A skilled nursing facility (SNF) accepts a resident in a Medicare Advantage plan for admission after the plan provides a prior authorization. The resident receives skilled services for the allotted amount of time, and the nurse assessment coordinator (NAC) and the rest of the interdisciplinary team follow the plan’s rules. …
Skilled nursing facilities (SNFs) today must manage more than 40 Quality Measures (QMs) from several different programs: the Minimum Data Set (MDS) 3.0 QMs, Five-Star Quality Rating System, SNF Value-Based Purchasing (VBP) program, and SNF Quality Reporting Program (QRP). The scope of quality management and improvement can be overwhelming, and …
The director of nursing services (DNS) in a nursing home often is presented with a newly hired nurse practitioner (NP) or other advanced practice registered nurse (APRN) as a fait accompli (i.e., a done deal), but no matter who is hiring the NP, the DNS should get involved and ask …
Increasingly, nurse practitioners (NPs) and clinical nurse specialists (CNSs), also known as advanced practice registered nurses (APRNs), work either directly for or closely with nursing homes to improve resident care outcomes—as do physician assistants (PAs). That growth may accelerate as providers transition to more value-based payment models amid the ongoing …
A resident-to-resident incident occurred on the dementia unit, resulting in an injury to one resident. The altercation surprised the staff, so their response to the situation was not immediate. Additionally, when they intervened, they did not de-escalate the situation well. Does this sound familiar? When an abuse situation occurs, it …
It’s the “Which came first, the chicken or the egg?” question of the Minimum Data Set (MDS) world: Which do you assess first, B0700 or the MDS scripted interviews? It’s easy to get lost in this question when reviewing the coding instructions for the scripted interviews and steps for assessment …
Almost all nursing homes are currently staffing-challenged, and that has a direct impact on the quality of the documentation available to support MDS coding, points out Brenda Sowash, RN, RAC-CT, director of clinical assessments, standards, and practices for Trinity Health Senior Communities in Livonia, MI. “Nursing staff have to prioritize …
Nurses use a common problem-solving technique in root-cause analysis called the “Five Whys.” This method asks “why?” as many times as needed to determine the root cause of the problem. Sometimes this process requires more than five “whys” to reveal the root cause; other times it can take less. When …
The care area assessments (CAAs) are a vital part of the Resident Assessment Instrument (RAI) process to develop a plan for individualized resident care. Taking shortcuts with the CAA process can result in generic care plans that fail to recognize the unique needs, choices, and preferences of each resident. Understanding …
Nursing homes are required to establish a surveillance system (i.e., “the routine, ongoing, and systematic collection, analysis, interpretation, and dissemination of surveillance data”) as part of their infection prevention and control program (IPCP) under F-tag 880 (Infection Prevention and Control) in Appendix PP of the State Operations Manual. This surveillance …
