Q&A: Are we responsible for dental appointments (toothache) on our Medicare Part A residents or does the dentist bill the family?

Question: Are we responsible for dental appointments (toothache) on our Medicare Part A residents or does the dentist bill the family? Answer: Dental coverage is not part of the Medicare Part A program, so the cost is also not the facility’s responsibility. In other words, there is no dental money …

Q&A: How should diagnoses be listed on the UB-04 claim?

Question: I understand that the diagnosis in I0020B should be listed as the principal diagnosis on the UB-04 claim; however, should the remaining diagnoses be listed in order according to the main reasons the resident is skilled how we list the codes in I8000, to include the codes that are …

Policy and Procedure Review and Development Guide Tool

Policies and procedures are essential to the operation of your organization because they provide written structure and clarity for employees and inform all staff of the expectations for how to go about the work they do. Survey agencies review a facility’s policies and procedures as part of their investigation to …

Q&A: When residents pass away at the facility and do not have a funeral home listed, how long (hours) are we able to keep the body?

Question: This situation seems to be happening at my facility more and more. When residents pass away at the facility and do not have a funeral home listed, how long (hours) are we able to keep the body? I have family members who seem to think that they can call …

Comprehensive Person-Centered Care Plan Audit Tool and Care Planning Cheat Sheet

The care plan should reflect a resident’s goals for health and wellness, and what the clinical team is doing to help the resident achieve those goals. AAPACN’s §483.21 Comprehensive Person-Centered Care Planning Cheat Sheet provides the DNS with an overview of the required components of the care plan, including the …

PDPM Case-Mix Group Conversion to HIPPS Characters Tool

The nurse assessment coordinator and team members can easily convert the case-mix groups achieved under the Patient-Driven Payment Model (PDPM) to the five-digit Medicare billing code by using the PDPM Case-Mix Group Conversion to HIPPS Characters tool.   For permission to use or reproduce this tool in full or in …

Staying Alert for Acute Conditions – Nursing Assistant In-service Education

Participants will learn to describe reasons nursing home residents are at risk for acute conditions, list symptoms and changes in vital signs, physical function, mental function, and body condition that could indicate acute conditions, identify ways to report a change in resident condition to the nurse, and discuss the CNA’s …