FY 2025 SNF PPS Proposed Rule: CMS Seeks More Enforcement Power With CMPs

A survey finding of noncompliance with the Medicare and Medicaid requirements of participation may soon be a little more difficult for nursing homes to navigate without significant financial burden. In the March 28, 2024 Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, the Centers …

FY 2025 SNF PPS Proposed Rule: Four Key Proposals for NACs to Keep an Eye on

In the March 28, 2024 Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) doesn’t propose the dizzying number of changes that ended up in the FY 2024 SNF PPS final rule. However, nurse assessment coordinators (NACs) …

Isolation Coding on the MDS: MAC Target Drives Home Documentation Needs

Almost all nursing homes are currently staffing-challenged, and that has a direct impact on the quality of the documentation available to support MDS coding, points out Brenda Sowash, RN, RAC-CT, director of clinical assessments, standards, and practices for Trinity Health Senior Communities in Livonia, MI. “Nursing staff have to prioritize …

4 Key Purposes of the Care Area Assessment Process

The care area assessments (CAAs) are a vital part of the Resident Assessment Instrument (RAI) process to develop a plan for individualized resident care. Taking shortcuts with the CAA process can result in generic care plans that fail to recognize the unique needs, choices, and preferences of each resident. Understanding …

Why NACs Need to Actively Manage Physician Certs/Recerts—and What to Look for

The nurse assessment coordinator (NAC) who also serves as the primary Medicare nurse doesn’t always complete either the physician certification/recertification process or the beneficiary notification process for Medicare residents, says Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC, director of clinical reimbursement for LeaderStat in Powell, OH. Heichel will …

Process Surveillance Plus QAPI Equals Better Infection Prevention Training

Nursing homes are required to establish a surveillance system (i.e., “the routine, ongoing, and systematic collection, analysis, interpretation, and dissemination of surveillance data”) as part of their infection prevention and control program (IPCP) under F-tag 880 (Infection Prevention and Control) in Appendix PP of the State Operations Manual. This surveillance …

Common Missteps in Addressing Plan of Correction Criteria and Best Practices for Compliance Sustainability

According to the Nursing Homes webpage of the Centers for Medicare & Medicaid Services (CMS) site, “Skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to receive payment under the Medicare or Medicaid programs. To …

Learn How to Take Staff Survey Preparation From Reactive to Proactive

“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 …

Interrupted Stays: Five Takeaways To Remember

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 …