed and treated for a UTI prior to admission, but there is not sufficient documentation to determine that UTI criteria (McGeer's) was met, do I code it in Section I? A: In the case of UTI diagnosis within 30 days of the admission...
The Relationship Between the Standards of Care (SoC) and a Wrongful Death
Wrongful death claims pose a significant concern for healthcare facilities. In a 2019 review of claims, roughly half of fall-related claims involved a death and 62% of closed claims involved death related to pressure injury with total payments related to pressure...
Ask Proactive – Can you code restorative programs in section O that are completed while performing ADL care? For example, can you code AROM when a resident is lifting their arms & legs while bathing & dressing?
Q: Can you code restorative programs in section O that are completed while performing ADL care? For example, can you code AROM when a resident is lifting their arms & legs while bathing & dressing? A: No. For both active and passive range of motion, the...
Ask Proactive – Since there are no changes to the MDS Item Set for this FY, am I able to open/schedule October assessments now without worry?
Q: Since there are no changes to the MDS Item Set for this FY, am I able to open/schedule October assessments now without worry? A: While it is true that there are no CMS directed changes to the MDS Item Sets for FY 2022, it would still be prudent to validate...
Medical Review: Preparing for TPE Audits
The Centers for Medicare & Medicaid Services (CMS) indicated in an August 2021 MLNConnects newsletter that the targeted probe and educate (TPE) program would resume ending the temporary suspension since in place since March 2020 due to the COVID-19 public health...
Leading Through Chaos
“Calm seas never made a good sailor” Franklin D. Roosevelt was quoted as saying, and if that’s true, I expect the storms weathered by nursing home leaders over the past two years have seasoned many into veteran skippers. While we certainly would not have chosen this...
Ask Proactive – For the goals you do not set in Section GG, should you use a dash or an “09” Not Applicable? Won’t dashes affect the QRP?
Q: For the goals you do not set in Section GG, should you use a dash or an “09” Not Applicable? Won’t dashes affect the QRP? A: A dash may be used in column 2 of section GG for any goals that are not set, and not affect the QRP as long as at least one goal is...