When Psychosocial Harm Occurs: How to Mitigate Further Risks for Residents

Psychosocial harm is such a critical issue in nursing homes that resident psychosocial outcomes are equally important to physical outcomes when surveyors are determining a deficiency’s severity level. Surveyors assign the severity level of a citation by establishing the highest level of physical or psychosocial harm—or potential harm—to the resident. …

Decision Support Software: How to Get the Benefits and Limit the Risks

Accuracy, efficiency, consistency—these are all work process gains that nurse assessment coordinators (NACs) can reap from decision support software, such as MDS “scrubbers” and automated care plan interventions, and they can help lead to improved reimbursement and higher quality of care. “The benefits are clear for some assessment components,” says …

CMS Takes Opioid Use Beyond §483.25 (Quality of Care) in Appendix PP Guidance

On Oct. 3. 2022, the U.S. Department of Health and Human Services (HHS) renewed the nationwide opioid public health emergency (PHE), marking the launch of the PHE’s sixth year. Some nursing homes have been slow to prioritize the crisis from a resident care perspective because residents experiencing opioid overdoses and …

Discharge Planning: NACs Have a Key Role as an Information Broker

Effective discharge planning is critical to smooth transitions of care, which help guard against both hospital readmissions and adverse drug events, according to the Agency for Healthcare Research and Quality (AHRQ). The benefit for residents is so clear that the Centers for Medicare & Medicaid Services (CMS) gave discharge planning …

SNF QRP HCP Influenza Vaccine Reporting: 10 Things DNSs Need to Know

It just got a little more difficult for skilled nursing facilities (SNFs) to avoid a 2 percent reduction to their annual payment update (APU) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). For fiscal year (FY) 2023, SNFs had to meet or exceed two separate data submission thresholds: …

Bring Clinical Case Management Into the Medicare Huddle Process

Nurse assessment coordinators (NACs) and directors of nursing services (DNSs) should work together either to implement or to finetune an interdisciplinary Medicare Part A huddle process that coordinates payment and clinical issues for residents, suggests Robin Hillier, CPA, STNA, LNHA, RAC-MT, president of RLH Consulting in Westerville, OH. “A Medicare …

Partner Up! Working With the DNS to Create a Shared Vision Reaps Rewards

Nurse assessment coordinators (NACs) should take the time to build a shared vision and a shared approach with the director of nursing services (DNS), suggests Melanie Tribe-Scott, BSN, RN, RAC-MT, RAC-MTA, QCP, director of quality initiatives for Zimmet Healthcare Services Group in Manalapan, NJ. “There are a lot of benefits to having …

Opioids: Three Issues That Merit Stronger Collaboration With Consultant Pharmacists

The new surveyor guidance in Appendix PP of the State Operations Manual that went into effect on Oct. 24, 2022, takes a multi-pronged approach to opioids, starting with the critical risks associated with using opioids for pain management that could lead to addiction or overdose. The guidance also addresses the …

Proactive Steps for FYs 2023 – 2024 Center on Census and Quality

October 1 is always an important date because it marks the transition to a new fiscal year for the fee-for-service Medicare Part A skilled nursing facility prospective payment system (SNF PPS). However, the next two firsts of October will usher in a significant number of noteworthy updates, according to the …

Working With Medicare Advantage Plans: 10 Tips to Maximize Results

Medicare Advantage enrollment continues to grow, representing 48 percent of eligible Medicare beneficiaries in 2022, according to the Aug. 25, 2022, issue brief, Medicare Advantage in 2022: Enrollment Update and Key Trends, from the Kaiser Family Foundation (KFF). Note: KFF considers eligible beneficiaries to be those who have Part A …