The role of the nurse assessment coordinator (NAC) can often be an enigma to many nursing home staff. Misunderstandings about the position abound, and NACs may find it frustrating that no one knows what they do or its true impact. One of the most common misunderstandings about the NAC’s role …
Emergencies can occur at any moment. Fires, hurricanes, snowstorms, ice storms, water main breaks, power outages, and outbreaks are just a few of the emergencies nursing homes must prepare for throughout the year. However, in September 2023, the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) …
The continuing expansion of the Skilled Nursing Facility Value-Based Purchasing program (SNF VBP) quality measure (QM) set is part of a multi-pronged approach by the Centers for Medicare & Medicaid Services (CMS) to encourage improvements in the quality of care for nursing home residents. The SNF VBP focuses on financial …
In the Jan. 18, 2023, Quality, Safety, and Oversight (QSO) memo QSO-23-05-NH, the Centers for Medicare & Medicaid Services (CMS) announced plans to conduct offsite audits to assess whether nursing homes appropriately assess, document, and code diagnoses captured in MDS item I6000 (Schizophrenia (e.g., Schizoaffective and Schizophreniform Disorders)) that are …
The transition from section G to section GG on Oct. 1, 2023, also had a substantial impact on Quality Measures (QMs) and the Five-Star Quality Rating System. The Centers for Medicare & Medicaid Services (CMS) released a memo in September detailing the affected QMs and the impact on the Five-Star …
On Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) kicked off a critical step in expanding the Skilled Nursing Facility Value-Based Purchasing program (SNF VBP) quality measure (QM) set. This expansion means that the director of nursing services (DNS) will need to work with both staff and …
To meet residents’ individualized needs, the director of nursing services (DNS) requires the expertise of many healthcare professionals working collaboratively. For expertise on nutrition, the DNS should collaborate with the registered dietician (RD), who is an invaluable addition to the team for both the residents and the facility. This article …
The Significant Change in Status Assessment (SCSA) has been a federal requirement since the inception of the Resident Assessment Instrument (RAI) process that resulted from the Omnibus Budget Reconciliation Act of 1987. The specifications of how to complete this assessment are described in chapter 2 of the RAI User’s Manual …
Skilled nursing facilities (SNFs) are increasingly subject to skilled medical review audits from both fee-for-service Medicare (e.g., the SNF Five-Claim Probe and Educate initiative) and individual Medicare Advantage plans. Audit success ultimately hinges on documentation quality, but the presence of documentation in the medical record is no guarantee of the …
In May 2023—after the Comprehensive Error Rate Testing (CERT) program determined that skilled nursing facility (SNF) Medicare Part A services have been “a top driver” of the overall Medicare fee-for-service improper payment rate since the switch to the Patient-Driven Payment Model (PDPM) on Oct. 1, 2019—the Centers for Medicare & …
