The Keys to Develop a Past Noncompliance Plan

The director of nursing services (DNS) received a call in the middle of the night that a resident with a diagnosis of dementia had eloped, and it appeared she had been missing for several hours—a conversation no DNS wants to have. She immediately enacted the missing resident protocol. Luckily, staff …

MDS 3.0 QM User’s Manual V17.0 and Risk Adjustment Appendix

The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual Version (V)17.0 is now available. The MDS 3.0 QM User’s Manual V17.0 contains detailed specifications for the MDS 3.0 QMs and includes a Notable Changes section that summarizes the major changes from MDS 3.0 QM User’s Manual V16.0. Changes …

NOMNC and DENC: New Forms Must Be Used Starting Jan. 1, 2025; Different Start Date for DENC Only for Medicare Advantage

FFS & MA NOMNC/DENC What’s New 11/18/2024: New NOMNC and DENC for Original Medicare and Medicare Advantage  The Office of Management and Budget (OMB) has approved a revised Notice of Medicare Non-Coverage (NOMNC / CMS-10123) and Detailed Explanation of Non-Coverage (DENC / CMS-10124). Please note the updated NOMNC and DENC …

Why Getting MDS Right Is Non-Negotiable: The Importance of MDS Accuracy

Written by Kristine Martinez BSN, RN, RAC-CTA, QCP Completing a Minimum Data Set (MDS) correctly is no small task. With approximately 510 answers or choices on a comprehensive MDS (not including CAA investigation), and approximately530 answers or choices on a 5-day MDS, the potential for missed or miscoded information on any …

OIG: Nursing Facility Industry Segment-Specific Compliance Program Guidance

From https://oig.hhs.gov/compliance/nursing-facility-icpg/ The Nursing Facility ICPG—together with OIG’s General Compliance Program Guidance (GCPG) that applies to all individuals and entities involved in the health care industry—serves as OIG’s updated and centralized source of voluntary compliance program guidance for nursing facilities. Nursing facilities can use the ICPG to help identify their own risks and …

Sepsis Primer: What Is It, and How Does It Tie Into Survey and QMs?

Sepsis—a key driver of hospital readmissions—can have negative clinical impacts for residents and negative financial, quality, survey, and even legal impacts for nursing homes. Here is a review of important basics: What is sepsis? The current clinical definition of sepsis is “life-threatening organ dysfunction caused by a dysregulated host response …

Diabetes Management in Post-Acute and Long-Term Care: JAMDA Clinical Practice Guideline

The newly revised Clinical Practice Guideline for Diabetes Management in the Post-Acute and Long-Term Care (PALTC) Setting provides (1) new information on overall goals in diabetes care, (2) detailed information on how to use and manage medication alternatives , and (3) information on the roles of interdisciplinary team members in …

CMS Revises QSO Memo re: Updates to Care Compare Staffing and Quality Measures

REVISED: Updates to Nursing Home Care Compare Staffing and Quality Measures Memo # QSO-25-01-NH REVISIONS TO QSO-23-21-NH, ORIGINALLY RELEASED ON September 20, 2023. • Adjustment to Staffing and Quality Measures: CMS will update the staffing level case-mix adjustment methodology and replace some of the Quality Measures (QMs) used on Nursing …

CMS QSO Memo: Nursing Home Residents’ Right to Vote

Compliance with Residents’ Rights Requirement related to Nursing Home Residents’ Right to Vote Memo #QSO-24-21-NH Posting Date 2024-09-26 Fiscal Year 2024 Memorandum Summary• The Centers for Medicare & Medicaid Services (CMS) is affirming the regulatory expectation that ensures nursing home residents have the unimpeded ability to exercise their right to …

CDC NHSN Long-term Care Facility Component (LTCF): Updated Resources

The National Healthcare Safety Network (NHSN) Long-Term Care Facility Component Manual Tracking Healthcare-Associated Infections (HAIs) in Long-term Care Facilities The National Healthcare Safety Network (NHSN) Manual 2025 COVID-19 VACCINATION PROTOCOL Weekly COVID-19 Vaccination Module for Healthcare Personnel The National Healthcare Safety Network (NHSN) Manual 2025 Healthcare Personnel Vaccination Module Protocol: …