The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF), which opened its online doors in December 2022 thanks to a three-year grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), is a centralized hub where any Medicare- or Medicaid-certified nursing home can access trainings, tools, and …
Restorative nursing programs are effective interventions to maintain or improve a resident’s independence in tasks of daily living. According to the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, on page O-42, “Restorative nursing program refers to nursing interventions that promote the resident’s ability to adapt and adjust …
Question: If an interim payment assessment (IPA) is determined to have a new primary diagnosis, does therapy need to re-evaluate the resident or can they continue treatment based on the 5-Day diagnosis? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: Therapy evaluations are not required every time the …
The RAI User’s Manual states that “A previous fall, especially a recent fall, recurrent falls, and falls with significant injury are the most important predictors of risk for future falls and injurious falls” (CMS, 2019, p. J-27). However, there are many more items that must be considered when assessing a …
The purpose of this Change Request (CR) is to update the annual per beneficiary incurred expenses amounts now called the KX modifier thresholds and related policy for calendar year 2023. These amounts were previously associated with the financial limitation amounts that were more commonly referred to as “therapy caps,” before …
By Liz Barlow, RN, CRRN, RAC-CT, DNS-CT, AVP Clinical Innovation, Synchrony Rehab At the end of August, the Centers for Medicare & Medicaid Services (CMS) held a National Provider Stakeholder call to review some of the recent COVID updates. CMS commented that data collected, along with nursing home surveys, are …
In nursing facilities, one of the primary regulatory requirements from Appendix PP of the State Operations Manual is that goods and services are provided to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident (§483.24 Quality of Life). One intervention frequently used is Medicare Part …
In the COVID-19 pandemic, some states now are seeing a decrease in cases, while others have continued growth, especially in rural and suburban areas. Much of the COVID-19 response is becoming localized to meet these varying caseloads, but one consistent factor nationwide for nursing homes is the continuing need for …
