Articles from AAPACN
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- SNF QRP Again Takes Center-Stage in the FY 2026 SNF PPS Proposed Rule
In the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026, officially published on April 30, 2025, the Centers for Medicare & Medicaid Services (CMS) … - Deep Dive into ICD-10-CM: Diagnosis Sequencing Guidelines
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) code assignment continues to be a bit of an enigma in the long-term care setting. Members regularly ask questions about ICD-10-CM coding in AAPACN’s online … - SNF VBP QMs: What’s Coming Online to Impact Payment—and What’s Proposed
The Centers for Medicare & Medicaid Services (CMS) does not propose any new quality measures (QMs) for the pay-for-performance Skilled Nursing Value-Based Purchasing program (SNF VBP) in the Medicare Skilled Nursing Facility Prospective Payment System … - Targeted Prevention: Stopping Urinary Infections in Their Tracks
Urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) remain significant concerns in long-term care settings. They contribute to increased morbidity, extended hospital stays, higher healthcare costs, and reduced quality of life for residents. … - DNS Takeaways From the FY 2026 SNF PPS Proposed Rule
Like every proposed rule before it, the Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) and Consolidated Billing Proposed Rule for Fiscal Year (FY) 2026 offers the director of nursing services (DNS) a preview … - Quality Measures IQ Series: UTIs and Catheters
The long-stay Quality Measures (QMs), Percent of Residents with a Urinary Tract Infection and Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder, have straightforward methodology but complex underlying implications. Managing … - Care Conference 101: Keys to a Meaningful Meeting
A well-run care conference or care plan meeting can help the interdisciplinary team (IDT) improve the resident’s quality of care and quality of life by establishing a more resident-centered, individualized, culturally competent, and trauma-informed care … - QAPI: How NACs Can Boost the Value They Bring to the Process
The nurse assessment coordinator (NAC) brings a unique understanding of facility operations and resident needs that can reap critical benefits for the Quality Assurance and Performance Improvement (QAPI) program, says Lauren Stenson, MSN, RN, CNDLTC, … - October 2025: Draft MDS Item Sets and RAI User’s Manual
The Centers for Medicare & Medicaid Services (CMS) recently released a second version of the draft item set files for Oct. 1, 2025, updates, version 1.20.1v2, and the draft Long-Term Care Facility Resident Assessment Instrument … - The Facility Assessment: What It Takes to Create an ‘Operational Care Plan’
The revised surveyor guidance in Appendix PP of the State Operations Manual that goes into effect on April 28, 2025, does not include any updates to F-tag 838 (Facility Assessment), says Robin Hillier, CPA, STNA, … - Calming the Agitation to Aggression Pipeline: Non-pharmacological Behavior Management
Using non-pharmacological approaches, not psychotropic medications (i.e., antipsychotic, antidepressant, anti-anxiety, and hypnotic dugs), as the first line of treatment for behavior management is not a new concept for nursing homes, says Amy Lee, RN, BSN, … - Rethinking Pain Management: Non-pharmacological Solutions for a Holistic Approach
Pain management is an essential piece of the care provided in long-term and post-acute care (LTPAC) settings. Many residents experience acute or chronic pain due to a variety of conditions, such as postsurgical recovery, arthritis, … - Medicare Advantage vs. FFS Part A Expedited Determinations: What’s the Difference?
The expedited determination process (called “fast-track appeals” in regulation) for appeals of service terminations by Medicare Advantage (MA) plans is very similar to—but not exactly the same as—the expedited determination process for service terminations under … - Breathe Easy: Code Respiratory Therapy Accurately
In long-term care (LTC) facilities, many residents need care for chronic and acute respiratory problems, such as chronic obstructive pulmonary disease (COPD), pneumonia, tracheostomy, and post-COVID complications. LTC nurses need to know how to manage … - Ethics in MDS Coding: Reimbursement and Quality Measures
In long-term care, the Minimum Data Set (MDS) ensures appropriate care planning, accurate reimbursement, and quality measurement while maintaining compliance with federal and state regulations. However, MDS coding may pose some ethical challenges. Completing the … - MDS Falsification: How MDS Coding Could Bring an OIG Referral During Survey
“MDS coding accuracy is important” is not a revolutionary new concept for any nurse assessment coordinator (NAC), says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC, director of education for Hansen, Hunter & Co. PC … - Appendix PP Revisions: How to Create a Workable Game Plan
A quick review of the draft revised surveyor guidance in Quality, Safety, and Oversight (QSO) memo QSO-25-14-NH that goes into effect on April 28, 2025, may initially concern the director of nursing services (DNS) and … - Draft Appendix PP Revisions: A REVISED Overview
On April 28, 2025, new and revised surveyor guidance, as well as revised critical element pathways, will go into effect during survey, according to the March 10, 2025 Quality, Safety, and Oversight memo QSO-25-14-NH, which … - Caught up in Survey Panic? Make a Plan to Break the Cycle
Hearing a staff member say, “State just walked in the door,” shouldn’t ignite survey panic mode in the director of nursing services (DNS) and other department leaders in the nursing home, says Michelle Synakowski, RN, … - Shifting Mindsets on Infection Prevention and Control: From Policy Adherence to Personal Ownership for Staff
An effective Infection Prevention and Control Program (IPCP) goes beyond compliance with policies and ideally reflects a cultural shift toward personal responsibility. The nurse leader has a key role in helping healthcare professionals recognize their … - Quality Measure IQ Series: Pressure Ulcer Measures
Quality Measure (QM) reporting on pressure ulcers is a significant metric used by the Centers for Medicare & Medicaid Services (CMS) to help ensure that nursing homes provide high-quality care to vulnerable residents. Those residents … - Section GG Accuracy: Helping Nursing Homes Get Fair Payment and Referrals
The ongoing staffing shortage amid growing economic turbulence and payment pressures means that every nursing home in the country is currently struggling with reimbursement, says Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, IPCO, QCP, ICC, director … - Compliance in Diagnosis Selection for Skilled Rehabilitation
For skilled nursing facilities (SNFs), diagnosis selection and accurate ICD-10-CM coding are essential for both quality resident care and compliance with regulations. For therapists providing skilled rehabilitation services, the ability to choose the correct diagnosis … - Care Conference: How Do Resident Rights Connect to Care Planning?
Some nurse assessment coordinators (NACs) may believe that having a care conference (aka care plan meeting) with the resident and/or their responsible party or family member is a regulatory requirement. “However, no regulations actually use … - CBC (Census, Budget, and Compliance): Learn to Speak the Administrator’s Language
The director of nursing services (DNS) and the facility administrator (or other executive leadership) share the overarching goal of providing nursing home residents with the best possible quality of care and quality of life, says … - Bolster the DNS/NAC Relationship to Boost Outcomes Across the Board
Nursing homes that achieve successful operational, clinical, and regulatory outcomes tend to share at least one common characteristic, says Stacy Grondel, RN, BSN, RAC-MT, CMAC, QCP, vice president of clinical reimbursement at Brickyard Healthcare in … - The Keys to Develop a Past Noncompliance Plan
The director of nursing services (DNS) received a call in the middle of the night that a resident with a diagnosis of dementia had eloped, and it appeared she had been missing for several hours—a … - Boost MDS, CAA, and Care Plan Accuracy—and Show the Value of the NAC Role
The MDS is more than a data collection tool, says Sabrena McCarley, MBA-SL, OTR/L, CLIPP, RAC-CT, QCP, FAOTA, RAC-CTA, vice president of clinical reimbursement and regulatory affairs for Transitional Care Management in Lisle, IL. McCarley … - Uncomplicating Drug Classifications
Medications are an essential part of the care and interventions provided to residents in a skilled nursing facility. These medications may be used to manage chronic conditions, slow disease progress, ease symptoms, or even prevent … - It’s Time to Solve the Mystery of the Discharge Function Score QM
The Discharge Function Score is an incredibly complicated quality measure (QM), notes Joel VanEaton, BSN, RN, RAC-MT, RAC-CTA, RAC-CT, executive vice president of post-acute care regulatory affairs and education for Broad River Rehab in Asheville, … - PDPM Overview for Supporting SNF Staff
The Centers for Medicare & Medicaid Services (CMS) implemented the Patient-Driven Payment Model (PDPM) in October 2019 for residents receiving Medicare Part A coverage in the skilled nursing facility (SNF). PDPM replaced the previous legacy … - Sepsis Assessment and Reporting: Tips for Nursing Staff
Nurses play a key role in the early identification and treatment of sepsis, assessing the resident and reporting to the physician or nonphysician practitioner (NPP), as well as potentially managing residents with sepsis in-house in … - The “Golden Hour” of Admission
For both residents and their loved ones, admission into a post-acute care facility can be an overwhelming experience. In addition to the condition that brought residents to the facility, the transition itself involves changing environment, … - October 2025 MDS Draft Item Sets: The SDOH Should Drive the NAC’s Planning
On Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS version 1.20.1 item sets and item matrix for implementation on Oct. 1, 2025. The change history included with the … - Quality Measure IQ Series: Antipsychotic Medication Measures
Monitoring and reducing the use of antipsychotic medications is a high priority for many nursing facilities. Top concerns are the increased risk of adverse effects for residents taking these medications, the scrutiny of their management … - Residents on Part B Therapy? Provide Beneficiary Notices to Avoid a Financial Hit
Nurse assessment coordinators (NACs) who manage Medicare services typically are at least familiar enough with the beneficiary notice requirements that skilled nursing facilities (SNFs) must meet under fee-for-service (FFS) Medicare Part A to monitor those … - ICD-10-CM: Navigating the Term “With,” Combination Codes, and Complications of Care
Accurate diagnosis coding is critical in nursing facilities (NFs) for care planning, reimbursement, and quality measurement. NF coders must understand ICD-10-CM conventions, general coding guidelines, and chapter-specific coding guidelines that affect how diagnoses are assigned. … - Why Getting MDS Right Is Non-Negotiable: The Importance of MDS Accuracy
Written by Kristine Martinez BSN, RN, RAC-CTA, QCP Completing a Minimum Data Set (MDS) correctly is no small task. With approximately 510 answers or choices on a comprehensive MDS (not including CAA investigation), and approximately530 answers … - Direct-Care Staff Are Front-Line Defenders Against Sepsis: What They Need to Know
Since the COVID-19 pandemic began in 2020, the risk of developing sepsis has increased nationwide, according to the September 2024 report An Assessment of Sepsis in the United States and Its Burden on Hospital Care … - Emergency Preparedness Plan: How the DNS Can Ensure the Nursing Department Is Ready When Disaster Strikes
Emergency preparedness is a vital component of maintaining safety and ensuring continuity of care in post-acute care settings. Facilities face unique challenges in emergency situations. The vulnerable people they care for, including the elderly and … - Mastering the Discharge Function Score for Skilled Nursing Facilities
By Greg Seiple Discharge planning is an essential component of patient care in skilled nursing facilities. But how do healthcare professionals determine when a resident is ready to leave and manage daily activities independently? Enter … - January Thaw: Get Ready for the QM Unfreeze
Although spring may seem like a mirage right now, it’s time for nurse assessment coordinators (NACs) to prepare for a literal thaw in the Five-Star Quality Rating System. As of January 2025, the Care Compare … - GG0130 and GG0170: Using Clinical Judgment to Establish Usual Performance
The ability to exercise clinical judgment to define usual performance in MDS items GG0130 (Self-Care) and GG0170 (Mobility) offers nursing homes unprecedented opportunity to impact quality measures (QMs), says Rosanna Benbow, RN, CCM, ICC, IP, … - SNF ABN Update: What Changed and How to Keep the Process Running Smoothly
Effective Oct. 31, 2024, skilled nursing facilities (SNFs) now are required to use an updated Skilled Nursing Facility Advance Beneficiary Notice of Noncoverage (SNF ABN), also known as form CMS-10055, and the corresponding revised instructions … - Sepsis Primer: What Is It, and How Does It Tie Into Survey and QMs?Sepsis—a key driver of hospital readmissions—can have negative clinical impacts for residents and negative financial, quality, survey, and even legal impacts for nursing homes. Here is a review of important basics: What is sepsis? The …
- Antibiotic Stewardship: Make Sure New IPs Have an Action Plan
Antimicrobial medications are used to treat infections (and sepsis) caused by bacteria, parasites, viruses, and fungi. Antimicrobial resistance (AR)—when germs conquer the drugs that are supposed to kill them and instead keep growing—occurs naturally. However, … - Opioid Overdose: Are Staff Prepared?
Many residents take opioids to relieve pain, and each of these residents is at risk for overmedication, overdose, or even death. According to the University of California, Los Angeles (UCLA), by 2021, 1 in 370 … - Ethics and Ramifications of Backdating the MDS
Backdating, or placing an earlier date than the actual date on a document, is only permissible in limited Minimum Data Set (MDS) scenarios. Has anyone asked the nurse assessment coordinator (NAC) to change the assessment … - Break the Bad Data Cycle: Keys to Boosting Accuracy in GG0130 and GG0170
MDS items GG0130 (Self-Care) and GG0170 (Mobility) are a common source of headaches for both the nurse assessment coordinator (NAC) and the interdisciplinary team (IDT). While there is no one-size-fits-all approach for obtaining accurate documentation … - Quality Measure IQ Series: All the Vaccine Measures
Vaccination measures play a critical role in long-term care, and the Centers for Medicare & Medicaid Services (CMS) closely monitors vaccination data to ensure the safety of residents and staff. Nineteen different measures for vaccination … - Section GG Strategies: Documentation and Collaboration
Section GG has greatly evolved since 2016. It was first introduced as just a few functional items completed only for Medicare Part A residents, but now it requires 26 functional tasks for all long-term care … - Improving Resident Care Through Effective Communication: The MDS 3.0 Scripted Interview
Effective communication with residents in skilled nursing facilities (SNFs) is essential to understand their needs and preferences. In accordance with Appendix D of the Long-Term Care Facility Resident Assessment 3.0 User’s Manual (RAI User’s Manual) … - Stop Assuming and Start Assessing: How to Improve Critical Thinking in Nurses
Identifying and dealing with a suspected change in condition before a clinical crisis occurs is a critical aspect of caring for fragile, elderly nursing home residents. To achieve that goal, nursing staff must think critically … - Early Lessons: How Onboarding and Retention Specialists May Boost Staffing
Over the last decade, a strong orientation and onboarding process has been linked to higher levels of knowledge, critical thinking skills, and job satisfaction among nursing staff—leading to lower staff turnover and improved retention. Conversely, … - Preparing for Respiratory Virus Season
Fall is here, and respiratory virus season is around the corner. Nursing leaders must take proactive steps to protect residents from these viruses, which carry the potential for serious illness and can lead to hospitalization. … - PPS Discharge Assessment: 10 Steps to a More Complete, Accurate MDS
The Medicare Part A PPS Discharge assessment (i.e., the NPE item set) is now a crucial assessment with far-reaching impacts for skilled nursing facilities (SNFs) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP), … - GG Goals: Not Really Gone
Effective Oct. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) removed column 2, discharge goals, from items GG0130 and GG0170 on the Minimum Data Set (MDS). Many nurse assessment coordinators will welcome the … - I0020B: Avoid Common Sources of Confusion When Coding This MDS Item
The ICD-10-CM code captured in MDS item I0020B (ICD-10 Code/Primary Medical Condition Category) is the foundation of case-mix classification for the Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) payment components in the … - Updates to ICD-10-CM Coding Guidelines: Key Revisions and Their Implications
The International Classification of Diseases, Clinical Modification, 10th revision (ICD-10-CM), coding system is an essential tool needed to document and bill accurately for healthcare services in the long-term care (LTC) setting. Annual updates to both … - Nursing Orientation and Onboarding Done Right Can Boost Retention
Working as a nurse in a nursing home can be overwhelming, especially if the director of nursing services (DNS) and executive leadership expect nurses to learn on the job and fail to set up a … - Steps to a Strong Discharge Process
The facility has a high number of discharges to the community every month, and the director of nursing services (DNS) feels the discharge process is a good one, as she has received no complaints from … - F677: How to De-Risk ADL Care for Dependent Residents
Providing residents with the appropriate level of assistance in the activities of daily living (ADLs) is foundational to care in nursing homes, yet the ADLs consistently remain a common citation risk in the survey process. … - Skilled Teaching and Training: Benefit From the Care Team’s Expertise
Like care plan management and evaluation and observation and assessment of a resident’s condition, teaching and training activities are a core nonskilled component of resident care that can rise to the level of a skilled … - Quality Measure IQ Series: Discharge Function Score Measure
The newest section GG Quality Measure (QM), the Discharge Function Score, has left many nurse assessment coordinators (NACs) with more questions than answers about how it is calculated. This measure estimates the percentage of Medicare … - FY 2025 SNF PPS Final Rule: SNF QRP Adds Third Way to Trigger 2% APU Cut
The Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule, released on July 31, 2024, and scheduled for publication on Aug. 6, 2024, largely finalized “as-is” the FY 2025 SNF … - Navigating the Role: Essential Training for New Nurse Assessment Coordinators
Navigating the multifaceted role of the nurse assessment coordinator (NAC) can be daunting, especially for those new to the position. Whether titled NAC, MDS coordinator, Medicare case manager, or another variant, the responsibilities are both … - Staff Work Schedules: It’s Time to Get Flexible—and Realistic—to Improve Retention
Flexible scheduling, which allows staff members to opt for shorter shifts, longer shifts, add-on shifts, and other staffing flexibilities, can be a strong tool for both recruitment and retention in long-term care, says Jasmine Travers, … - Staff Performance: When Expectations Don’t Match Reality
To implement the minimum nurse staffing standards for registered nurses (RNs) and nurse aides (NAs) and the increased on-site RN requirement in the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment … - Substance Use Disorders: What the DNS Should Know
Over 1 million people aged 65 and over live with substance use disorders (SUD) (Alliance for Aging Research, 2022). As with most trends, what is prevalent in the community will also be prevalent in nursing … - Preferences and Routines: Use Section F to Collaborate on the Care Plan
The Resident Assessment Instrument (RAI) process begins with the Minimum Data Set (MDS) assessment and ends with the resident-centered comprehensive care plan. In the MDS, section F focuses on the resident’s preferences for customary routines … - Skilled Observation and Assessment Hinges on a Reasonable Probability of Complication
Direct skilled services under Medicare Part A often are easy to identify because these services involve specific, complex caregiver-to-resident actions. Their “inherent complexity” means that they can “be performed safely and/or effectively only by or … - Care Plan Management and Evaluation Can Be a Skilled Service for At-Risk Residents
The development, management, and evaluation of the resident care plan is the OBRA backbone of the Resident Assessment Instrument (RAI) process for all residents regardless of payer source, so it may surprise some nurse assessment … - How to Use the ICD-10-CM Coding Manual
Since the start of the Patient-Driven Payment Model (PDPM) in October 2019, the International Classifications of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) has been thrust into the forefront of daily tasks for the nurse assessment … - Burnout, Compassion Fatigue, and Moral Injury: Keys to Prevention and Mitigation
Protecting and supporting the nursing home workforce is not optional—it is the daily work of managers and leaders, says Patricia McGaffigan, RN, MS, CPPS, senior advisor for safety at the Institute for Healthcare Improvement (IHI), president … - F689 Accident Survey Citations: What’s Behind These Immediate Jeopardies?
F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the No. 1 tag cited at the immediate jeopardy (IJ) level in 2023—and remains at the top halfway into 2024, according to QCOR data accessed on June 30, … - Taking the Mystery out of the Facility Assessment
Everyone loves a good mystery. Many like to watch their favorite mysteries on television or read a good thriller. However, mystery and suspense should not be a part of the facility assessment review. The final … - Individualized Care Plan: Made to Order
Think about individualization like the almost endless variations of coffee drinks available these days. With an extra pump of this or a drizzle of that, we enjoy endless ways to individualize our order. Beyond coffee, … - PPS Discharge Assessment: Why Is It More Important Than Ever?
Nurse assessment coordinators (NACs) will soon begin preparing the interdisciplinary team for the finalized MDS 3.0 version 1.19.1 item set changes, as well as the revised coding instructions in the yet-to-be-finalized Long-Term Care Facility Resident … - A Closer Look at the Medicare Part A Presumption of Coverage
Skilled nursing facility (SNF) staff must understand the intricate guidelines that regulate Medicare Part A coverage for SNF stays. Several technical requirements must be met before a resident qualifies for a Medicare Part A SNF … - Part A Basics: 30-Day Transfers and the Medical Appropriateness Exception
The 30-day transfer rule and its medical appropriateness exception typically don’t come up on a daily basis in skilled nursing facilities (SNFs), yet these requirements—and flexibilities—are a key component of the fee-for-service Medicare Part A … - Dementia Care: Keys to Implementing Technologies Effectively and Responsibly
Using technologies to engage residents with dementia is becoming increasingly common in nursing homes across the country. Local news shows are peppered with segments on facilities using dancing robots, robotic cats, and other technologies that … - Fall Prevention and Management: How the Consultant Pharmacist Can Add Value
F-tag 689 (Free of Accident Hazards/Supervision/Devices) was the top immediate jeopardy (IJ) citation nationwide—and the second most-frequent citation overall—in calendar year (CY) 2023, and that citation pattern is being maintained so far in CY 2024, … - Beyond Physical Function: Psychosocial Needs of Residents Post-Stroke
Stroke is a common issue among residents in long-term care facilities. When caring for this population, staff often focus on physical issues, yet post-stroke residents often have emotional or behavioral changes as well. It is … - Draft RAI User’s Manual v1.19.1 Study Guide: Key Changes to Review
What the MDS will look like effective Oct. 1, 2024, is beginning to take shape for nurse assessment coordinators (NACs) and the rest of the interdisciplinary team (IDT). Following up on the May 17, 2024, … - Late or Missed PPS 5-Day Assessments: Know the Consequences and How to Avoid Them
Many new nurse assessment coordinators (NACs)—and even some experienced ones—don’t understand what counts as a late MDS assessment, what counts as a missed MDS assessment, or what the financial ramifications are for late vs. missed … - Quality Measure IQ Series: Long-Stay Falls Measures
Someone with an intelligence quotient (IQ) of 130 may be considered above average for intelligence but still not understand the complexities of the MDS 3.0 Quality Measures (QMs). This series of articles on QMs will … - PDPM Clinically Complex Nursing Qualifiers: Coding and Documentation Refresher
The Patient-Driven Payment Model (PDPM) includes four ways for a resident to classify into the Clinically Complex category of the Nursing payment component. If a resident has conditions or is receiving services that qualify for … - Tricky NAC Issues Even Some Experts Miss
Nurse assessment coordinators (NACs) definitely experience variety in their jobs, to state the obvious. Management and completion of the Minimum Data Set/Resident Assessment Instrument (MDS/RAI) process, Medicare management, and ICD-10-CM coding are just a few … - Physician Services: How to Level Up From F-Tag Compliance to Better Quality of Care
In calendar year 2023, F712 (Physician Visits – Frequency/Timeliness/Alternate Nonphysician Practitioners (NPPs)) was the most frequently cited F-tag among the six physician services citations—and only 0.8 percent of nursing homes received that citation, according to … - Improving Resident Outcomes Through Collaboration
Improving resident outcomes is a top priority for nursing home teams. Outcomes, good or bad, not only affect the residents and their families but also influence the facility’s Quality Measures (QMs), Five-Star ratings, and regulatory … - Seven Ways NACs Can Be Proactive With New Medicare Advantage Plan Rules
A skilled nursing facility (SNF) accepts a resident in a Medicare Advantage plan for admission after the plan provides a prior authorization. The resident receives skilled services for the allotted amount of time, and the … - SNF QRP: Where Is It? Where Is It Going?
Skilled nursing facilities (SNFs) today must manage more than 40 Quality Measures (QMs) from several different programs: the Minimum Data Set (MDS) 3.0 QMs, Five-Star Quality Rating System, SNF Value-Based Purchasing (VBP) program, and SNF … - CMS Minimum Staffing Final Rule: Staffing Mandates Only Set the BaselineThe Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting final rule adopts the Centers for Medicare & Medicaid Services’ (CMS) proposed three-pronged, comprehensive staffing approach for Medicare- and Medicaid-certified …
- How to Hire the Best NP—Even if Someone Else Is Doing the Hiring
The director of nursing services (DNS) in a nursing home often is presented with a newly hired nurse practitioner (NP) or other advanced practice registered nurse (APRN) as a fait accompli (i.e., a done deal), … - Working With NPs and Other APRNs: Learn to Maximize the Benefits
Increasingly, nurse practitioners (NPs) and clinical nurse specialists (CNSs), also known as advanced practice registered nurses (APRNs), work either directly for or closely with nursing homes to improve resident care outcomes—as do physician assistants (PAs). … - Mock Drills for Abuse Situations
A resident-to-resident incident occurred on the dementia unit, resulting in an injury to one resident. The altercation surprised the staff, so their response to the situation was not immediate. Additionally, when they intervened, they did … - Navigating B0700 and MDS Interviews
It’s the “Which came first, the chicken or the egg?” question of the Minimum Data Set (MDS) world: Which do you assess first, B0700 or the MDS scripted interviews? It’s easy to get lost in … - Isolation Coding on the MDS: MAC Target Drives Home Documentation Needs
Almost all nursing homes are currently staffing-challenged, and that has a direct impact on the quality of the documentation available to support MDS coding, points out Brenda Sowash, RN, RAC-CT, director of clinical assessments, standards, … - Medication Indication of Use: The Big Why
Nurses use a common problem-solving technique in root-cause analysis called the “Five Whys.” This method asks “why?” as many times as needed to determine the root cause of the problem. Sometimes this process requires more … - 4 Key Purposes of the Care Area Assessment Process
The care area assessments (CAAs) are a vital part of the Resident Assessment Instrument (RAI) process to develop a plan for individualized resident care. Taking shortcuts with the CAA process can result in generic care …