Writing MDS Supplemental Notes: How NACs Can Ace This Role

The COVID-19 pandemic is quite diminished but still a concern in some nursing homes due in part to SARS-CoV-2 variants, as well as unvaccinated staff. With the public health emergency worsening the already significant staffing shortage, simply relying on the documentation in the electronic medical record (EMR) may not be …

Discharge AMA Requires More Than ‘Good-bye and Good Luck’

“Against medical advice” (AMA) is a term that nursing homes use to describe a resident unexpectedly leaving the facility in a self- or representative-initiated discharge that is inconsistent with their identified care needs. “Some providers do an excellent job with discharges against medical advice. Others have the attitude, ‘The resident …

Care Area Assessments: Don’t Let CAAs Be the Missing Link in the RAI Process

The care area assessment (CAA) process sometimes mistakenly gets lumped under the “required but not critical to resident care” label of regulatory paperwork. While working the CAAs is indeed a mandatory step in the Resident Assessment Instrument (RAI) process for OBRA comprehensive MDS assessments, it’s also a crucial link between …

Loop in the Consultant Pharmacist to Lower Fall Risk

Falls are common in nursing homes—they are a driver of surveyor citations under F-tag 689 (Free of Accident Hazards/Supervision/Devices), which is consistently among the top three survey citations nationwide, according to the S&C QCOR online reporting system from the Centers for Medicare & Medicaid Services (CMS). “There has been an …

H0400 – H0600: Keys to Coding Bowel MDS Items

As a group, the bowel MDS items H0400 (Bowel Continence), H0500 (Bowel Toileting Program), and H0600 (Bowel Patterns) impact nursing homes on multiple levels, including the following: The Nursing Home Quality Initiative Quality Measures (NHQI QMs); The Skilled Nursing Facility Quality Reporting Program Quality Measures (SNF QRP QMs); The annual …

Staff Recruitment: How to Stand Out From the Crowd

While many nursing homes thankfully are no longer in crisis staffing mode, recruiting staff remains a top priority in a highly competitive job market. “Staff recruitment breaks down into meeting two overarching challenges,” says Julie Osborne, director of recruitment at Powell, OH-based LeaderStat. “First, how do you attract quality staff? …

Cognitive & Mood Assessment Four-Course Training Series for SNFs (5/21)

By CMS The Centers for Medicare & Medicaid Services (CMS) is offering web-based training that provides an overview of the general and key clinical considerations important for conducting standardized cognitive and mood assessments. This four-course series is designed for providers in the Skilled Nursing Facility (SNF) setting. The courses contained …

COVID-19: Community Champions Video for Vaccinating Long-term Care Staff

By CMS On May 5, 2021, as a part of CMS’ ongoing COVID response efforts to support the long term care community, CMS debuted its first social media videos highlighting staff, also referred to as Community Champions, who moved from being initially uncertain about receiving the COVID-19 vaccine to accepting …

Medicare Managed Care: Know Each Payer’s Rules and Be Ready to Appeal

Traditional fee-for-service Medicare Part A is a national program with a core set of program guidance from the Centers for Medicare & Medicaid Services (CMS) in the Internet-Only Manuals and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual. This guidance applies to every participating skilled nursing facility (SNF) …