Q&A: Would you code a positive nasal swab for MRSA as a multidrug-resistant organism (MDRO) in section I?

Question: Would you code a positive nasal swab for MRSA as a multidrug-resistant organism (MDRO) in section I? Answer from Heide Keen, RN, BSN, RAC-CT: Most often, we find that MRSA of nares is colonized and not considered actively infectious, and not being medically treated. It all depends on the …

Q&A: Is there specific guidance regarding staff working in multiple facilities?

Question: Is there specific guidance regarding staff working in multiple facilities? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP: Currently, there are no federal guidelines specific to staff who work in multiple facilities. However, facility leaders should check with their state and local entities as well to see if …

Q&A: How do you determine “while a resident” or “while not a resident” when a resident goes out to the hospital and returns?

Question: How do you determine “while a resident” or “while not a resident” when a resident goes out to the hospital and returns? Answer from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The line between “while not a resident” and “while a resident” is basically the Entry Date …

Q&A: Can a resident disenroll in a Medicare Advantage (MA) plan and revert back to Original Medicare when the 3-day qualifying hospital stay was waived for the MA plan?

Question: A resident admitted for skilled care under a Medicare Advantage (MA) plan. The plan did not require a 3-day qualifying hospital stay (QHS) and the resident was hospitalized for observation only. The resident has elected to disenroll in the MA plan and revert back to Original Medicare. Is this …

Q&A: What will happen to the online AADNS communities, discussion groups, and libraries?

Question: What will happen to the online AADNS communities, discussion groups, and libraries? Answer from AAPACN: The AADNS Network has become a new member community named the Management/Leadership General Discussion community on AAPACN.org. The discussion groups and libraries are there, too! This means that you are still be able to …

Q&A: Will I still be able to access AADNS courses that I am currently taking on the new AAPACN website?

Question: Will I still be able to access AADNS courses that I am currently taking on the new AAPACN website? Answer from AAPACN: Yes. You still have access to any courses that have not expired and will be able to complete the exams. You are still able to access any …

Q&A: Is overseeing the Therapy department within the scope of the DNS position?

Question: I am a relatively new DNS and my job description includes overseeing the Therapy Department. Is this within my scope? Answer: In most SNFs, the therapy department usually has its own director/manager, with ultimate oversight by the administrator. But in smaller facilities, such as yours, sometimes those oversight roles are shared. …

Q&A: Does anyone have an ‘International Dysphagia Diet Standardization Initiative’ policy?

Question: Does anyone have an ‘International Dysphagia Diet Standardization Initiative’ policy? Answer: The IDDSI framework has many resources and guidance on how to implement the framework. https://iddsi.org/framework/  Consider convening a meeting with the dietitian, ST, dietary manager, and the rep from your food service company to discuss use and implementation. …

Q&A: How do I code the primary diagnosis on the UB-04 for a Medicare Part A resident?

Question: When I received training for ICD-10 coding as it relates to billing, I was taught that the primary diagnosis code for long term SNF residents on a UB-04 claim would be their primary diagnosis for why they remain in the nursing facility. Therefore, if the primary diagnosis code was …

Q&A: Are we responsible for dental appointments (toothache) on our Medicare Part A residents or does the dentist bill the family?

Question: Are we responsible for dental appointments (toothache) on our Medicare Part A residents or does the dentist bill the family? Answer: Dental coverage is not part of the Medicare Part A program, so the cost is also not the facility’s responsibility. In other words, there is no dental money …