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), the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, the Five-Star Quality Rating System, and …
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 Patient-Driven Payment Model (PDPM) under the fee-for-service Medicare Part A skilled nursing facility prospective payment …
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 comprehensive program that includes adequate orientation (short-term training and support) and onboarding (longer-term training and …
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. From 2021 to summer 2024, F677 (ADL Care Provided for Dependent Residents) is the eighth most-cited F-tag …
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 service. Another way that these indirect skilled services are alike is that they historically haven’t …
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, PhD, MHS, RN, AGPCNP-BC, assistant professor at the New York University Rory Meyers College of …
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 Transparency Reporting final rule starting as early as May 2026 on some requirements for urban …
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 under the general supervision of skilled nursing or skilled rehabilitation personnel,” explains the Centers for …
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 coordinators (NACs) and directors of nursing (DNSs) to learn that care plan management and evaluation …
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, 2024. In many ways, F689 is a catch-all tag, says Angie Szumlinski, LNHA, RN, GERO-BC, …
