The Discharge Function Score is an incredibly complicated quality measure (QM), notes Joel VanEaton, BSN, RN, RAC-MT, RAC-CTA, RAC-CT, executive vice president of post-acute care regulatory affairs and education for Broad River Rehab in Asheville, NC. “Its technical specifications are as close to rocket science as we have ever seen …
The Centers for Medicare & Medicaid Services (CMS) implemented the Patient-Driven Payment Model (PDPM) in October 2019 for residents receiving Medicare Part A coverage in the skilled nursing facility (SNF). PDPM replaced the previous legacy payment model, the Resource Utilization Group (RUG-IV) system, still used by some state Medicaid agencies …
Nurses play a key role in the early identification and treatment of sepsis, assessing the resident and reporting to the physician or nonphysician practitioner (NPP), as well as potentially managing residents with sepsis in-house in some cases. Nurse leaders can take the following steps to help nursing staff effectively assess …
On Feb. 24, 2025, new and revised surveyor guidance, as well as revised critical element pathways, will go into effect during survey, according to the Nov. 18, 2024 Quality, Safety, and Oversight memo QSO-25-07-NH. These revisions to Appendix PP of the State Operations Manual and the survey tools are extensive …
For both residents and their loved ones, admission into a post-acute care facility can be an overwhelming experience. In addition to the condition that brought residents to the facility, the transition itself involves changing environment, acclimating to new routines, and entrusting one’s care to a team of unfamiliar people. Amid …
On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS version 1.20.1 item sets and item matrix for implementation on Oct. 1, 2025. The change history included with the item sets indicates planned changes to sections A (Identification Information), B (Hearing, Speech, and Vision), …
Monitoring and reducing the use of antipsychotic medications is a high priority for many nursing facilities. Top concerns are the increased risk of adverse effects for residents taking these medications, the scrutiny of their management by the Centers for Medicare & Medicaid Services (CMS), and the impact of their use …
Nurse assessment coordinators (NACs) who manage Medicare services typically are at least familiar enough with the beneficiary notice requirements that skilled nursing facilities (SNFs) must meet under fee-for-service (FFS) Medicare Part A to monitor those processes. “However, NACs may not always be as aware that facilities also have a responsibility …
Accurate diagnosis coding is critical in nursing facilities (NFs) for care planning, reimbursement, and quality measurement. NF coders must understand ICD-10-CM conventions, general coding guidelines, and chapter-specific coding guidelines that affect how diagnoses are assigned. Coding guidance can be found in the ICD-10-CM Official Guidelines for Coding and Reporting for FY …
Written by Kristine Martinez BSN, RN, RAC-CTA, QCP Completing a Minimum Data Set (MDS) correctly is no small task. With approximately 510 answers or choices on a comprehensive MDS (not including CAA investigation), and approximately530 answers or choices on a 5-day MDS, the potential for missed or miscoded information on any …
