How to Utilize Your Staff to Mentor and Fill Gaps in the MDS Department

Leadership and Management / MDS 3.0 and the RAI Process / NAC / Podcast

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN is joined by AAPACN Master Teacher and Board Member, Maureen McCarthy, RN, BS RAC-MT, QCP-MT, DNS-MT, RAC-MTA to discuss how leadership can often find potential nurse assessment coordinators (NACs) among …

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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: 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 …

TIP: CMS Will Begin Posting Staffing Data on the Care Compare Website

NAC / QAPI and Quality Initiatives / Tip

Weekend Staffing: The level of total nurse and registered nurse (RN) staffing on weekends provided by each nursing home over a quarter. Staff Turnover: The percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period. This information will be added to …

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 …

SNF VBP and SNF QRP MUC List Includes VBP Nursing Hours Measure (12/21)

Billing and Reimbursement / DNS / NAC / Post-Acute Care News / QAPI and Quality Initiatives

The annual Measures Under Consideration (MUC) List from CMS includes four SNF VBP measures and two SNF QRP measures. 2021 MUC List (PDF) from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Pre-Rulemaking See Appendix A for measure specifications. MUC ID Measure Title Description Measure Type Measure Steward CMS Program(s) MUC2021 -095 CoreQ: Short Stay Discharge Measure The …

PHQ-9 Monitoring Can Help Counter Mood/Depression Issues in Residents

Article / MDS 3.0 and the RAI Process / NAC

Depression and other mood disorders historically have been a significant risk for nursing home residents. “In 2011 and 2012, the percentage of users of long-term care services with a diagnosis of depression was highest in nursing homes (49 percent),” says the Centers for Disease Control and Prevention (CDC) in QuickStats: …

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 …