News / Blog
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Q & A – Can we query the MD AFTER the MDS assessment is completed for documentation of an active diagnosis, or does it have to be prior to the ARD?
Q: Can we query the MD AFTER the MDS assessment is completed for documentation of an active diagnosis, or does it have to be prior to the ARD? A: Unfortunately, the documentation needs to be present during the appropriate assessment reference period (which ends...
Safe Strategies for Visitation
Nursing facilities are moving toward safe reopening while adhering to guidance described in the CMS reopening recommendations, CDC guidance and state and local directives. While recognizing the potential psychosocial effects of resident separation from family and...
Returning to Work After Suspected or Confirmed COVID-19
Healthcare personnel (HCP) who are suspected or confirmed to have COVID-19 should meet the Centers for Disease Control and Prevention (CDC) Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance)[i]. Decisions about...
Current State of the 5-Star Rating System
As of mid-June, the only announcement that CMS has made regarding the 5-Star Rating system is that the Health Inspection rating is being held constant to include only data from surveys that occurred on or before March 3, 2020. Health inspections conducted after March...
Q & A – Can I code TIA if a resident is receiving Eliquis routinely to prevent further TIAs
Q: Can I code TIA if a resident is receiving Eliquis routinely to prevent further TIAs A: In order for TIA to be considered an active diagnosis, the physician would need to specifically document that the diagnosis is active (and not by listing TIA on the...
Q & A – Would C-diff be a qualifying diagnosis when coding Multi-Drug Resistant Organism (MDRO) in I1700?
Q: Would C-diff be a qualifying diagnosis when coding Multi-Drug Resistant Organism (MDRO) in I1700? A: According to the Centers for Disease Control, C-diff is not considered a MDRO. Common MDRO’s include, Methicillin/oxacillin-resistant Staphylococcus aureus...
Enhanced Enforcement for Infection Control Deficiencies
Infection Control requirements are nothing new, but the Centers for Medicare and Medicaid Services (CMS) is ramping up efforts to identify and assist providers who may be performing poorly in infection control practices. Providers struggling to comply with...
Q & A – Will there be an updated RAI manual that will accompany these changes? If so, when will it be available?
Q: Will there be an updated RAI manual that will accompany these changes? If so, when will it be available? A: CMS will post coding instructions, but a complete RAI manual will not be occurring at this point. Excerpted from CMS MDS 3.0 Vendor Call on...
Q & A – Where should the OBRA PDPM HIPPS be calculated (historically this has been Z0200, however Issue ID #12 seems to call for Z0100)?
Q: Where should the OBRA PDPM HIPPS be calculated (historically this has been Z0200, however Issue ID #12 seems to call for Z0100)? A: It will be placed in Z0100 for states that have indicated they want PDPM calculations for OBRAs. We are not using Z0200...
Q & A – When can we expect the state PDPM OBRA CD to be released?
Q: When can we expect the state PDPM OBRA CD to be released? A: That item should be on ALL assessments with target date of 10/01/2020 or later. Excerpted from CMS MDS 3.0 Vendor Call on June 11, 2020.
Q & A – Will a set of updated item sets be released along-side this Errata or will the existing v3.00.3 items sets remain the official item sets?
Q: Will a set of updated item sets be released along-side this Errata or will the existing v3.00.3 items sets remain the official item sets? A: In response to State Medicaid Agency and stakeholder requests, CMS has updated the MDS 3.0 item sets (version 1.17.2)...
Virtual Activity Resources for Resident Engagement
Across the nation, nursing homes have accessed new and creative ways of facilitating social interaction with their residents while minimizing the spread of COVID-19. As staff and residents began to settle into the ‘new normal,’ facilities were adjusting to rapidly...
Back to Basics: Environmental Services Infection Control Best Practices to Avoid F880 Citation
Preventing and mitigating the spread of COVID-19 in long-term care centers is a top priority considering CMS’ enhanced enforcement effective June 1, 2020 for infection control deficiencies. CMS has cited F880 at immediate jeopardy level relating to examples such as:...
Medicaid Case Mix Index (CMI): Common Errors & Opportunities
Case mix index (CMI) is the metric by which the relative cost of treating residents covered by Medicaid is measured. It also sheds light on the type of residents being treated and the burden of care required. Because the primary payer source for most facilities is...
Q & A – When interviewing the resident using the questions in the PHQ-9, what do you do when they answer them all as “no”, but in the charting and documentation, you see they had episodes of crying or tearfulness, pain, insomnia, etc.? Is this information to be incorporated into the PHQ-9 or must we code using only the resident’s actual responses?
Q: When interviewing the resident using the questions in the PHQ-9, what do you do when they answer them all as “no”, but in the charting and documentation, you see they had episodes of crying or tearfulness, pain, insomnia, etc.? Is this information to be...