Substance Use Disorders: What the DNS Should Know

Over 1 million people aged 65 and over live with substance use disorders (SUD) (Alliance for Aging Research, 2022). As with most trends, what is prevalent in the community will also be prevalent in nursing homes. Therefore, the director of nursing services (DNS) should understand the nuances of this disorder …

Preferences and Routines: Use Section F to Collaborate on the Care Plan

The Resident Assessment Instrument (RAI) process begins with the Minimum Data Set (MDS) assessment and ends with the resident-centered comprehensive care plan. In the MDS, section F focuses on the resident’s preferences for customary routines and activities, asking scripted questions about how the person rates the importance of these items. …

Skilled Observation and Assessment Hinges on a Reasonable Probability of Complication

Direct skilled services under Medicare Part A often are easy to identify because these services involve specific, complex caregiver-to-resident actions. Their “inherent complexity” means that they can “be performed safely and/or effectively only by or under the general supervision of skilled nursing or skilled rehabilitation personnel,” explains the Centers for …

Template for Care Area Assessment Summary Note

AAPACN’s Template for Care Area Assessment (CAA) Summary Note can help guide the interdisciplinary team members through how to determine and document rationale for the care plan determination by summarizing the underlying causes, contributing factors, risk factors, and other relevant considerations related to the assessment. This AAPACN resource is copyright …

CMS Patient Mood Interview (Patient Health Questionnaire PHQ-2 to 9) Video Tutorial

The Centers for Medicare & Medicaid Services (CMS) is offering a video tutorial for completing D0150, Patient Mood Interview (PHQ-2 to 9) and D0160, Total Severity Score. This video depicts two scenarios that demonstrate the coding of the PHQ-2 to 9 for the purposes of completing D0150, Patient Mood Interview (PHQ-2 to …

Care Plan Management and Evaluation Can Be a Skilled Service for At-Risk Residents

The development, management, and evaluation of the resident care plan is the OBRA backbone of the Resident Assessment Instrument (RAI) process for all residents regardless of payer source, so it may surprise some nurse assessment coordinators (NACs) and directors of nursing (DNSs) to learn that care plan management and evaluation …

How to Use the ICD-10-CM Coding Manual

Since the start of the Patient-Driven Payment Model (PDPM) in October 2019, the International Classifications of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) has been thrust into the forefront of daily tasks for the nurse assessment coordinator (NAC). ICD codes were always applied in long-term care (before 2015, ICD-9-CM codes were …

Improve Staff Retention by Following Hiring Best Practices and Elevating the Onboarding Process

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, curriculum development specialist for AAPACN, discuss how the director of nursing services (DNS) can improve staff retention through the onboarding process. Additional Resources:

F689 Accident Survey Citations: What’s Behind These Immediate Jeopardies?

F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the No. 1 tag cited at the immediate jeopardy (IJ) level in 2023—and remains at the top halfway into 2024, according to QCOR data accessed on June 30, 2024. In many ways, F689 is a catch-all tag, says Angie Szumlinski, LNHA, RN, GERO-BC, …