Educational Planning Starts—but Doesn’t Stop—With the Facility Assessment

Using the facility assessment to create an educational planning table seems pretty simple, but effective educational planning requires a more comprehensive, ongoing approach that addresses both competencies and global training needs identified from multiple sources. Keys to creating a solid educational planning process that begins but doesn’t end with the …

AAPACN Responds to CMS’s Comment Request for FY 2023 SNF PPS Proposed Rule

Jessie McGill, RN, RAC-MT, RAC-MTA and Alexis Roam, MSN, RN-BC, DNS-CT, QCP The annual rulemaking process enables stakeholders to comment on proposals that will affect skilled nursing facilities (SNFs) throughout the next year. In early April, the Centers for Medicare & Medicaid Services (CMS) issued its fiscal year (FY) 2023 …

Baseline Care Plan: Connecting the Dots to the Comprehensive

Unlike the baseline care plan, the comprehensive care plan is largely MDS-based and analysis-driven, points out Mary Madison, RN, RAC-CT, CDP, a long-term care and senior living clinical consultant for Briggs Healthcare in Clive, IA. “It goes beyond the minimal requirements for the baseline. As a result of these differences, some …

Work-Life Balance for the Director of Nursing Services

The vital role of director of nursing services (DNS) in skilled nursing facilities (SNFs) comes with so many demands. DNSs are often—or always—on call for questions regarding changes in resident conditions; they often fill in for staff who called off; and they put out fires when emergencies arise. Just when …

Communicating Comfort: Help the IDT Help the Residents and Themselves

The clinical skills that nursing home staff need to care for residents are just one piece of the care puzzle, says Joan Devine, RN, LNHA, the Weldon Springs, MO-based director of education for the Pioneer Network. “You don’t want staff to go in with a singular focus on tasks when …

Part A Physician Certs/Recerts: Don’t Strike Out on This Condition of Payment

Physician certifications and recertifications are a technical requirement of payment (i.e., a condition of payment) under fee-for-service Medicare Part A. These certifications are needed to verify that a resident requires daily skilled care in a skilled nursing facility (SNF) for an ongoing condition for which they received inpatient hospital services …

Coding Diagnoses in MDS Section I: The Art of the Physician Query

The coding instructions for MDS section I (Active Diagnoses) in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual require that every diagnosis coded in this section be documented by a physician or a physician extender (i.e., a nurse practitioner, physician assistant, or clinical nurse specialist when allowed under …

Becoming a Fiscally Savvy DNS – Part 2: Budget, Revenue, and Five-Star Ratings

When one considers financial management, thoughts usually go to managing expenses first, which part one of this series discussed. However, managing revenue, Five-Star ratings, and the budgeting process are equally important to keeping the nursing department and the facility as a whole financially sound. The second part of this article series will …

Preventing Unnecessary ED Visits: Steps That Can Reassure Residents and Families

Residents or their family members sometimes demand to be sent to the emergency department (ED) for an issue that the nursing home can handle in-house. Unnecessary ED trips can disrupt the continuity of care, be traumatic for the residents, and potentially lead to hospital inpatient admissions that could have been …