Q&A: If a mechanically altered diet is being trialed during a speech therapy visit to facilitate oral intake, could K0510C, mechanically altered diet, be coded on the MDS?

Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC / Q&A

Question: We are seeking clarification on MDS item K0510C, mechanically altered diet. If a resident is being trialed on a mechanically altered diet or given thickened liquids provided during a speech therapy visit to facilitate oral intake, could K0510C, mechanically altered diet, be coded on the MDS if it was …

Q&A: What are the changes affecting SNFs in the updated blanket waiver that was recently released?

Billing and Reimbursement / COVID-19 / DNS / Q&A

The COVID-19 Emergency Blanket Waivers for Health Care Providers that was updated and released on Nov 29, 2021 adds a new waiver that allows more flexibility in the education and training requirements for individuals serving as Directors of Food and Nutrition Services. Want to read more Q&As? Visit the AAPACN …

Q&A: Has anyone encountered surveyors requesting consents for assist bars/enabler bars used for functional mobility not posing as a restraint per the interdisciplinary team assessment?

MDS 3.0 and the RAI Process / NAC / Q&A / Survey and Regulatory Compliance

Question: Has anyone encountered surveyors requesting consents for assist bars/enabler bars used for functional mobility not posing as a restraint per the interdisciplinary team assessment? Answer by Carol Maher, RN-BC, CPC, RAC-MT : A restraint assessment should be done when there are rails or “assist bars” on the bed. Depending …

Q&A: Is there a waiting period to continue therapy services when a resident transitions from Medicare Part A to Medicare Part B therapy services?

NAC / Q&A / Survey and Regulatory Compliance

Question: Is there a waiting period to continue therapy services when a resident transitions from Medicare Part A to Medicare Part B therapy services? Answer by Kim Steele RN, WCC, RAC-CT, RAC-CTA: There is no waiting period for this transition. However, therapy should complete an evaluation to transition from Medicare …

Q&A: Where can I find the CMS Quality Safety and Oversight (QSO) memos?

DNS / Q&A / QAPI and Quality Initiatives

Question: Where can I find the CMS Quality Safety and Oversight (QSO) memos? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT AAPACN Curriculum Development Specialist: QSO memos issued from CMS can be found on their webpage. Want to read more Q&As? Visit the AAPACN Connect community, where 15,000+ of …

Q&A: Is a Significant Change in Status Assessment required for a new stage 3 pressure ulcer?

Clinical Care Solutions / MDS 3.0 and the RAI Process / NAC / Q&A

Question: Is a Significant Change in Status Assessment required for a new stage 3 pressure ulcer? Answer from Janine Cortesa RN, BSN: A stage 3 pressure ulcer may signify the need for a Significant Change in Status Assessment (SCSA), but not necessarily. The RAI User’s Manual in chapter 2, states …

Q&A: When a Medicare Part A resident discharges to another SNF and will continue skilled Medicare there, what assessments are required and what is the date used in A2400C?

Billing and Reimbursement / NAC / Q&A

Question: I have a Medicare Part A resident discharging to another SNF and will continue skilled Medicare there. Would I combine the OBRA Discharge with a PPS Part A Discharge assessment?  In A2400, would I put the day she discharged as her Medicare Part A end of stay or would …

Q&A: Where can I find information on the new CMS COVID-19 vaccination requirements?

COVID-19 / DNS / Q&A / Survey and Regulatory Compliance

Question: Where can I find information on the new CMS COVID-19 vaccination requirements? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP: CMS has developed a FAQ document regarding the Interim Final Rule that answers a lot of questions regarding the 214-page document that was released on Nov. 4. CMS …

Q&A: A resident discharged to the hospital, return anticipated, but went to a sister facility from the hospital for a few days because we did not have a bed available. Now that he is returning, is a new OBRA Admission assessment required?

DNS / NAC / Q&A

Question: We have a resident who discharged to the hospital (completed an OBRA DC Return-Anticipated). When he was ready to be discharged from the hospital, we did not have a bed available, so he discharged to a sister facility for a few days. We now have a bed available, and …

Q&A: Where can I find resources to help our facility prevent and manage sepsis?

Clinical Care Solutions / DNS / Q&A

Question: Where can I find resources to help our facility prevent and manage sepsis? Answer: TMF, a Quality Improvement Organization, offers a free toolkit called the Sepsis Post-Acute Care Training Toolkit for Nursing Homes. This toolkit educates nursing home staff, residents, and families about the early identification of sepsis in …