Dementia Care: Keys to Implementing Technologies Effectively and Responsibly

Using technologies to engage residents with dementia is becoming increasingly common in nursing homes across the country. Local news shows are peppered with segments on facilities using dancing robots, robotic cats, and other technologies that are designed to improve the quality of life for these residents. However, providers must proceed …

Fall Prevention and Management: How the Consultant Pharmacist Can Add Value

F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the top immediate jeopardy (IJ) citation nationwide—and the second most-frequent citation overall—in calendar year (CY) 2023, and that citation pattern is being maintained so far in CY 2024, according to QCOR data accessed May 7, 2024. Falls are a frequent driver of F689 …

Draft RAI User’s Manual v1.19.1 Study Guide: Key Changes to Review

What the MDS will look like effective Oct. 1, 2024, is beginning to take shape for nurse assessment coordinators (NACs) and the rest of the interdisciplinary team (IDT). Following up on the May 17, 2024, posting of the final MDS item sets version 1.19.1, the Centers for Medicare & Medicaid …

Late or Missed PPS 5-Day Assessments: Know the Consequences and How to Avoid Them

Many new nurse assessment coordinators (NACs)—and even some experienced ones—don’t understand what counts as a late MDS assessment, what counts as a missed MDS assessment, or what the financial ramifications are for late vs. missed assessments in the Skilled Nursing Facility Prospective Payment System (SNF PPS), says Robin Hillier, CPA, …

PDPM Clinically Complex Nursing Qualifiers: Coding and Documentation Refresher

The Patient-Driven Payment Model (PDPM) includes four ways for a resident to classify into the Clinically Complex category of the Nursing payment component. If a resident has conditions or is receiving services that qualify for Extensive Services, Special Care High, or Special Care Low, but does not have a PDPM …

Physician Services: How to Level Up From F-Tag Compliance to Better Quality of Care

In calendar year 2023, F712 (Physician Visits – Frequency/Timeliness/Alternate Nonphysician Practitioners (NPPs)) was the most frequently cited F-tag among the six physician services citations—and only 0.8 percent of nursing homes received that citation, according to QCOR data released April 10, 2024. For immediate jeopardy citations, F710 (Resident’s Care Supervised by …

Seven Ways NACs Can Be Proactive With New Medicare Advantage Plan Rules

A skilled nursing facility (SNF) accepts a resident in a Medicare Advantage plan for admission after the plan provides a prior authorization. The resident receives skilled services for the allotted amount of time, and the nurse assessment coordinator (NAC) and the rest of the interdisciplinary team follow the plan’s rules. …

CMS Minimum Staffing Final Rule: Staffing Mandates Only Set the Baseline

The Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule adopts the Centers for Medicare & Medicaid Services’ (CMS) proposed three-pronged, comprehensive staffing approach for Medicare- and Medicaid-certified skilled nursing facilities (SNFs) and nursing facilities (NFs) as part of the federal requirements for …

How to Hire the Best NP—Even if Someone Else Is Doing the Hiring

The director of nursing services (DNS) in a nursing home often is presented with a newly hired nurse practitioner (NP) or other advanced practice registered nurse (APRN) as a fait accompli (i.e., a done deal), but no matter who is hiring the NP, the DNS should get involved and ask …

Working With NPs and Other APRNs: Learn to Maximize the Benefits

Increasingly, nurse practitioners (NPs) and clinical nurse specialists (CNSs), also known as advanced practice registered nurses (APRNs), work either directly for or closely with nursing homes to improve resident care outcomes—as do physician assistants (PAs). That growth may accelerate as providers transition to more value-based payment models amid the ongoing …