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Keys to Managing Survey in Process
Navigating the intricacies of the survey process can seem difficult. However, with the right strategies, mindset, and preparedness plan your facility can emerge stronger and better equipped for success than ever before. In this week’s blog, we delve into the key...
Ask Proactive – When coding IV fluids “while not a resident” in section K of the MDS for a resident who does not have a dehydration diagnosis what documentation would support that the IVFs were administered for nutrition/hydration?
Q: When coding IV fluids “while not a resident” in section K of the MDS for a resident who does not have a dehydration diagnosis what documentation would support that the IVFs were administered for nutrition/hydration? A: The key to supporting the coding...
Ask Proactive – How does oral care impact the risk of death in a nursing home?
Q: How does oral care impact the risk of death in a nursing home? A: Aspiration pneumonia is a leading cause of death in nursing homes. Aspiration pneumonia occurs when a non-air substance (e.g. food, liquid, saliva) and bacteria from the mouth is...
DON Success: Delegation of Duties
As the acuity and complexity of long-term care residents has increased, the responsibilities of the Director of Nursing (DON) have also escalated significantly. The duties of the DON are not just clinical in nature, they also involve regulatory, reimbursement, and...
Ask Proactive – How long does CMS’ Abuse Icon remain on Care Compare?
Q: How long does CMS’ Abuse Icon remain on Care Compare? A: Criteria that identify a facility of non-compliance related to abuse, and placement of the Abuse Icon on Care Compare includes: Harm-level abuse citation in the most recent survey cycle:...
Retaining Top-Notch MDS Staff—Tips for Supporting Your MDS Team
In the ever-evolving landscape of healthcare, the retention of skilled and dedicated MDS (Minimum Data Set) staff is critical. MDS coordinators play a pivotal role in assessing patients' needs, maintaining compliance with regulations, and facilitating smooth...
Sharpening Pain Management Charting
Pain is a significant issue for many nursing home residents that can negatively impact quality of life when not appropriately managed. Unrelieved pain can lead to a decline in the resident’s function, cognitive, mood, behavior, and psychosocial status. An effective...
Ask Proactive – We have a resident who was admitted to the nursing home on 2/4/24 and scheduled their MDS admission assessment with an ARD (assessment reference date) for 2/11/24. They elected to enroll in a hospice program on 2/9/24. We know a significant change MDS assessment needs to be completed when a resident elects hospice. Do we need to schedule a significant change MDS assessment in addition to their admission MDS assessment?
Q: We have a resident who was admitted to the nursing home on 2/4/24 and scheduled their MDS admission assessment with an ARD (assessment reference date) for 2/11/24. They elected to enroll in a hospice program on 2/9/24. We know a significant change MDS assessment...
Upholding Standards: Investigating Abuse and Neglect in Nursing Homes
As leaders in the nursing home industry, ensuring the well-being and safety of residents is paramount. One of the most challenging aspects of this responsibility is investigating allegations of abuse and neglect within our facilities. In this article, we will explore...
Ask Proactive – We have a lot of residents on Scheduled Toileting. I’m worried we won’t get credit for them during our next CMI validation. What will I need to show our review nurse to receive credit?
Q: We have a lot of residents on Scheduled Toileting. I’m worried we won’t get credit for them during our next CMI validation. What will I need to show our review nurse to receive credit? A: The RAI Manual MDS item H0200C, 'Current Toileting Program'...
Ask Proactive – When is it appropriate to use staff interviews on the MDS?
Q: When is it appropriate to use staff interviews on the MDS? A: For the four interviews on the MDS (BIMS, PHQ2/9, Activities, and Pain), direct resident input should be the primary approach as observations may be misleading. For instance, the RAI manual...
Mastering Behavioral Health Documentation: Top 5 Tips for Skilled Nursing Facilities
Behavioral health issues in skilled nursing facilities (SNFs) require meticulous documentation to ensure proper care and compliance with regulations. Accurate documentation not only facilitates effective treatment but also helps in addressing legal and regulatory...
ICD-10-CM Common Errors and How to Avoid Them
PDPM coding and reimbursement success relies significantly on ICD-10 coding accuracy. In particular, the impact of ICD.10 coding on the clinical category, SLP, Nursing, and NTA comorbid diagnoses cannot be overstated; Medicare reimbursement for SNF services depends on...
Ask Proactive – As a new DON, what duties should I expect from the Medical Director?
Q: As a new DON, what duties should I expect from the Medical Director? A: The duties of the Medical Director are addressed in the CMS regulations as follows: F841 483.70(h) Medical director. 483.70(h)(1) The facility must designate a physician to serve...
The Impact of Accurate Depression Screening
The Minimum Data Set (MDS) plays a crucial role in influencing facility reimbursement, quality measures, and overall care quality. The accuracy of MDS coding is paramount, relying heavily on precise assessments and interviews. Accuracy in assessing and screening for...