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PDPM Insights: Are You Leaving Money on the Table?
To ensure accurate coding of all PDPM clinical conditions and comorbidities, it is essential to review the medical record prior to the 5-day MDS ARD. This chart review process is important to identify the need for gaps which may require additional supporting...
Essentials of the 12/28/21 CMS Vaccine Mandate Enforcement Memo
On Dec. 28, CMS released QSO-22-07-ALL Guidance for the Interim Final Rule that was released on Nov. 5, 2021 that established requirements regarding COVID-19 vaccine immunization of staff. The guidance and survey procedures included in this memo currently does not...
Updated CDC Guidance: Managing Staff with COVID-19 Infection or Exposure
On Dec. 23, the CDC released updated Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 and Strategies to Mitigate Healthcare Personnel Staffing Shortages. Key points included in the revised guidance include: In...
Ask Proactive – What do I do if a resident is admitted Med A and then has an unplanned discharge or death in facility prior to the 5 Day MDS being opened/created?
Q: What do I do if a resident is admitted Med A and then has an unplanned discharge or death in facility prior to the 5 Day MDS being opened/created? A: This would be considered a Missed PPS Assessment. The facility would be liable and would not be able to...
Day in the Life of the Effective Infection Preventionst
With COVID Cases on the rise again, and now 3 different COVID variants identified, COVID prevention and management is a primary focus of the Infection Preventionist (IP). However, COVID is only one of many infection related issues challenging our IP professionals...
Ask Proactive – I’m confused about the Interrupted Stay. If a Medicare A resident discharges home and then returns to the SNF two days later due to inability to care for themselves at home, is this an interrupted stay? The discharge was planned and their return was not anticipated.
Q: I’m confused about the Interrupted Stay. If a Medicare A resident discharges home and then returns to the SNF two days later due to inability to care for themselves at home, is this an interrupted stay? The discharge was planned and their return was not...
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...