Q&A: Can an LVN who is a certified treatment nurse stage a pressure injury?

Question: Can an LVN who is a certified treatment nurse stage a pressure injury? Answer from Denise Winzeler, BSN, RN, DNS-MT, QCP-MT: Many states do not allow LVNs to stage pressure injuries. I recommend you review your state’s nurse practice act or contact your state’s board of nursing to see if staging …

Q&A: Can I cover a resident under Medicare Part A who is receiving hospice care at the same time, or does the resident need to disenroll from hospice first?

Question: Can I cover a resident under Medicare Part A who is receiving hospice care at the same time, or does the resident need to disenroll from hospice first? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: The answer is maybe. Usually, Medicare coverage ends when hospice services begin—both …

Q&A: What is required if a resident passes away the day after the ARD for a Significant Change in Status Assessment (SCSA) due to hospice initiation?

Question: What is required if a resident passes away the day after the ARD for a Significant Change in Status Assessment (SCSA) due to hospice initiation? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO:You do not need to complete an SCSA for this situation as the resident …

Q&A: A resident on Medicare Part A admitted during the weekend. How much time do I have to open the 5-Day PPS assessment?

Question: A resident on Medicare Part A admitted during the weekend. How much time do I have to open the 5-Day PPS assessment? Answer from Jeff Taylor:The 5-Day PPS assessment must be opened before the end of the ARD window. This could be day 1-8 of the Medicare stay, but …

Q&A: Can I still register for the AAPACN 2023 Conference?

Question: Can I still register for the AAPACN 2023 Conference? Answer from AAPACN: Absolutely! Registration is open and available on the AAPACN conference webpage. This page also includes information regarding the schedule, preconference workshops, hotel and travel information, and more. Early-Bird registration ends March 26, 2023. Want to read more …

Q&A: How does the new CMS memo, QSO-23-05-NH, for the schizophrenia diagnosis apply to OBRA assessments for residents who have been in the facility long-term?

Question: How does the new CMS memo, QSO-23-05-NH, for the schizophrenia diagnosis apply to OBRA assessments for residents who have been in the facility long-term? Answer from Jeff Taylor: I would say that memo, the errata document, and related State Operations Manual (SOM), Appendix PP changes apply to all MDS …

Q&A: When a ​resident is admitted with a diagnosis of UTI from the hospital, and has physician documentation and a lab from the hospital in the medical record, do we code UTI at I2300 on the MDS?

Question: When a ​resident is admitted with a diagnosis of UTI from the hospital, and has physician documentation and a lab from the hospital in the medical record, do we code UTI at I2300 on the MDS? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Yes, you …

Q&A: If the dietitian documents a resident is at risk of malnutrition, can I code this diagnosis on the MDS at item I5600? 

Question: If the dietitian documents a resident is at risk of malnutrition, can I code this diagnosis on the MDS at item I5600?  Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: I would recommend caution when adding a diagnosis to the medical record. We cannot add a diagnosis based …

Q&A: Would padded upper bedrails that are raised for a resident who experiences seizures be coded as a restraint?

Question:Would padded upper bedrails that are raised for a resident who experiences seizures be coded as a restraint? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC:You must assess the effect the padded rails have on the resident’s freedom of movement or normal access to his or her body. If …

Q&A: Therapy is discharging a Medicare Part A resident, but he will continue to be skilled for daily nursing services. Do I need to complete any MDS assessments to reflect this change?

Question:Therapy is discharging a Medicare Part A resident, but he will continue to be skilled for daily nursing services. Do I need to complete any MDS assessments to reflect this change? Answer from Janine Cortesa, RN, BSN:Nothing needs to be done at this point. Continue using the PDPM score that was …