PPS Discharge Assessment: Why Is It More Important Than Ever?

Nurse assessment coordinators (NACs) will soon begin preparing the interdisciplinary team for the finalized MDS 3.0 version 1.19.1 item set changes, as well as the revised coding instructions in the yet-to-be-finalized Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.19.1 (RAI User’s Manual), that will go into effect on …

A Closer Look at the Medicare Part A Presumption of Coverage

Skilled nursing facility (SNF) staff must understand the intricate guidelines that regulate Medicare Part A coverage for SNF stays. Several technical requirements must be met before a resident qualifies for a Medicare Part A SNF stay. For example, the resident must have benefit days available, meet the 3-day qualifying hospital …

Part A Basics: 30-Day Transfers and the Medical Appropriateness Exception

The 30-day transfer rule and its medical appropriateness exception typically don’t come up on a daily basis in skilled nursing facilities (SNFs), yet these requirements—and flexibilities—are a key component of the fee-for-service Medicare Part A rules for SNF coverage in chapter 8, “Coverage of Extended-Care (SNF) Services Under Hospital Insurance,” …

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 …

Beyond Physical Function: Psychosocial Needs of Residents Post-Stroke

Stroke is a common issue among residents in long-term care facilities. When caring for this population, staff often focus on physical issues, yet post-stroke residents often have emotional or behavioral changes as well. It is important for staff to understand how a stroke can affect residents’ psychosocial well-being. By recognizing …

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, …

Quality Measure IQ Series: Long-Stay Falls Measures

Someone with an intelligence quotient (IQ) of 130 may be considered above average for intelligence but still not understand the complexities of the MDS 3.0 Quality Measures (QMs). This series of articles on QMs will improve the QM IQs of healthcare professionals in long-term care, starting here with two long-stay …