Question: How do you code walking if the resident only walks with therapy staff?

MDS 3.0 and the RAI Process / NAC / Q&A

Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, and Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: If the resident only walked with therapy, then the assessment for usual performance is based on the resident’s usual performance with therapy. The only coding tip that restricts using the walking performance during therapy …

Question: With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury? With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury?

MDS 3.0 and the RAI Process / NAC / Q&A

Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, and Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: Your team will need to assess each individual injury from a fall, using clinical standards of practice and clinical judgement. Your team’s assessment of the injury, its effect on the resident (e.g., neuro checks, …

Question: I am confused by the new section GG guidance for when the activity “is being/will be” routinely performed. What does “will” mean?

MDS 3.0 and the RAI Process / NAC / Q&A

Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, and Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: The term “will” in this coding tip is likely referring to the resident’s goals or preferences. The example in this instruction states “walking might be assessed for a resident who did/does/will use a wheelchair …

Q&A: A resident came to our facility for a short stay with a Stage 4 pressure ulcer. The resident has since exhausted his 100 days of Medicare, became a long-term resident, and still has the Stage 4 pressure ulcer. Will this resident trigger the long-stay pressure ulcer measure?

NAC / Q&A / QAPI and Quality Initiatives

Question: A resident came to our facility for a short stay with a Stage 4 pressure ulcer. The resident has since exhausted his 100 days of Medicare, became a long-term resident, and still has the Stage 4 pressure ulcer. Will this resident trigger the long-stay pressure ulcer measure? Answer from Jessie …

Q&A: When a resident received IV fluids (K0520A) for hydration, but did not have any calories from the fluids, do we code K0710A (Proportion of total calories the resident received through parenteral or tube feeding) as 1. 25% or less?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: When a resident received IV fluids (K0520A) for hydration, but did not have any calories from the fluids, do we code K0710A (Proportion of total calories the resident received through parenteral or tube feeding) as 1. 25% or less? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Correct, …

Q&A: A resident was admitted to our facility on Medicare Part A and passed in facility after only a couple of hours. I had scheduled a 5-Day/Admission for the 7th day before she passed. How do I set up MDS assessments?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident was admitted to our facility on Medicare Part A and passed in facility after only a couple of hours. I had scheduled a 5-Day/Admission for the 7th day before she passed. How do I set up MDS assessments? I know I can’t combine the death in facility …

Q&A: We have a resident that is in our facility for skilled services under Medicare Part A. The family took the resident out for a funeral, and she did not return within 24 hours. Is this a Medicare Part A discharge?

Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC / Q&A

Question: We have a resident that is in our facility for skilled services under Medicare Part A. The family took the resident out for a funeral, and she did not return within 24 hours. Is this a Medicare Part A discharge? Answer from Jeff Taylor: This would not be a …

Q&A: Does an inpatient rehab stay count toward a qualifying hospital stay for Medicare coverage?

Billing and Reimbursement / NAC / Q&A

Question: We have a referral for a resident with Medicare Part A who has been in an inpatient rehab facility (IRF) for six weeks. Is the IRF still considered acute and can qualify for the 3-day qualifying hospital stay (QHS)? Answered by Janine Cortesa RN, BSN: Acute inpatient rehab facilities …

Q&A: Where can I find the latest guidance regarding health care personnel returning to work after COVID-19?

COVID-19 / DNS / Q&A

Question: Where can I find the latest guidance regarding health care personnel returning to work after COVID-19? Answer: The Work Restrictions for HCP Table on the Center for Disease and Prevention’s (CDC) webpage provides information regarding return to work criteria based on both the staff member’s vaccination status and staffing …

Q&A: If hospital documentation supports a diagnosis of hip fracture as the initial encounter, do I need to query the physician for the subsequent encounter diagnosis to be used in the SNF?

Billing and Reimbursement / NAC / Q&A

Question: If a resident had a hospital stay for hip fracture repair, with no complications documented, and the hospital documentation supports a diagnosis of hip fracture as the initial encounter, do I need to query the physician for the subsequent encounter diagnosis to be used in the SNF? Answer: The …