In nursing facilities, one of the primary regulatory requirements from Appendix PP of the State Operations Manual is that goods and services are provided to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident (§483.24 Quality of Life). One intervention frequently used is Medicare Part …
At first glance, the methodology of the non-therapy ancillary (NTA) component of the Patient-Driven Payment Model (PDPM) seems simple: code qualifying items on the MDS to achieve points. Yet while the purpose of the NTA component is simple—to capture high expense medications and supplies—its calculation is more complex. Under PDPM, …
“No one even looks at the care area assessments (CAAs) once they’re done, so why spend so much time on them?” It’s a conundrum that nurse assessment coordinators (NAC) and interdisciplinary team (IDT) members often echo. However, it is also a misconception. Not only do surveyors review the CAAs—as evidenced …
Rejection of care can occur in many ways—Mr. Jones refuses to have his nails trimmed; Mrs. Abrahams clenches her mouth, refusing to take medications in the evening; or Mr. Martin discharges against medical advice. However, not all of these instances may be coded as rejection of care on the MDS. …
During their first days on the job, new nurse assessment coordinators (NACs) can expect paperwork and orientation videos as they are introduced to their role. But what should a new NAC expect by the end of the first week, first month, and beyond? Unfortunately, if the position was vacant for …
Jessie McGill, RN, RAC-MT, RAC-MTA Every spring, the Centers for Medicare & Medicaid Services (CMS) releases the notice of proposed rulemaking (NPRM) for the next fiscal year’s (FY’s) payment policies and rates. This provides an opportunity for stakeholders and providers to respond during the comment period. Each year, the American …
We have all struggled with a stubborn knot or tangle at some point in our lives—whether it’s your kids’ shoelaces, your earbud cord, a garden hose, or even a fishing line. If you are a nurse assessment coordinator (NAC), you can also add Quality Measures (QMs) to that list. But …
The Patient-Driven Payment Model (PDPM) uses 161 MDS items to establish the five case-mix adjusted components. Some of these 161 items will have supporting documentation easily found in the medical record, but other items may require some digging. From burrowing through hospital records and querying the physician to probing staff …
Chronic conditions and comorbidities are common among both long-term residents and short-term patients in skilled nursing facilities (SNFs). However, when the symptoms from these chronic conditions become part of the resident’s normal routine, they may be under-charted—which could result in inaccuracies in MDS assessments, care plans, Quality Measures, and reimbursement. …
One year. When asked how long it takes a new nurse assessment coordinator (NAC) to fully learn the job, I say at least one year. The nuances of the Resident Assessment Instrument (RAI) and Minimum Data Set (MDS) are substantial. The instructions for coding the MDS, the RAI User’s Manual, …
