FY 2022 SNF PPS Proposed Rule Comments: AAPACN Highlights Impact of COVID-19 on SNFs

Jessie McGill, RN, RAC-MT, RAC-MTA Every spring, the Centers for Medicare & Medicaid Services (CMS) releases the notice of proposed rulemaking (NPRM) for the next fiscal year’s (FY’s) payment policies and rates. This provides an opportunity for stakeholders and providers to respond during the comment period. Each year, the American …

Writing MDS Supplemental Notes: How NACs Can Ace This Role

The COVID-19 pandemic is quite diminished but still a concern in some nursing homes due in part to SARS-CoV-2 variants, as well as unvaccinated staff. With the public health emergency worsening the already significant staffing shortage, simply relying on the documentation in the electronic medical record (EMR) may not be …

The Nurse Leader’s Clinical Toolbox: Urinary Incontinence

Urinary incontinence (UI), defined as any involuntary leakage of urine, affects over half the population living in post-acute long-term care (PALTC) and costs an estimated 5.5 billion annually, according to the Society for Post-Acute and Long-Term Care Physicians. Moreover, nurses care for residents who express embarrassment in losing control of …

Discharge AMA Requires More Than ‘Good-bye and Good Luck’

“Against medical advice” (AMA) is a term that nursing homes use to describe a resident unexpectedly leaving the facility in a self- or representative-initiated discharge that is inconsistent with their identified care needs. “Some providers do an excellent job with discharges against medical advice. Others have the attitude, ‘The resident …

Avoid These 5 Common Mistakes NACs Make Coding I0020B

by Carol Maher, RN-BC, RAC-MTA, RAC-MT, CPC ICD-10-CM coding is not a skill nursing school conveys to students, yet it is one that nurse assessment coordinators (NACs) must acquire to perform their diagnosis coding duties competently. Medicare’s transition to the Patient-Driven Payment Model (PDPM) on October 1, 2019, elevated the …

Care Area Assessments: Don’t Let CAAs Be the Missing Link in the RAI Process

The care area assessment (CAA) process sometimes mistakenly gets lumped under the “required but not critical to resident care” label of regulatory paperwork. While working the CAAs is indeed a mandatory step in the Resident Assessment Instrument (RAI) process for OBRA comprehensive MDS assessments, it’s also a crucial link between …

How to Leverage Positive Peer Pressure to Improve Hand Hygiene

Hand hygiene has always been a primary focus of infection prevention, but due to the COVID-19 pandemic, it is under intense scrutiny. Even though the skill of hand hygiene is straightforward and easy to learn, consistent compliance has been difficult to achieve in healthcare settings, including post-acute long-term care (PALTC). …

Loop in the Consultant Pharmacist to Lower Fall Risk

Falls are common in nursing homes—they are a driver of surveyor citations under F-tag 689 (Free of Accident Hazards/Supervision/Devices), which is consistently among the top three survey citations nationwide, according to the S&C QCOR online reporting system from the Centers for Medicare & Medicaid Services (CMS). “There has been an …

5 Key Strategies for Reengagement in PDPM

By Liz Barlow, RN, CRRN, RAC-CT, DNS-CT With the onset of the COVID-19 public health emergency (PHE), skilled nursing facilities (SNFs) have been focused on infection control, staffing, and heightened patient care. But as facilities settle into their new normal, they need to think about reengaging in Patient-Driven Payment Model …