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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.

  • Dementia Care: Use MDS and Other Tools to Interpret Behavior, Boost Comfort
    Comfort—palliation—should be a critical component of all nursing home care, suggests Ann Wyatt, a palliative and residential care consultant for CaringKind in New York City. “It is not about giving up. It’s about deciding, Why …
  • PDPM: Clearing up Nursing Component Confusion: Part Two – Focus on Special Care High
    Editor’s note: This is the second article in a series on the PDPM categories for the nursing component, covering various missteps to avoid in PDPM calculation, as well as essential coding tips. Part one focused …
  • Preventing and Detecting Drug Diversions: Quick Tips for Success
    Roughly 30 percent of the United States’ total drug abuse problem can be linked to prescription drugs, says Angie Szumlinski, LNHA, RN-BC, RAC-CT, BS, director of risk management for HealthCap/QA Reader in Ann Arbor, MI. …
  • Achieving Personal and Professional Goals
    It’s the New Year, and that means it’s time to set goals. These are often lofty aspirations to achieve amazing feats, like transforming into a sleek powerhouse of muscle reflecting the epitome of health. However, …
  • MDS Section Q: Unlock the Full Potential of This Foundational Section
    Section Q (Participation in Assessment and Goal Planning) is not a high-powered section of the MDS that drives payment or any of the quality measures (QMs). As a result, nurse assessment coordinators (NACs) sometimes may …
  • The Risky Business of Falls and Care Planning’s Role in Prevention
    There are plenty of statistics documenting the hazard falls pose for the elderly. The Centers for Disease Control and Prevention (CDC) has a website sharing important facts about falls. CDC notes that: One out of …
  • Tips for the New Year to Get and Stay Organized
    Some 4,000 years ago, ancient Babylonians started making New Year’s resolutions, hoping to avoid famine, illness, and other punishment they believed their gods would cast upon them. Given the motivation behind the beginning of this …
  • Get Agency Staff up to Speed on Emergency Preparedness and Safety
    F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the second most frequently cited at the immediate jeopardy (IJ) level during fiscal year (FY) 2021, according to the Citation and Frequency Report from QCOR (Quality, Certification, and …
  • Avoid Costly SNF QRP Coding Mistakes
    Misunderstandings about the Skilled Nursing Facility Quality Reporting Program (SNF QRP) can involve everything from the risk adjustments to the quality measure (QM) calculations to how to use certain reports. These issues can cause headaches …
  • PDPM: Extensive Services Nursing Category Simplified
    Editor’s note: This is the first article in a series on the PDPM categories for the nursing component, covering missteps to avoid in PDPM calculation, as well as essential coding tips. Future articles will address …
  • Staffing the DNS Role Turnover, Retention, and Development
    The purpose of this report is to provide skilled nursing facility (SNF) operators with insights into the factors that may contribute to turnover of directors of nursing services (DNSs), as well as challenges related to …
  • Family Arguments and Grievances: How to Dial down the Tension
    Family arguments and grievances can have a negative impact on residents and families if nursing homes don’t employ an organized approach to setting expectations and communicating with families. The following steps can help directors of …
  • Showing Staff Appreciation During the Holidays
    Believe it or not, the holiday season is upon us once again. It’s time for holiday traditions such as baking, caroling, and decorating. (For inquiring minds, yes, my Christmas tree went up in early November!) …
  • Survey and Section I: Diagnosis-Related Deficiencies
    Long-term care leadership often observes that the nurse assessment coordinator (NAC) role calls for detail-orientation and strong time-management and assessment skills, because these nurses must coordinate the resident assessment that drives the care plan, quality …
  • PHQ-9 Monitoring Can Help Counter Mood/Depression Issues in Residents
    Depression and other mood disorders historically have been a significant risk for nursing home residents. “In 2011 and 2012, the percentage of users of long-term care services with a diagnosis of depression was highest in …
  • COVID-19 PHE: CMS Re-sets Key Rules for Nursing Homes
    The parameters of the COVID-19 public health emergency (PHE) are shifting at a rapid pace for nursing homes. In the midst of their work to implement (and document) a staff vaccination plan that includes a …
  • The Daily Clinical Brief Sets a Nursing Unit Up for Success
    Nurse leaders who hear comments like “I didn’t know that happened,” “I didn’t realize that was important,” or “I didn’t know you wanted me to do that” from the charge nurses and certified nurse aides …
  • The Era of Agency Staff: How to Prevent Immediate Jeopardies
    While still a small percentage of overall nursing home citations, citations at the level of immediate jeopardy (IJ) have skyrocketed since the start of the COVID-19 public health emergency, largely driven by an explosion of …
  • PDPM: Making the Speech Language Pathology (SLP) Component Easier to Swallow
    Editor’s note: this article was reviewed and revised December 2, 2021. Without a full understanding of how the SLP component of the Patient-Driven Payment Model (PDPM) is calculated, it can seem complicated. The SLP methodology …
  • Coding UTI on the MDS: I2300 Requirements Are Not One-Size-Fits-All
    Since the implementation of the Patient-Driven Payment Model (PDPM) in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS), urinary tract infections (UTIs) can be coded on the MDS in up to …
  • Important CMS Updates for Skilled Nursing Facilities
    AAPACN’s mission is to support the professional development, empowerment, and success of members with resources. We especially want to provide that support during the current COVID-19 emergency. Federal guidance is rapidly developing and changing. AAPACN …
  • Resident-Centered Care: How—and Why—to Learn the Resident’s Story
    Consider this common scenario: Mr. Smith, a resident with dementia, is scheduled to have a bath on Tuesday, but he’s combative. “Even veteran staff may be set on the idea that Mr. Smith has to …
  • How Does Your Daily Stand-Up Meeting Measure Up?
    Almost every facility has a daily “stand-up” meeting for its management team. When done well, this meeting can be a font of information for everyone involved. However, without structure and focus, it can become cumbersome. …
  • I Spy… Behavioral Symptoms
    Imagine you are eating dinner in a restaurant. It is a small, quaint place with a warm, homey atmosphere. A man in the corner picks up his fork and begins to tap it loudly against …
  • IPAs: Better Payment Can Drive Better Care Decisions
    The Interim Payment Assessment (IPA) in the Patient-Driven Payment Model (PDPM) of the Skilled Nursing Facility Prospective Payment System (SNF PPS) is completed solely at the discretion of the SNF—and so far, few providers have …
  • How to Be Proactive in a Reactive Staffing Environment
    Although staffing has always been a challenge, the situation has worsened over the last year and doesn’t seem likely to improve anytime soon. An American Health Care Association (AHCA) survey found that 73% of 616 …
  • Suspect a Drug Diversion? Here’s What to Do
    The September 2021 Full Text of Statements of Deficiencies is chock-full of survey citations involving a facility’s failure to investigate and respond appropriately to drug diversion. For example, some surveyor notes indicate that a facility …
  • 2021 AAPACN NAC Work Time Study and Salary Report Highlights: Reassessing NAC Hours for Success
    During the pandemic, priorities shifted. They had to. The safety and care of the residents was the number one priority, and it required all hands on deck. Nurse assessment coordinators (NACs) found themselves working the …
  • Get the Most Out of the BIMS in Care Planning
    The Brief Interview for Mental Status (BIMS) in MDS items C0200 – C0500 or, if appropriate instead, the Staff Assessment for Mental Status in items C0700 – C1000 is the basis of the cognitive level …
  • Mock Drills – An Essential Part of Preparation
    When a resident suffers a cardiac arrest in the facility, do nurses know how to initiate a code? If a resident elopes, do facility staff know what to do? When emergency events happen, such as …
  • F608 and F609: Are You Meeting Reporting Requirements?
    While F-tags like F600 (Free From Abuse and Neglect) directly address acts of abuse, neglect, misappropriation of resident property, exploitation, and other critical—even criminal—incidents involving residents, the substandard quality-of-care tags F608 (Reporting of Reasonable Suspicion …
  • ADR Successful Outcomes with Part B Therapy Audits
    In nursing facilities, one of the primary regulatory requirements from Appendix PP of the State Operations Manual is that goods and services are provided to attain or maintain the highest practicable physical, mental, and psychosocial …
  • Looking Ahead: FY 2022 SNF PPS Final Rule Offers NACs a Crystal Ball
    The Fiscal Year (FY) 2022 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule contains a number of finalized changes—from revised SNF PPS payment rates for FY 2022 to updates to the Skilled Nursing …
  • Utilizing the Wound Nurse Role to Champion Skin Integrity
    Imagine if the infection preventionist’s sole responsibility were to treat residents who have an infection. This suggestion seems odd because it ignores the scope and breadth of activities necessary to control and prevent infections for …
  • Staffing Rating Under 4 Stars? Review PBJ Data; Set and Monitor Goals
    Staffing is difficult—that was a defining truth for nursing homes before the COVID-19 public health emergency created a full-blown staffing crisis that still is harming providers throughout healthcare. So, it may seem like the wrong …
  • PDPM: Clearing Up NTA Confusion
    At first glance, the methodology of the non-therapy ancillary (NTA) component of the Patient-Driven Payment Model (PDPM) seems simple: code qualifying items on the MDS to achieve points. Yet while the purpose of the NTA …
  • SNF HAI Measure Puts the Spotlight on Billing, Not Just Infection Prevention
    The Skilled Nursing Facility Healthcare-Associated Infections (SNF HAI) Requiring Hospitalization measure is one of two new quality measures (QMs) that the Centers for Medicare & Medicaid Services (CMS) adopted into the Skilled Nursing Facility Quality …
  • In-Service Education Improvements for Regulatory Compliance and Staff Competency
    An effective in-service program not only ensures competency and meets regulatory requirements, but also incorporates many learning styles and fosters the enjoyment of learning. Given the resources that a facility must dedicate to its in-service …
  • Lead CNA Programs: Learn How to Hire and Support the Best In-House Candidates
    Lead certified nursing assistant (CNA) programs can create positive change in nursing homes. While program goals often vary from facility to facility, lead CNA programs may improve resident quality of life and quality of care, …
  • Consequences of Poorly Written CAAs
    “No one even looks at the care area assessments (CAAs) once they’re done, so why spend so much time on them?” It’s a conundrum that nurse assessment coordinators (NAC) and interdisciplinary team (IDT) members often …
  • COVID–19 HCP Vaccination Measure Changes the SNF QRP APU Equation
    Effective with the fiscal year (FY) 2023 Skilled Nursing Facility Quality Reporting Program (SNF QRP), SNFs must fulfill two separate but equal reporting requirements to avoid a 2 percent reduction in their annual payment update …
  • The Exit of the CNA: Mandate or Me—What Now?
    With the introduction of the vaccine mandate for nursing home employees, many organizational leaders fear staff, especially certified nursing assistants (CNAs), will quit rather than get the vaccine. This week, several industry experts have voiced …
  • Refocusing on Systems Management to Improve Survey Outcomes
    Since the public health emergency began, both the Centers for Medicare & Medicaid Services (CMS) and directors of nursing services (DNSs) have been focused on infection control and prevention—and rightfully so. Yet while crisis-oriented actions …
  • Elopement Risk Management: Learn How to Increase Resident Safety and Reduce Facility Risk
    Editor’s note: This is the final article in a three-part series on elopement prevention and response in nursing homes. The first article looked at risk assessment and care planning, and the second article addressed staff …
  • Strategies Nurse Leaders Can Take Regarding the New Vaccination Mandate
    Yesterday, President Biden announced that nursing homes must vaccinate their staff or lose Medicare and Medicaid funding. The exact guidance and compliance requirements are expected in September. Although this mandate is an effort to help …
  • Recognizing Rejection of Care: MDS Coding Accuracy for E0800
    Rejection of care can occur in many ways—Mr. Jones refuses to have his nails trimmed; Mrs. Abrahams clenches her mouth, refusing to take medications in the evening; or Mr. Martin discharges against medical advice. However, …
  • Use MDS Section B to Improve Holistic Discharge Planning
    MDS section B (Hearing, Speech, and Vision) is a lot more important than many nurse assessment coordinators (NACs) and other interdisciplinary team members give it credit for, says Jillian Martin, RN, BS, DNS-CT, RAC-MT, RAC-CTA, …
  • Creating a Process for Compliance with F947, Required In-Service Training for Nurse Aides
    Appendix PP of the State Operations Manual details the requirements for F947 (Required in-service training for nurse aides). To comply with this regulation, a facility’s nurse aide in-service training program must: Ensure competence of all …
  • Elopement Program Success Hinges on Staff Education and Training
    Editor’s note: This is the second article in a three-part series on elopement prevention and response in nursing homes. The first article addressed risk assessment and care planning, and a future article will tackle elopement …
  • Applying the Four Keys of Trauma-Informed Care to Care Planning
    F699 of the State Operations Manual (SOM) requires facilities to ensure that residents who have experienced trauma receive culturally competent, trauma-informed care (TIC) to eliminate or mitigate triggers that may cause re-traumatization of the resident. …
  • SNF QRP: Monitor Data Submission Threshold Performance With These Reports
    Swingtech, a contractor with the Centers for Medicare & Medicaid Services (CMS), alerts skilled nursing facilities (SNFs) that are not meeting the Skilled Nursing Facility Quality Reporting Program (SNF QRP) data submission threshold for the …
  • FY 2022 SNF PPS Final Rule: No PDPM Parity Cuts, but Other Changes Impact SNFs
    FY 2022 SNF PPS Final Rule: No PDPM Parity Cuts, but Other Changes Impact SNFs Providers can breathe a sigh of relief that the Centers for Medicare & Medicaid Services (CMS) will not move forward …
  • Conflict Resolution: Achieving the Win-Win
    Conflict is a daily reality, yet many of us do our best to avoid it, dreading the time when we will have to navigate interpersonal disputes. Many nurse leaders are similarly uncomfortable with or do …
  • Elopement Prevention Starts With Risk Assessment and Care Planning
    Editor’s note: This is the first article in a three-part series on elopement prevention and response in nursing homes. Future articles will address staff training, policy and procedure development, and elopement risk management, including mechanical …
  • The First Month as a New NAC
    During their first days on the job, new nurse assessment coordinators (NACs) can expect paperwork and orientation videos as they are introduced to their role. But what should a new NAC expect by the end …
  • SNF QRP: Common Sources of Dashes on Data Submission Threshold MDS Items
    It’s never a good time for a skilled nursing facility (SNF) to be hit with a two percent reduction in its Medicare Part A annual payment update (APU) due to not meeting the MDS data …
  • Hiring for Character and Talent: 4 Tips for Interviewing
    Nursing school does not prepare nurse leaders to interview job applicants, so figuring out the process to find the right candidate is often a challenge. Leaders want to find the best fit for the position—someone …
  • ‘Problem’ Physicians? The Medical Director Can Be the Nursing Home’s Liaison
    A physician who always sends residents to the emergency department (ED) when nurses call them about a significant change in condition, an advanced practice provider (APP) who routinely orders expensive and unnecessary tests, a physician …
  • How to Take a Vacation When You’re the NAC
    With staffing shortages and specific, regulation-mandated job duties, nurse assessment coordinators (NACs) today may feel that taking time for vacation just isn’t possible. The NAC must ensure the facility has MDS assessments in place, makes …
  • Focus on These MDS/ICD-10 Denial Trends in Medicare Advantage Audits
    Medicare managed care (Part C) plans, which are still predominantly Medicare Advantage plans, tend to conduct more medical reviews than traditional Medicare Part A contractors, says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC, director …
  • COVID-19 Staff Vaccination Rates: Tips From Facilities That Achieved 90 – 100 Percent
    The current weekly data provided by the Centers for Medicare & Medicaid Services (CMS) shows that 1,136 nursing homes have met the provider-set national goal of getting 75 percent of staff fully vaccinated with a …
  • Improving Documentation Starts with Proper Assessment
    One of a nursing student’s most exciting milestones is purchasing a stethoscope. In addition to serving as a critical tool, the stethoscope is also a symbol signifying that the nursing student has taken a leap …
  • FY 2022 SNF PPS Proposed Rule Comments: AAPACN Highlights Impact of COVID-19 on SNFs
    Jessie McGill, RN, RAC-MT, RAC-MTA Every spring, the Centers for Medicare & Medicaid Services (CMS) releases the notice of proposed rulemaking (NPRM) for the next fiscal year’s (FY’s) payment policies and rates. This provides an …
  • Writing MDS Supplemental Notes: How NACs Can Ace This Role
    The COVID-19 pandemic is quite diminished but still a concern in some nursing homes due in part to SARS-CoV-2 variants, as well as unvaccinated staff. With the public health emergency worsening the already significant staffing …
  • The Nurse Leader’s Clinical Toolbox: Urinary Incontinence
    Urinary incontinence (UI), defined as any involuntary leakage of urine, affects over half the population living in post-acute long-term care (PALTC) and costs an estimated 5.5 billion annually, according to the Society for Post-Acute and …
  • Discharge AMA Requires More Than ‘Good-bye and Good Luck’
    “Against medical advice” (AMA) is a term that nursing homes use to describe a resident unexpectedly leaving the facility in a self- or representative-initiated discharge that is inconsistent with their identified care needs. “Some providers …
  • Avoid These 5 Common Mistakes NACs Make Coding I0020B
    by Carol Maher, RN-BC, RAC-MTA, RAC-MT, CPC ICD-10-CM coding is not a skill nursing school conveys to students, yet it is one that nurse assessment coordinators (NACs) must acquire to perform their diagnosis coding duties …
  • Care Area Assessments: Don’t Let CAAs Be the Missing Link in the RAI Process
    The care area assessment (CAA) process sometimes mistakenly gets lumped under the “required but not critical to resident care” label of regulatory paperwork. While working the CAAs is indeed a mandatory step in the Resident …
  • How to Leverage Positive Peer Pressure to Improve Hand Hygiene
    Hand hygiene has always been a primary focus of infection prevention, but due to the COVID-19 pandemic, it is under intense scrutiny. Even though the skill of hand hygiene is straightforward and easy to learn, …
  • Loop in the Consultant Pharmacist to Lower Fall Risk
    Falls are common in nursing homes—they are a driver of surveyor citations under F-tag 689 (Free of Accident Hazards/Supervision/Devices), which is consistently among the top three survey citations nationwide, according to the S&C QCOR online …
  • 5 Key Strategies for Reengagement in PDPM
    By Liz Barlow, RN, CRRN, RAC-CT, DNS-CT With the onset of the COVID-19 public health emergency (PHE), skilled nursing facilities (SNFs) have been focused on infection control, staffing, and heightened patient care. But as facilities …
  • H0400 – H0600: Keys to Coding Bowel MDS Items
    As a group, the bowel MDS items H0400 (Bowel Continence), H0500 (Bowel Toileting Program), and H0600 (Bowel Patterns) impact nursing homes on multiple levels, including the following: The Nursing Home Quality Initiative Quality Measures (NHQI …
  • Staff Recruitment: How to Stand Out From the Crowd
    While many nursing homes thankfully are no longer in crisis staffing mode, recruiting staff remains a top priority in a highly competitive job market. “Staff recruitment breaks down into meeting two overarching challenges,” says Julie …
  • Reduce Turnover and Increase Staff Retention with Employee First Culture
    “Across the country, the high rate of turnover in long-term care is a serious workforce problem,” says Dr. Linda Shell, DNP, MA, BSN, DNS-CT, Chief Learning Officer, LindaShell.com. “The cost associated with this turnover—the organizational …
  • CMS Revises Visitation and Staff Testing Guidance – What Does this Mean for Your Facility?
    The past year has brought a multitude of changes for everyone, but especially those in nursing homes. While the public health emergency (PHE) situation continues to evolve, the Centers for Medicare & Medicaid Services (CMS) …
  • Detangling the Quality Measures
    We have all struggled with a stubborn knot or tangle at some point in our lives—whether it’s your kids’ shoelaces, your earbud cord, a garden hose, or even a fishing line. If you are a …
  • Medicare Managed Care: Know Each Payer’s Rules and Be Ready to Appeal
    Traditional fee-for-service Medicare Part A is a national program with a core set of program guidance from the Centers for Medicare & Medicaid Services (CMS) in the Internet-Only Manuals and the Long-Term Care Facility Resident …
  • Re-FOCUSing: CMS Reveals PDPM-Driven Data
    The 2021 AAPACN Conference featured a highly-anticipated session, “ReFOCUS: 2021 CMS Regulatory Updates,” in which representatives from the Centers for Medicare & Medicaid Services (CMS) shared their insights on current regulatory challenges and future regulatory …
  • Is Telehealth Viable for Mental Health Needs Post-Pandemic?
    Mental and behavioral healthcare is one of many resident care needs that transitioned to telehealth (i.e., telephone or video visits) in nursing homes during the COVID-19 pandemic. The U.S. Department of Health and Human Services, …
  • How to Use PEPPER to Audit for Accurate Coding and Billing for Medicare Part A
    By Liz Barlow, RN, CRRN, RAC-CT, DNS-CT – April 20, 2021 The federal government focuses intently on preventing fraud, waste, and abuse within the Medicare system. As a part of those efforts, the Program for Evaluating Payment …
  • O0100: Learn Potential Coding Issues With This High-Impact MDS Item
    MDS item O0100 (Special Treatments, Procedures, and Programs) has 12 sections with two columns (24 total subitems) that identify specific services the resident received either while not a resident (column 1) or while a resident (column …
  • 3 Steps to Improving Resident Safety in a Skilled Nursing Facility
    The safety of residents is a top priority for a skilled nursing facility (SNF). But how does one promote safety in such a dynamic environment? Three critical steps the director of nursing services (DNS) and …
  • Common Concerns in Med Pass: Where to Target Audits
    While areas of concern related to medication administration (i.e., medication pass or med pass) are specific to each facility, there are certain common issues. Directors of nursing services (DNSs) can use the following tips to …
  • FY 2022 SNF PPS Proposed Rule Puts the Spotlight on Quality Measures
    On April 8, the Centers for Medicare & Medicaid Services (CMS) released for public inspection the Fiscal Year (FY) 2022 Proposed Rule for the Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing, …
  • Beneficiary Notices Really Can Be Understood
    Although the Centers for Medicare & Medicaid Services’ (CMS) beneficiary notices have been part of Medicare regulations for a long time, they can still be cited during any survey. Lengthy discussions in the AANAConnect LTC …
  • Observation and Assessment: Learn the Ropes of This Underused Skilled Service
    Observation and assessment of a resident’s condition is a skilled service under Medicare Part A that many nurse assessment coordinators (NACs) and Medicare case managers hesitate to use because it’s not a direct skilled nursing …
  • How to Implement Safe Visitation in Your Facility
    It’s hard to believe that it has been a year since the first nursing home resident contracted the novel coronavirus. Our way of living changed drastically, especially in long-term care. In-person visitation ended, and residents …
  • COVID-19 Discharges: Keys to Preventing Hospital Readmissions
    While data on hospital readmissions of skilled nursing facility (SNF) residents who have had COVID-19 following SNF discharge currently remains scarce, at least one study indicates the need for careful management of the discharge planning …
  • The Big Dig and PDPM Gold
    The Patient-Driven Payment Model (PDPM) uses 161 MDS items to establish the five case-mix adjusted components. Some of these 161 items will have supporting documentation easily found in the medical record, but other items may …
  • MDS Item M1200: Think Past Checkmarks With Skin and Ulcer/Injury Treatments
    MDS item M1200 (Skin and Ulcer/Injury Treatments) in section M (Skin Conditions) can impact payment under the Patient-Driven Payment Model (PDPM) in the Medicare Part A skilled nursing facility prospective payment system (SNF PPS), as …
  • Interventions to Promote Staff Recovery After Experiencing the COVID-19 Pandemic
    “Heroes work here.” It was a common theme in the early days of the pandemic. Signs were placed in front of the facility, and people would cheer and line the streets as healthcare personnel went …
  • Restorative Nursing Helps Offer DNSs a Path Forward
    Long-term care is in a difficult state right now, acknowledges Jessie McGill, RN, RAC-MT, RAC-MTA, curriculum development specialist at AAPACN. “It has been a full year of battling COVID-19. The pandemic heavily impacted residents, staff, and …
  • Pitfalls of Missing Shortness of Breath Documentation
    Chronic conditions and comorbidities are common among both long-term residents and short-term patients in skilled nursing facilities (SNFs). However, when the symptoms from these chronic conditions become part of the resident’s normal routine, they may …
  • Coding N2001 – N2005: Part A Drug Regimen Review
    MDS items N2001 (Drug Regimen Review), N2003 (Medication Follow-up), and N2005 (Medication Intervention) are the primary drivers of the Skilled Nursing Facility Quality Reporting Program (SNF QRP) Quality Measure (QM), Drug Regimen Review Conducted With …
  • New NAC: Five Tips for Successful Orientation
    One year. When asked how long it takes a new nurse assessment coordinator (NAC) to fully learn the job, I say at least one year. The nuances of the Resident Assessment Instrument (RAI) and Minimum …
  • MDS Item C1310: Keys to Navigating the CAM
    The Confusion Assessment Method (CAM) is a standardized cognitive assessment that determines whether a resident has signs and symptoms of delirium. The CAM is located in MDS item C1310 (Signs and Symptoms of Delirium), which …
  • Why Nurses Eat Their Young and How to Stop This Damaging Practice
    There is a phenomenon of hostility among nurses and certified nursing assistants (CNAs), commonly referred to as “nurses eating their young.” This incivility is pervasive, often seen as a rite of passage, and directed at …
  • Want Better Care Plans? Look at the CAAs
    As the COVID-19 pandemic eases, directors of nursing services (DNSs) may want to turn their attention to the care area assessments (CAAs) in the Resident Assessment Instrument (RAI) process, suggests Barbara Bates, RN, MSN, RAC-CT, …
  • How to Thrive as a New Director of Nursing Services
    Accepting a new position as the director of nursing services (DNS) often begins with excitement for the new challenges and many opportunities to make a positive difference. However, in the first few days and weeks, …
  • Effective Communication: Get the Nursing Team on the Right Track
    Effective Communication: Get the Nursing Team on the Right Track Establishing strong, open communication in the nursing department has always been a challenge, says Suzy Harvey, RN-BC, RAC-CT, director of clinical specialty services for Foster …

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