Over the last few years, nurse assessment coordinators (NACs) are being hired with less long-term care experience, being paid more, and facing a multitude of challenges including stress and burnout, staffing shortages, and increased workloads. The 2023 AAPACN NAC Work Study and Salary Report received responses from 632 NACs. The …
In the long-awaited Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule, the Centers for Medicare & Medicaid Services (CMS) proposes a three-pronged, comprehensive staffing approach for Medicare- and Medicaid-certified skilled nursing facilities (SNFs) and nursing facilities (NFs): “Literature evidence [e.g., here, here, …
The Minimum Data Set (MDS) determines Medicare and often state Medicaid reimbursement; prompts initial and MDS-assessment-based care planning; provides data that the Centers for Medicare & Medicaid Services (CMS) uses to calculate Quality Measures (QMs) included in the Five-Star Quality Rating System, Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, …
F740 (Behavioral Health Services) is not a frequently cited F-tag so far in calendar year (CY) 2023, according to QCOR data posted on Aug. 13, 2023. However, the consequences can be severe—surveyors often issue this citation at the level of immediate jeopardy (IJ) when it does occur. Specifically, F740 is …
In preparation for the upcoming Oct. 1, 2023, implementation of the also-just-updated v1.18.11v5 MDS item sets, the Centers for Medicare & Medicaid Services (CMS) has released the final Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual version 1.18.11 and a draft-to-final change table. Highlights of these revisions include the …
Section GG, Functional Abilities and Goals, will expand to all OBRA assessments starting Oct. 1, 2023, with the retirement of the section G activities of daily living (ADL) items. This change disrupts the long-standing practices and policies facilities have developed to capture episode-level-of-care information from nurse aides on the section …
Note: This is the third in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse assessment coordinators (NACs). The first two articles were “RAI Manual v1.18.11 Surprises: Section M and …
Infusion therapy services are so inherently complex that the Centers for Medicare & Medicaid Services (CMS) identifies “intravenous or intramuscular injections and intravenous feeding” and “enteral feeding that comprises at least 26 percent of daily calorie requirements and provides at least 501 milliliters of fluid per day” as two of …
The phrase “budget development time” often elicits moans and groans from facility leadership. During this process, leadership usually asks the director of nursing services (DNS) if he or she has any requests of items to include in the budget. Often, the DNS makes a list of nursing department wants and …
The Patient-Driven Payment Model (PDPM) has been the case-mix classification model used for Medicare Part A skilled nursing facility (SNF) reimbursement since October 2019. Although this payment system has been in place for nearly four years for Medicare payment, some states have recently transitioned to PDPM for Medicaid payment. That …
