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 assessment coordinators (NACs). The first two articles were “RAI Manual v1.18.11 Surprises: Section M and …

Infusion Therapy: Solve These Clinical and Documentation Issues to Provide Better Care

Infusion 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 calorie requirements and provides at least 501 milliliters of fluid per day” as two of …

RAI Manual v1.18.11 Surprises: Standout Issues in Sections D and K

Note: 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 assessment coordinators (NACs). The first article was RAI Manual v1.18.11 Surprises: Section M and N …

F609 Abuse/Crime Reporting Obligations: Keys to Success

Nursing 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 & Aronoff in Columbus, OH. “This risk is more than just regulatory. There may be …

RAI Manual v1.18.11 Surprises: Section M and N Updates Include Course Corrections

Note: 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 assessment coordinators (NACs). Even seemingly small changes to the draft RAI User’s Manual coding instructions …

OSA Crash Course: Keys to Navigating this Medicaid-Only Payment Assessment

In 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 items, such as section G (Functional Status), “going away,” suggests Scott Heichel, RN, RAC-MT, RAC-CTA, …

CMS QSO Memo: Posting of Nursing Home Ownership/Operatorship Affiliation Data on Nursing Home Care Compare and data.cms.gov

Memo # QSO-23-18-NH Posting Date 2023-06-28 Fiscal Year 2023 Memorandum Summary • Posting Nursing Home Affiliation on Nursing Home Care Compare: CMS will include ownership and operatorship affiliation information on our Nursing Home Care Compare website. • Posting Aggregate Nursing Home Performance Data on data.cms.gov: CMS will publish combined inspection, …

Medicare Managed Care Basics: Critical Intel for the DNS

Data 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 Foundation report. Additional CMS data released in June 2023 indicates that although the number of …

Restorative Nursing Payment and Documentation Issues: Keys to Success

Restorative 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 Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC, director of education for Hansen, Hunter & Co. …

Did COVID-19 Slow Down Restorative Nursing? Learn How to Jumpstart the Program

Restorative 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. “Dedicated restorative nursing assistants (RNAs) and restorative nurses were often the first staff members to …