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.
- Implement the New and Revised Resident Interviews on the MDS: How to Be Ready for Oct. 1
Most of the changes in the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are resident-driven, says Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, a curriculum … Read more - Preparing for Success with ICD-10-CM Changes Oct. 1: How the Facility Coder and Provider Can Ensure Accurate Diagnosis Codes
Effective International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) coding relies on meticulous clinical documentation. It’s not just about assigning codes; it’s about ensuring consistent and comprehensive documentation that substantiates every facet and the … Read more - Behavioral Health Education and Training: How to Ensure Staff Can Meet Resident Needs
The guidance to surveyors in Appendix PP of the State Operations Manual addresses behavioral health education, training, and competencies under two separate F-tags: Did the facility have sufficient staff who provide direct services and implement … Read more - Tips to Prepare for the Upcoming Respiratory Illness Season
Fall is fast approaching, and colder weather increases prevalence of respiratory illness. Colds, flu, and other respiratory illnesses such as COVID-19 and Respiratory Syncytial Virus (RSV) become more common in colder months as people stay … Read more - Oct. 1, 2023 Will See Performance Period Data Collection for Five SNF VBP QMs
The key takeaway of the Fiscal Year (FY 2024) Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule, published on Aug. 7, 2023, is that the director of nursing services (DNS) will need to … Read more - Oral Health: More Than Just Brushing Teeth
As people age, oral health often declines. Teeth can lose enamel, and gums may recede, causing tooth loss and pain. Oral health is much more than just brushing and flossing. Symptoms in a resident’s oral … Read more - FY 2024 SNF PPS Final Rule Initial Timeline for NACs: How/When the MDS Takes Center-Stage
Breathing room will be in short supply for nurse assessment coordinators (NACs) and other interdisciplinary team members who need to implement and monitor the multitude of changes to the Skilled Nursing Facility Quality Reporting Program … Read more - NACs Like a Reasonable Challenge: 2023 AAPACN NAC Work Study and Salary Report
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. … Read more - Proposed Staffing Rule: CMS Focuses on a Comprehensive Approach
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- … Read more - How the Director of Nursing Services Can Support the MDS Process
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) … Read more - Behavioral Health: Eight Ways to Boost Compliance—and Help Residents—Under F740
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 … Read more - Finalized RAI User’s Manual: Eight Key Points to KnowIn 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 … Read more
- Solving the Mystery: How to Document for Section GG
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 … Read more - RAI Manual v1.18.11 Surprises: PPS Discharges Get More Complex
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 … Read more - Infusion Therapy: Solve These Clinical and Documentation Issues to Provide Better CareInfusion 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 … Read more
- Effective Business Case Development for Budget Wins and Better Care OutcomesThe 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 … Read more
- Accurate PDPM Reimbursement: Four Areas of Focus to Shore Up MDS DocumentationThe 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 … Read more
- RAI Manual v1.18.11 Surprises: Standout Issues in Sections D and KNote: This is the second 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 … Read more
- Psychotropic Medications in the Skilled Nursing Facility: How to Manage the ProcessThe use of psychotropic medications in the skilled nursing facility (SNF) is a controversial issue with implications for resident, regulatory, and financial outcomes. The many requirements can be confusing, especially for a relatively new director … Read more
- F609 Abuse/Crime Reporting Obligations: Keys to SuccessNursing homes face significant risk and liability under F-tag 609 (Reporting of Alleged Violations), says Janet Feldkamp, RN, BSN, LNHA, CHC, JD, a partner in the Benesch Healthcare + Practice Group at Benesch, Friedlander, Coplan … Read more
- Develop an Action Plan for CMS’s Schizophrenia MDS AuditsWritten by: Jessica Stucin, RN, BSN, LNHA, RAC-CT, Assistant Director of Education, MDS Consultants On Jan. 18, 2023, the Centers for Medicare & Medicaid Services (CMS) announced they will be conducting offsite audits in nursing … Read more
- RAI Manual v1.18.11 Surprises: Section M and N Updates Include Course CorrectionsNote: This is the first 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 … Read more
- Using New MDS Items Beyond the MDSSeveral new items added or revised on the Minimum Data Set (MDS) this October are considered social determinants of health (SDOHs): ethnicity, race, language, transportation, health literacy, and social isolation. SDOHs are nonmedical factors that … Read more
- F607: CMS Expects a Comprehensive Approach to Abuse/Neglect Policies and ProceduresSo far in fiscal year 2023 (Oct. 1, 2022 – Sept. 30, 2023), F-tag 607 (Develop/Implement Abuse/Neglect, etc. Policies) is not even in the top 20 most frequently cited F-tags nationwide. However, this citation does … Read more
- DNS and IDT Must Plan Ahead for Oct. 1 MDS ChangesThe Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual (RAI User’s Manual), version 1.18.11, in April 2023, noting substantial revisions. These … Read more
- OSA Crash Course: Keys to Navigating this Medicaid-Only Payment AssessmentIn a number of Medicaid case-mix states, the MDS v1.18.11 item sets won’t be the only MDS item sets that are implemented on Oct. 1, 2023—a fact that should temper some excitement about certain MDS … Read more
- How Will October 2023 MDS Changes Impact PDPM and Medicare Payment?Many changes are coming to the Minimum Data Set (MDS) effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Resident Assessment Instrument (RAI) User’s Manual … Read more
- How to Make the Survey Process Smoother: Tips for the New Director of Nursing Services (DNS)The director of nursing services (DNS) position is multi-faceted, and a new DNS must learn a lot quickly. Areas such as providing residents quality care and staffing take top priority, and rightfully so. However, another … Read more
- Medicare Managed Care Basics: Critical Intel for the DNSData from the Centers for Medicare & Medicaid Services (CMS) shows that, as of January 2023, half of all Medicare beneficiaries are now enrolled in a Medicare Advantage plan, according to a recent Kaiser Family … Read more
- 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 … Read more
- 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 … Read more
- 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. … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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, … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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, … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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, … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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 … Read more
- 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, … Read more
- 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 … Read more
- 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 … Read more