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PDPM Coding Question – If MDS Section GG documentation information is not filled out, can we use section G documentation to code Section GG?
Q: If MDS Section GG documentation information is not filled out, can we use section G documentation to code Section GG? A: The difference between Section G & Section GG is more than one letter. Key variances include the steps for assessment,...
PDPM Coding Question – What procedure should we follow if a staff member refuses to participate in our facility’s mandatory routine COVID-19 testing?
Q: What procedure should we follow if a staff member refuses to participate in our facility’s mandatory routine COVID-19 testing? A: It is recommended that your facility policy and procedure regarding COVID-19 testing is consistent with your policies for other...
Common Citations During Infection Focused Surveys
Now that routine surveys are beginning to take place in most states, it is important that vigilant infection prevention and control practices do not take a backseat to other survey-ready quality assurance activities. Notably, In September 2020, HHS announced a $2.0...
PDPM Coding Question – Does the resident have to have a cannula in their tracheostomy to be able to code O0100E tracheostomy care?
Q: Does the resident have to have a cannula in their tracheostomy to be able to code O0100E tracheostomy care? A: No, they do not. According to page 0-9 pf the RAI manual, you can “code cleansing of the tracheostomy and/or cannula in this item”, so the presence...
Supporting Coronavirus (COVID-19) Positive Staff Members
As we know, Skilled Nursing Facilities (SNF’s) have a lot to manage during the current pandemic. Ensuring the staff and residents remain healthy has always been at the forefront in the fight against COVID-19. While there are efforts everyone needs to take to prevent...
Care Planning Considerations for COVID-19
A person-centered, comprehensive, and realistic plan of care is integral to ensuring an individual receives the best care possible. The insurgence of COVID-19 has complicated the care of those affected, either directly or indirectly in a myriad of ways. From common...
PDPM Coding Question – Should PRF payments offset expenses on the Medicare cost report?
Q: Should PRF payments offset expenses on the Medicare cost report? A: No, providers should not adjust the expenses on the Medicare cost report based on PRF payments received. However, providers must adhere to HRSA’s guidance regarding appropriate uses of PRF...
PDPM Coding Question – Are days when therapy completes an evaluation only supposed to be counted as therapy days on the MDS?
Q: Are days when therapy completes an evaluation only supposed to be counted as therapy days on the MDS? A: The day of evaluation should be counted in terms of determining the Therapy Start Date, but not counted as a “therapy day” if no direct treatment was...
Pressure Ulcers: How Does Your Facility Measure Up?
Improving performance in pressure ulcer/injury prevalence rates within your facility will result in many benefits including improved quality measures, star ratings, survey results, and patient outcomes. If your facility’s pressure ulcer rate is above industry...
CMS Issues Guidance on COVID-19 Testing of NF Staff & Residents
Yesterday, CMS released guidance related to Long-Term Care (LTC) facility COVID-19 testing requirements and a revised COVID-19 Focused Survey Tool. CMS has added a new regulation at 42 CFR § 483.80(h) which requires that the facility test all residents and staff for...
PDPM Coding Question – If a resident admits the skilled nursing facility with two pressure ulcers and the ulcers then merge, is it appropriate to continue to code the ulcer as “present on admission”?
Q: If a resident admits the skilled nursing facility with two pressure ulcers and the ulcers then merge, is it appropriate to continue to code the ulcer as “present on admission”? A: If two pressure ulcers merge, that were both present on admission, it would be...
PDPM Mistakes are Costing SNFs, Analysis Indicates
Skilled Nursing News (8/20, Spanko) reports that many SNFs are failing to accurately capture PDPM reimbursement while continuing to struggle with the costs and operational concerns surrounding the pandemic. Read the full article here. Schedule a PDPM coding audit with...
Enforcement Cases Held during the Prioritization Period and Revised Survey Prioritization
On 08/17/2020 CMS announced that they are revising guidance on the expansion of survey activities to authorize onsite revisits and other surveys, and guidance was provided to State Survey Agencies (SA) on resolving previously “on hold” enforcement cases. A temporary...
OSHA Compliant COVID-19 Reporting
Recently some facilities have been finding out the hard way that in addition to all of the other COVID-19 reporting requirements, certain employee COVID-19 cases must also be reported to OSHA. According to the Ohio Health Care Association (OHCA) presentation...
Coronavirus Disease 2019 (COVID-19) and Diabetes
The Centers for Disease Control recently held a call for providers to review the effects COVID-19 is having on those with multiple comorbidities. One of the most prevalent comorbidities in the long-term care setting is diabetes. While we still have much to learn about...