Q&A: Please clarify when a device would or would not be considered a restraint?

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

Question: Can a winged versus a concave mattress be considered a restraint if it fits the definition? Can a tilt and space wheelchair be considered a restraint? It is being explained to me that it is not a restraint. Can someone please clarify when a device would or would not …

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 …

Q&A: Where can I find resources to assist me with increasing COVID-19 vaccine and booster uptake?

COVID-19 / DNS / Q&A / Survey and Regulatory Compliance

There are several great resources for facility leaders to utilize. The Society for Post-Acute and Long-term Care Medicine (AMDA) has several great resources in their COVID-19 Vaccine Education Toolkit.  These resources are free to everyone, however, you will need to register with AMDA to access them. The Centers for Disease …

Q&A: If a mechanically altered diet is being trialed during a speech therapy visit to facilitate oral intake, could K0510C, mechanically altered diet, be coded on the MDS?

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

Question: We are seeking clarification on MDS item K0510C, mechanically altered diet. If a resident is being trialed on a mechanically altered diet or given thickened liquids provided during a speech therapy visit to facilitate oral intake, could K0510C, mechanically altered diet, be coded on the MDS if it was …

Q&A: What are the changes affecting SNFs in the updated blanket waiver that was recently released?

Billing and Reimbursement / COVID-19 / DNS / Q&A

The COVID-19 Emergency Blanket Waivers for Health Care Providers that was updated and released on Nov 29, 2021 adds a new waiver that allows more flexibility in the education and training requirements for individuals serving as Directors of Food and Nutrition Services. Want to read more Q&As? Visit the AAPACN …

Q&A: Has anyone encountered surveyors requesting consents for assist bars/enabler bars used for functional mobility not posing as a restraint per the interdisciplinary team assessment?

MDS 3.0 and the RAI Process / NAC / Q&A / Survey and Regulatory Compliance

Question: Has anyone encountered surveyors requesting consents for assist bars/enabler bars used for functional mobility not posing as a restraint per the interdisciplinary team assessment? Answer by Carol Maher, RN-BC, CPC, RAC-MT : A restraint assessment should be done when there are rails or “assist bars” on the bed. Depending …

Q&A: Is there a waiting period to continue therapy services when a resident transitions from Medicare Part A to Medicare Part B therapy services?

NAC / Q&A / Survey and Regulatory Compliance

Question: Is there a waiting period to continue therapy services when a resident transitions from Medicare Part A to Medicare Part B therapy services? Answer by Kim Steele RN, WCC, RAC-CT, RAC-CTA: There is no waiting period for this transition. However, therapy should complete an evaluation to transition from Medicare …