Q&A: Where can I find the CMS Quality Safety and Oversight (QSO) memos?

DNS / Q&A / QAPI and Quality Initiatives

Question: Where can I find the CMS Quality Safety and Oversight (QSO) memos? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT AAPACN Curriculum Development Specialist: QSO memos issued from CMS can be found on their webpage. Want to read more Q&As? Visit the AAPACN Connect community, where 15,000+ of …

Q&A: Is a Significant Change in Status Assessment required for a new stage 3 pressure ulcer?

Clinical Care Solutions / MDS 3.0 and the RAI Process / NAC / Q&A

Question: Is a Significant Change in Status Assessment required for a new stage 3 pressure ulcer? Answer from Janine Cortesa RN, BSN: A stage 3 pressure ulcer may signify the need for a Significant Change in Status Assessment (SCSA), but not necessarily. The RAI User’s Manual in chapter 2, states …

Q&A: When a Medicare Part A resident discharges to another SNF and will continue skilled Medicare there, what assessments are required and what is the date used in A2400C?

Billing and Reimbursement / NAC / Q&A

Question: I have a Medicare Part A resident discharging to another SNF and will continue skilled Medicare there. Would I combine the OBRA Discharge with a PPS Part A Discharge assessment?  In A2400, would I put the day she discharged as her Medicare Part A end of stay or would …

Q&A: Where can I find information on the new CMS COVID-19 vaccination requirements?

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

Question: Where can I find information on the new CMS COVID-19 vaccination requirements? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP: CMS has developed a FAQ document regarding the Interim Final Rule that answers a lot of questions regarding the 214-page document that was released on Nov. 4. CMS …

Q&A: A resident discharged to the hospital, return anticipated, but went to a sister facility from the hospital for a few days because we did not have a bed available. Now that he is returning, is a new OBRA Admission assessment required?

DNS / NAC / Q&A

Question: We have a resident who discharged to the hospital (completed an OBRA DC Return-Anticipated). When he was ready to be discharged from the hospital, we did not have a bed available, so he discharged to a sister facility for a few days. We now have a bed available, and …

Q&A: Where can I find resources to help our facility prevent and manage sepsis?

Clinical Care Solutions / DNS / Q&A

Question: Where can I find resources to help our facility prevent and manage sepsis? Answer: TMF, a Quality Improvement Organization, offers a free toolkit called the Sepsis Post-Acute Care Training Toolkit for Nursing Homes. This toolkit educates nursing home staff, residents, and families about the early identification of sepsis in …

Q&A: Would you code a positive nasal swab for MRSA as a multidrug-resistant organism (MDRO) in section I?

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

Question: Would you code a positive nasal swab for MRSA as a multidrug-resistant organism (MDRO) in section I? Answer from Heide Keen, RN, BSN, RAC-CT: Most often, we find that MRSA of nares is colonized and not considered actively infectious, and not being medically treated. It all depends on the …

Q&A: Is there specific guidance regarding staff working in multiple facilities?

DNS / Q&A / Workforce Solutions

Question: Is there specific guidance regarding staff working in multiple facilities? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP: Currently, there are no federal guidelines specific to staff who work in multiple facilities. However, facility leaders should check with their state and local entities as well to see if …

Q&A: How do you determine “while a resident” or “while not a resident” when a resident goes out to the hospital and returns?

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

Question: How do you determine “while a resident” or “while not a resident” when a resident goes out to the hospital and returns? Answer from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The line between “while not a resident” and “while a resident” is basically the Entry Date …

Q&A: Can a resident disenroll in a Medicare Advantage (MA) plan and revert back to Original Medicare when the 3-day qualifying hospital stay was waived for the MA plan?

Billing and Reimbursement / NAC / Q&A

Question: A resident admitted for skilled care under a Medicare Advantage (MA) plan. The plan did not require a 3-day qualifying hospital stay (QHS) and the resident was hospitalized for observation only. The resident has elected to disenroll in the MA plan and revert back to Original Medicare. Is this …