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 …
The interrupted-stay policy in the Patient-Driven Payment Model (PDPM) of the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) governs when multiple SNF stays are combined into a single interrupted stay (i.e., one continued stay that includes one or more interruption windows) vs. when they are treated …
In the ever-evolving realm of healthcare data management, the transition of the Minimum Data Set (MDS) submission process to the Internet Quality Improvement and Evaluation System (iQIES) in April 2023 marked a significant milestone for skilled nursing facilities (SNFs). Replacing the outdated Quality Improvement and Evaluation System Assessment and Submission …
Pressure-related deep tissue injury (DTI) coded in M0300G (Unstageable Pressure Injuries Related to Deep Tissue Injury) does not play a role in Medicare payment under the Patient-Driven Payment Model (PDPM). While DTI is an unstageable pressure ulcer/injury, only ulcers that are unstageable due to slough and/or eschar (MDS item M0300F1) …
