“Why in the world did my staff member say this?” and “Why did my staff do that?” are two questions that no director of nursing services (DNS) wants to have when reading the Statement of Deficiencies and Plan of Correction (form CMS-2567) handed out by the state survey team at …
The interrupted-stay policy in the Patient-Driven Payment Model (PDPM) of the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) governs when multiple SNF stays are combined into a single interrupted stay (i.e., one continued stay that includes one or more interruption windows) vs. when they are treated …
Pressure-related deep tissue injury (DTI) coded in M0300G (Unstageable Pressure Injuries Related to Deep Tissue Injury) does not play a role in Medicare payment under the Patient-Driven Payment Model (PDPM). While DTI is an unstageable pressure ulcer/injury, only ulcers that are unstageable due to slough and/or eschar (MDS item M0300F1) …
Under F-tag 726 (Competent Nursing Staff) in Appendix PP of the State Operations Manual, nursing staff, including registered nurses (RNs), licensed practical or vocational nurses (LPNs/LVNs), and certified nursing assistants (CNAs), must have “the competencies and skill sets necessary to provide nursing and related services to meet the residents’ needs …
With the influenza season in full swing plus the ongoing peaks and valleys of COVID-19 and respiratory syncytial virus (RSV) outbreaks across the United States, nurse assessment coordinators (NACs) should take steps both to protect the MDS process and to capture relevant clinical events on MDS assessments when a respiratory …
Like in-house hospital readmissions, post-discharge hospital readmissions can affect provider performance in the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), says Carol Hill, MSN, RN, LNHA, RAC-MT, RAC-MTA, DNS-MT, QCP-MT, CPC, president of Hill Educational Services in Warrior, AL. “With the Skilled Nursing Facility 30 Day All-Cause Readmission Measure …
The expedited determination beneficiary notification process covers a lot of ground in skilled nursing facilities (SNFs), affecting residents in the fee-for-service (FFS) Medicare Part A program and Medicare Advantage plans, as well as residents who receive Part B rehabilitation therapies under consolidated billing, says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, …
A top-down or autocratic management style is becoming increasingly outdated for dealing with today’s healthcare workforce in non-emergent situations. Other leadership styles, such as transformational leadership, often work better to help staff feel valued, supported, and satisfied in their job—and to give them the sense of ownership in creating positive …
Effective communication is the glue holding the MDS process together, says Stacy Grondel, BSN, RN, RAC-MT, CMAC, QCP. director of reimbursement operations at QRM in Addison, TX. “The nurse assessment coordinator (NAC) who is a strong communicator can develop better working relationships with the interdisciplinary team and executive leadership—and establish …
The average cost of a hospital readmission is 12.4 percent higher than the average cost of the original hospital admission ($16,300 vs. $14,500), according to a 2023 analysis by the Agency for Healthcare Research and Quality (AHRQ). At the same time, hospital readmissions from skilled nursing facilities (SNFs) remain relatively …
