Articles from AAPACN
Browse expert-written articles on topics that impact your everyday work. Find practical and compelling content written by AAPACN nursing experts who scour through mountains of information to identify the breaking news you need to do your job, to help your team perform, and to improve resident outcomes. Want access to all AAPACN articles? Learn more about AAPACN and AAPACN membership.
- Restorative Nursing Payment and Documentation Issues: Keys to SuccessRestorative nursing can impact fee-for-service Medicare Part A payment in the Behavioral Symptoms and Cognitive Performance category and the Reduced Physical Function category of the nursing component in the Patient-Driven Payment Model (PDPM), says Carol …
- AAPACN Advocates for Skilled Nursing Facilities: Response to Comment Request for FY 2024 SNF PPS Proposed RuleThe American Association of Post-Acute Care Nursing (AAPACN) team collaborated with its members and post-acute care experts to advocate for skilled nursing facility (SNF) professionals by making comments on the fiscal year (FY) 2024 SNF …
- Did COVID-19 Slow Down Restorative Nursing? Learn How to Jumpstart the ProgramRestorative nursing took a big hit in many nursing homes during the COVID-19 public health emergency (PHE), says Carol Hill, MSN, RN, RAC-MT, RAC-MTA, DNS-MT, QCP-MT, CPC, president of Hill Educational Services in Warrior, AL. …
- Implement a Survey Preparedness Program: How to Be Survey-Ready All Year LongOn May 11, 2023, the Centers for Medicare & Medicaid Services (CMS) ended certain emergency waivers; put in place during the public health emergency, these waived some F-tag elements that would otherwise have applied during …
- MDS Item O0110: Get Ready for Multiple Look-Back Periods on the Same MDSThis Oct. 1, 2023, MDS 3.0 item O0100 (Special Treatments, Procedures, and Programs) will be retired and replaced with O0110 (Special Treatments, Procedures, and Programs) as part of the transition to the v1.18.11 MDS item …
- Top Attendee Questions from the May 18 AAPACN Webinar on Upcoming RAI Manual ChangesThe Centers for Medicare & Medicaid Services (CMS) recently released the draft Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual v.1.18.11. With several changes coming this October, the American Association of Post-Acute Care …
- Avoid Playing Psychotropic Shell Games to Resolve Resident BehaviorsAntipsychotic drug use among long-stay residents decreased steadily from 31 percent in 2011 to 22 percent in 2019, according to the November 2022 report Long-Term Trends of Psychotropic Drug Use in Nursing Homes from the …
- F694: Keys to Admitting Residents With Infusion Therapy NeedsPrior to the COVID-19 public health emergency (PHE), skilled nursing facilities (SNFs) were gearing up to take more medically complex fee-for-service Medicare Part A residents, including residents with infusion therapy needs, as a result of …
- Best Practices to Dispute Takebacks for Medicare/Insurance Begin With PreventionIn the 1730s, Benjamin Franklin wrote “An ounce of prevention is worth a pound of cure” to inspire the city of Philadelphia to adopt better fire prevention techniques. What he delivered to history was a …
- Deep Dive into ICD-10-CM: Misunderstood Coding GuidelinesDiagnosis accuracy, long a critical component of the MDS, is escalating in importance. With the recently released draft Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual version 1.18.11, which will become effective October …
- What the DNS Should Know to Hire an Infection Preventionist: From Regulatory Requirements to Onboarding Best PracticesThe Infection Preventionist (IP) has become an integral part of the nurse leadership team in skilled nursing facilities (SNFs). Therefore, turnover in this important position brings many ramifications. When the IP position is vacant, it …
- The “Personal” in Personal Property Matters—Even With Suspected Illegal SubstancesF557 (Respect, Dignity/Right to Have Personal Property) is one of the shorter F-tags in terms of the amount of guidance provided by the Centers for Medicare & Medicaid Services (CMS), coming in at well under …
- CAA Considerations with Oct. 1, 2023 MDS UpdatesThe draft Long-Term Care Resident Assessment Instrument (RAI) 3.0 User’s Manual v1.18.11, released in early April, presents revised care area triggers (CATs) in chapter 4 and care area assessment (CAA) worksheets in appendix C. To …
- MDS Section GG: Why It May Be Time to Bring in Restorative NursingEffective Oct. 1, 2023, section G (Functional Status) will officially be retired from the MDS 3.0 except in states that choose to implement the Optional State Assessment (OSA) with its limited four-item section G for …
- Why Height and Weight Matter on the MDS and How to Get Them RightWhile many nurse assessment coordinators (NACs) are understandably focused on the changes in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, important MDS items that will remain as-is effective Oct. 1, …
- Long-Term Care Survey Process Basics: What the NAC Needs to Know to Prepare for SurveyAccording to the Centers for Medicare & Medicaid Services (CMS), “Skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to …
- How the DNS Can Ensure Staff Preparation for Code SituationsA certified nursing assistant (CNA) conducting afternoon rounds finds Mr. Smith slumped over in his chair. The CNA notices that he does not appear to be breathing and calls the nurse for help. The nurse …
- Two IJ Generators: Emergency Trach Care and New Respiratory Care NeedsIn calendar year (CY) 2022, F-tag 695 (Respiratory/Tracheostomy Care and Suctioning) was the 13th most-cited at the immediate jeopardy (IJ) level. In comparison, F695 was the 17th most frequent citation at the IJ level in …
- White Paper: FY 2024 SNF PPS Proposed Rule: SNF QRP and SNF VBP Changes GaloreThe Centers for Medicare & Medicaid Services (CMS) recently posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is good—a 3.7 percent …
- Respiratory Care: Lay the Groundwork to Avoid Common CitationsIn calendar year (CY) 2022, F-tag 695 (Respiratory/Tracheostomy Care and Suctioning) was the 11th most commonly cited F-tag nationwide. In comparison, F695 was the 16th most common citation overall in CY 2021 and only the …
- Turnover Solutions Series – Part 2: Understanding Why Employees Leave and Strategies to Reduce TurnoverThe staffing crisis is an ongoing dilemma for long-term care. To combat the effects of this crisis, directors of nursing services (DNS) may be tasked with finding creative solutions. Often, DNSs focus on the lack …
- FY 2024 SNF PPS Proposed Rule: SNF QRP and SNF VBP Changes GaloreOn April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is …
- Restorative and Therapy: Collaborate for Successful OutcomesRestorative 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 …
- Long COVID May Be Lurking: Learn How to Help ResidentsThe Centers for Disease Control and Prevention (CDC) now uses the term “post-COVID conditions” (PCC) to label the multitude of physical and mental health consequences that some people—including those who had an initial mild or …
- Fiscal Management and Budget Efficiency During Lean TimesWhen a skilled nursing facility (SNF) is operating on a tight budget, while also being census- and staff-challenged, the director of nursing services (DNS) needs to be more directly and proactively involved in fiscal management …
- Achieving Strong Resident Quality of Life Starts With Better Staff ManagementQuality of life is a “fundamental principle” that feeds into—and flows from—all resident care and services, according to 42 Code of Federal Regulations (CFR) §483.24. The F-tag 675 surveyor guidance in Appendix PP of the …
- Person-Centered Fall Prevention Interventions: Beyond Rehab Screen and 15-Minute ChecksThe Centers for Disease Control and Prevention (CDC) cites falls as the leading cause of injury-related death in adults aged 65 and older (CDC, 2023). It is imperative that nursing facility staff identify fall risk …
- Culturally Competent Care Planning: What It Takes to Get It RightEffective with the Oct. 1, 2023, implementation of MDS v1.18.11, items A1005 (Ethnicity), A1010 (Race), A1110 (Language), and B1300 (Health Literacy) will provide nurse assessment coordinators (NACs) and other interdisciplinary team members with a starting …
- Turnover Solutions Series – Part 1: Interpreting the Staff Turnover RateDuring a QAA/QAPI meeting, the director of human resources announces the monthly staff turnover rate and shares information about a job fair she will attend. After this report, another department director takes a turn sharing …
- Pain Management for Residents With OUD: Prioritize Staff TrainingLike every aspect of nursing home operations, staff education and training are critical to providing pain management for residents with opioid use disorder (OUD), other substance use disorders, or an addiction history. Each resident’s pain …
- 5 Major MDS Changes and How to Operationalize What’s Coming October 1, 2023Significant changes are coming with the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, version 1.18.11, which will become effective October 1, 2023. Facilities that prepare ahead of time will integrate the updates into …
- Set up an Audit Response Process to Navigate TPESkilled nursing facilities (SNFs) seem to be experiencing a significant uptick in Targeted Probe and Educate (TPE) prepayment medical review of fee-for-service Medicare Part A claims, says Stacy Grondel, RN, BN, RAC-CTA, RAC-MT, QCP, CMAC, director …
- Ethnicity, Race, Language, Health Literacy: New MDS Items Are a Cultural Starting PointEffective Oct. 1, 2023, seven social determinants of health (SDOH) standardized patient assessment data elements (SPADEs) will be added to the MDS v1.18.11 item sets as follows: SDOH Items on the MDS v1.18.11 Draft Item …
- How NACs Can Support Administrative Level of Care Presumption During Medical ReviewWhen a Medicare beneficiary is admitted to a skilled nursing facility (SNF), there are specific requirements that the resident must meet for the facility to bill Medicare for the services provided. The physician must certify …
- Nursing Staff Conflicts: Gracefully Resolve Issues With These Mindset ShiftsInteractions Among Staff (i.e., the extent to which staff are rude to, or bully, other staff) is one of six workplace safety composite measures derived from the Agency for Healthcare Research and Quality’s (AHRQ) new …
- Strategies for Overcoming the Struggles of Dementia CareDementia is a difficult diagnosis to manage in long-term care. The disease robs individuals of precious memories and their ability to communicate. This loss can cause residents and their loved ones fear, sadness, and sometimes …
- Staff Retention: Check-Ins with New EmployeesNurse leaders make a tremendous difference in whether certified nurse aides (CNAs) and nurses decide to stay or leave the job, especially in the first 90 days of employment. One of the key ways the …
- From Glucometers to Podiatry Equipment: Where Cleaning and Disinfection Can FailInadequate hand hygiene before and after care processes (e.g., when donning or doffing gloves) is a perennial problem for nurses and other staff members in nursing homes. However, even staff who perform hand hygiene correctly …
- TPE Medical Review Prep: Revive These MDS Best PracticesThe general consensus is that Medicare Administrative Contractors (MACs) are targeting—more than ever before—skilled nursing facility (SNF) fee-for-service Medicare Part A claims for Targeted Probe and Educate (TPE) prepayment medical review. SNFs that undergo TPE audits …
- Back to Basics: Returning to Pre-Pandemic Medicare Regulatory ComplianceSince March of 2020, skilled nursing facilities (SNFs) have relied on two distinct waivers related to technical eligibility for Medicare. Due to the COVID-19 Public Health Emergency (PHE), temporary changes related to the 3-day qualifying …
- How the DNS Can Lead Risk Mitigation for Schizophrenia Diagnoses2015—the year that the Centers for Medicare & Medicaid Services (CMS) added antipsychotic medication use quality measures (QMs) to the Five-Star Quality Rating System—marked the beginning of some difficult trends in the potentially inappropriate diagnosis …
- How to Lead the Team When Everyone is TiredWith a long-lasting pandemic, staff shortages, increased federal reporting requirements, and survey changes in 2022, and new MDS changes in the year to come, one thing is certain—everyone is tired. Amid all this, the director …
- Prepare for iQIES to Avoid MDS Submission FailuresThe Centers for Medicare & Medicaid Services (CMS) is on target to transition MDS submissions from the current Quality Improvement and Evaluation System (QIES) to the cloud-based Internet Quality Improvement and Evaluation System (iQIES). “While …
- NACs Empowered: Tips to Optimize the Resident Interview for MDS CodingThe nurse assessment coordinator (NAC) is responsible for coordinating the completion of the MDS assessment, a process which depends on the interdisciplinary team (IDT) supplying documentation to support MDS coding. While the IDT’s role in …
- MDS 3.0 v1.18.11 Draft Item Sets: PPS Discharge (NPE) Item Set Will See Big ChangesOn Dec. 23, 2022, the Centers for Medicare & Medicaid Services (CMS) released the nine revised MDS 3.0 v1.18.11 draft item sets so that nurse assessment coordinators (NACs) and other interdisciplinary team members can begin …
- Medical Review Audits and Regulatory Compliance: It Takes a VillageLong-term care is one of the most regulated settings in this country. The interpretive guidance in Appendix PP of the State Operations Manual, which surveyors apply during an onsite survey, is 856 pages long—and that …
- Bed Safety: Tips to Stay Out of the Danger Zone!Performing bed safety checks is often an essential duty of the maintenance supervisor. However, the risk to residents of injury or even death while they are in bed is a serious matter, and the DNS …
- Resident Care Items and Environmental Surfaces: Infection Prevention KeysF-tag 880 (Infection Prevention and Control) is the second most frequent citation nationwide in calendar year (CY) 2022—and the third most frequently cited at the immediate jeopardy (IJ) severity level, according to QCOR (Quality, Certification, …
- Pain Management and Addiction: Strategies for SuccessEffective Oct. 24, 2022, nursing homes are required to implement revised pain management guidance under F-tag 697 (Pain Management) in Appendix PP of the State Operations Manual for residents with active opioid use disorder or …
- Details, Details, Details: Five Keys for DNSs to Understand Five-Star StaffingWith the Staffing domain in the Five-Star Quality Rating System more complex than ever, Jessie McGill, RN, RAC-MTA, RAC-MT, a curriculum development specialist with AAPACN, offers directors of nursing services (DNSs) and other nurse managers …
- Schizophrenia: Keys to Coding I6000 and Supporting This Critical DiagnosisFrom 2015 – 2019, the number of long-stay residents who were coded in MDS item I6000 (Schizophrenia (e.g., Schizoaffective and Schizophreniform Disorders)) jumped by 35 percent, according to the November 2022 report Long-Term Trends of …
- Final Step of MDS Management: The Final Validation ReportWhen an MDS has been signed as complete, grouped into a batch, and submitted to the national repository, the nurse assessment coordinator (NAC) still is not yet done with managing that assessment. The last crucial …
- How to Implement and Sustain Changes in Practice to Comply with Appendix PP UpdatesAs of October 24, 2022, nursing facilities must comply with updates the Centers for Medicare & Medicaid Services (CMS) made to the surveyor guidance in Appendix PP of the State Operations Manual. Although changes to …
- When Psychosocial Harm Occurs: How to Mitigate Further Risks for ResidentsPsychosocial harm is such a critical issue in nursing homes that resident psychosocial outcomes are equally important to physical outcomes when surveyors are determining a deficiency’s severity level. Surveyors assign the severity level of a …
- Back to Basics: Daily and Weekly Tasks of a Nurse Assessment CoordinatorNurse assessment coordinators (NACs) new to the job often receive guidance from a mentor during their first two weeks in the role. That mentor might lead the new NAC step by step through all the …
- Decision Support Software: How to Get the Benefits and Limit the RisksAccuracy, efficiency, consistency—these are all work process gains that nurse assessment coordinators (NACs) can reap from decision support software, such as MDS “scrubbers” and automated care plan interventions, and they can help lead to improved …
- Tips to Provide a Safe and Happy Holiday SeasonOver the last two years, the holidays have been difficult for many residents, families, and providers. However, things seem to be looking up as we near the end of 2022! The Centers for Disease Control …
- CMS Takes Opioid Use Beyond §483.25 (Quality of Care) in Appendix PP GuidanceOn Oct. 3. 2022, the U.S. Department of Health and Human Services (HHS) renewed the nationwide opioid public health emergency (PHE), marking the launch of the PHE’s sixth year. Some nursing homes have been slow …
- Uncover Unusual Contributors to Fall RiskThe 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, …
- Discharge Planning: NACs Have a Key Role as an Information BrokerEffective discharge planning is critical to smooth transitions of care, which help guard against both hospital readmissions and adverse drug events, according to the Agency for Healthcare Research and Quality (AHRQ). The benefit for residents …
- Staff Retention: The Power of Purpose and Meaningful WorkWhen the pandemic pummeled the nursing home workforce, nursing homes lost more jobs than any other healthcare setting. This loss compounded the staffing shortage facilities were already confronting, leaving many facility leaders physically and emotionally …
- SNF QRP HCP Influenza Vaccine Reporting: 10 Things DNSs Need to KnowIt just got a little more difficult for skilled nursing facilities (SNFs) to avoid a 2 percent reduction to their annual payment update (APU) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). For …
- Understand the MDS Trickle-Down EffectA tall glass of crystal-clear water is very refreshing. But water that is murky, has particles floating around, or a mineral odor isn’t appealing – and may be dangerous. The source of the water is …
- Bring Clinical Case Management Into the Medicare Huddle ProcessNurse assessment coordinators (NACs) and directors of nursing services (DNSs) should work together either to implement or to finetune an interdisciplinary Medicare Part A huddle process that coordinates payment and clinical issues for residents, suggests …
- Partner Up! Working With the DNS to Create a Shared Vision Reaps RewardsNurse assessment coordinators (NACs) should take the time to build a shared vision and a shared approach with the director of nursing services (DNS), suggests Melanie Tribe-Scott, BSN, RN, RAC-MT, RAC-MTA, QCP, director of quality initiatives for …
- Tips for Accurate ICD-10-CM Coding of COVID-19 InfectionOn October 13, 2022, the U.S. Department of Health and Human Services (HHS) renewed the COVID-19 public health emergency (PHE) determination for another 90 days. Although COVID-19 has been affecting skilled nursing facilities (SNFs) for …
- Aligning the Regulatory Requirements with DNS Decision-MakingAmong the many decisions directors of nursing services (DNSs) make during their day, some of the most challenging involve regulatory requirements the Centers for Medicare & Medicaid Services (CMS) has issued. DNSs may find themselves …
- Opioids: Three Issues That Merit Stronger Collaboration With Consultant PharmacistsThe new surveyor guidance in Appendix PP of the State Operations Manual that went into effect on Oct. 24, 2022, takes a multi-pronged approach to opioids, starting with the critical risks associated with using opioids …
- Does Your Facility Staffing Data Tell the True Story? Ensure PBJ Accuracy for a Complete PictureStaffing is a topic that is always on the director of nursing services’ (DNS’s) mind, and its importance only continues to increase. Usually, the focus is on filling open positions to meet workload demands. However, …
- Proactive Steps for FYs 2023 – 2024 Center on Census and QualityOctober 1 is always an important date because it marks the transition to a new fiscal year for the fee-for-service Medicare Part A skilled nursing facility prospective payment system (SNF PPS). However, the next two …
- How to Speak the Same Language for Section K Coding: NACs and SLPsWhen a nurse assessment coordinator (NAC) reviews the speech language pathologist (SLP) evaluation notes and encounters the term globus sensation, he or she may not even consider that the phrase could indicate a potential swallowing …
- Working With Medicare Advantage Plans: 10 Tips to Maximize ResultsMedicare Advantage enrollment continues to grow, representing 48 percent of eligible Medicare beneficiaries in 2022, according to the Aug. 25, 2022, issue brief, Medicare Advantage in 2022: Enrollment Update and Key Trends, from the Kaiser …
- The Use of Critical Element Pathways to Identify NoncomplianceOn June 29, 2022, the Centers for Medicare and Medicaid Services (CMS) released updates to the surveyor guidance in Appendix PP of the State Operations Manual. Highlights of the updates can be found in the …
- CoreQ: Where It Stands With CMS—and How It Still May Help the DNSOne way or another, patient-reported outcome (PRO) measures eventually will come to nursing homes across the country. Meaningful Measures 2.0, the framework that the Centers for Medicare & Medicaid Services (CMS) established to guide quality …
- ICD-10 Coding: Keys to the Achieving the Highest SpecificityLike the Fiscal Year (FY) 2022 ICD-10-CM Official Guidelines for Coding and Reporting, the general coding guidelines in the FY 2023 ICD-10 Official Coding Guidelines instruct coders that “diagnosis codes are to be used and …
- Section G: Scheduled for Retirement October 2023The Activities of Daily Living (ADLs) in section G of the MDS are interwoven throughout the Care Area Assessments (CAAs), Quality Measures (QMs), and some state Medicaid reimbursement systems—and have been for years. Yet CMS …
- Updates to Requirements of Participation May Trigger More Citations for Resident-to-Resident AltercationsMrs. C is an 85-year-old resident with cognitive impairments. She often wanders from room to room and likes to pick up pretty trinkets and put them in her purse for safekeeping. Mr. M finds her …
- Get Baseline Care Plans Survey-Ready: Teach Staff to Set a Strong FoundationThe baseline care plan has been a requirement of Medicare/Medicaid participation under F-tag 655 (Baseline Care Plans) since the November 2017 implementation of phase two of the Reform of Requirements for Long-Term Care Facilities. “While …
- October 2023 MDS Item Set: No Section G and More Three-Day Look-BacksOn Sept. 1, 2022, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS Nursing Home Comprehensive (NC) Item Set version 1.18.11, noting that it plans to post all of the final v1.18.11 …
- FY 2023 – 2024 Parity Recalibrations Demand a Back-to-Basics ApproachFee-for-service Medicare Part A reimbursement is under significant pressure over the next two fiscal years due to a parity adjustment recalibration that will reduce aggregate payments by $780 million just in FY 2023 (Oct. 1, …
- Is Your Facility’s Medicare Reimbursement Faucet Leaking? 3 Areas to Check for RepairsNurse assessment coordinators’ (NACs’) actions drive the Medicare reimbursement that a skilled nursing facility (SNF) receives for the care it provides. NACs oversee the process of assessing residents, developing documentation, and submitting the MDS—all of …
- PBJ Takes Center-Stage: What the DNS Needs to KnowThe Payroll-Based Journal (PBJ) electronic staffing data system remains a little bit of a mystery to many directors of nursing services (DNSs), but the Centers for Medicare & Medicaid Services (CMS) is going all-in on …
- The Road to Compliance Starts with a Gap AnalysisOn June 29, 2022, the Centers for Medicare and Medicaid Services (CMS) released updates to the surveyor guidance in Appendix PP of the State Operations Manual. Some are minor technical updates, while others introduce entirely …
- Get Ready: SNF QRP Data Submission Requirements Are IncreasingWhile key details are still pending, the Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule makes clear that meeting the reporting requirements of the Skilled Nursing Facility Quality Reporting …
- Don’t Shortcut the CAAsClinical education teaches nurses a process of problem identification. Encompassing assessment, nursing diagnosis, planning, implementation, and evaluation, it is often just called the nursing process. Many nurse assessment coordinators (NACs) may also recognize that the …
- Discharge Planning: How to Ensure a Smooth Transition for the ResidentThe words “It’s time for you to go home” can evoke happiness and excitement for both residents and staff. Smiles appear on the faces of residents and their families, and giddiness is in the air. …
- Infection Prevention: Lay the Groundwork for Collaboration With the Medical DirectorThe medical director’s role in infection prevention and control involves more than just signing off on whatever comes their way via quality assessment and assurance committee (QAA) meetings, says Deb Patterson Burdsall, PhD, RN-BC, CIC, …
- CMS Softens the Blow of the Parity Recalibration, but Change Is Coming QuicklyThe Fiscal Year (FY) 2023 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule may not “turn that frown upside down” as the popular saying goes, but it does give SNFs—and in some cases …
- What NACs Need to Know About Five-Star Staffing ChangesEffective July 27, the Centers for Medicare & Medicaid Services (CMS) has overhauled the methodology for the Staffing domain’s star rating calculations in the Five-Star Quality Rating System on Care Compare, says Jessie McGill, RN, …
- Tips to Achieve Supporting Documentation: Get the Information NACs Need to Code the MDSCompleting the MDS assessment requires documentation in the medical record to support nearly every item’s coding. When supporting documentation is in place, the MDS assessment process can be smooth and efficient. If it is not, …
- 3 Common QAPI Questions and Answers Nurse Leaders Need to KnowWhile most skilled nursing facility (SNF) leaders are aware of QAPI and have executed a QAPI plan, many view QAPI itself as nebulous, abstract, or vague. This lack of clarity complicates QAPI execution. This, in …
- Who Is the Infection Preventionist? If It’s the DNS, ReconsiderNursing homes must designate “one or more individuals as the infection preventionist (IP) who is responsible for assessing, developing, implementing, monitoring, and managing the infection prevention and control program (IPCP),” which includes the requirements at …
- Solve the Mystery of the Interrupted StayAh, the great mysteries of life. Which came first, the chicken or the egg? Is there intelligent life on other planets? Where do all the missing socks go? And of course, the enduring mystery: what …
- 10 Tips to Feel More Confident as a New Nurse Assessment CoordinatorStarting out as a new nurse assessment coordinator (NAC) can be overwhelming. There’s so much to keep track of—from ensuring MDS assessments are in place to understanding all the components of the Patient-Driven Payment Model …
- Time to Review Those 2022 Goals: Will They Be Met?Long-term care has seen many changes this year; new vaccination regulations, the removal of some COVID-19 waivers, and, of course, ongoing changes related to COVID-19 have all required frequent adaptation. In this context, nurse leaders …
- How—and Why—to Maximize Your Staff’s Communication SkillsThis Oct. 24, surveyors will begin enforcing mandatory communication training requirements to ensure that direct-care staff can communicate effectively with residents under F-tag F941 (Communication Training) in Appendix PP of the State Operations Manual, according …
- Accurately Code Wounds in MDS Section M: How to Get Strong Supporting DocumentationIn many facilities, the wound nurse may not be doing weekly wound rounds because they are getting pulled to the floor, which can create a nerve-wracking situation for nurse assessment coordinators (NACs) trying to code …
- Section GG Education and Spot Audits Boost Coding QualityAny staff members, including nurses or certified nursing assistants (CNAs), who document for section GG (Functional Abilities and Goals) need to be trained on how to observe the resident in those areas, says Scott Heichel, …
- Appendix PP Revisions in the State Operations Manual: Breaking Down Key ChangesOn June 29, the Centers for Medicare & Medicaid Services (CMS) issued a major update to surveyor guidance via Quality, Safety and Oversight (QSO) memo QSO-22-19-NH to strengthen the implementation of the already-in-effect Phases 2 …
- Nurse Leader Fundamentals: An OverviewWhen I was an assistant director of nursing, I accepted a promotion and became the director of nursing services (DNS). I had been a nurse manager for a few years and thought I was prepared …