To meet residents’ individualized needs, the director of nursing services (DNS) requires the expertise of many healthcare professionals working collaboratively. For expertise on nutrition, the DNS should collaborate with the registered dietician (RD), who is an invaluable addition to the team for both the residents and the facility. This article …
The Significant Change in Status Assessment (SCSA) has been a federal requirement since the inception of the Resident Assessment Instrument (RAI) process that resulted from the Omnibus Budget Reconciliation Act of 1987. The specifications of how to complete this assessment are described in chapter 2 of the RAI User’s Manual …
Skilled nursing facilities (SNFs) are increasingly subject to skilled medical review audits from both fee-for-service Medicare (e.g., the SNF Five-Claim Probe and Educate initiative) and individual Medicare Advantage plans. Audit success ultimately hinges on documentation quality, but the presence of documentation in the medical record is no guarantee of the …
In May 2023—after the Comprehensive Error Rate Testing (CERT) program determined that skilled nursing facility (SNF) Medicare Part A services have been “a top driver” of the overall Medicare fee-for-service improper payment rate since the switch to the Patient-Driven Payment Model (PDPM) on Oct. 1, 2019—the Centers for Medicare & …
The director of nursing services (DNS) has many issues to prioritize each day, such as resident falls, staffing, and grievances. Unfortunately, the DNS may be tempted to relegate clinical rounds to “later,” considering them a low priority due to time constraints, which can prove to be a costly mistake. Daily …
The Significant Change in Status Assessment (SCSA) was not a major focus of the revisions in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11. However, some of the v1.18.11 MDS coding changes could have an outsized impact on the SCSA process if nurse assessment coordinators (NACs) fail …
In the updated Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, v1.18.11, the Centers for Medicare & Medicaid Services (CMS) added several clarifications to help ease the pressure that nurse assessment coordinators (NACs) experience attempting to code section M accurately. Although strong clinical documentation of these wounds is …
Over the past few years, the Centers for Medicare & Medicaid Services (CMS) has placed increasing emphasis on drug regimen review (DRR) aka medication regimen review (MRR). Since 2018, skilled nursing facilities have captured one type of DRR/MRR in item N2001 (Drug Regimen Review) on PPS 5-Day MDS assessments for …
Admissions are vital to a facility. They may occur daily, or even multiple times a day, and should be a part of routine operations. However, the admission process can be cumbersome, and it is easy for staff to miss things, especially if the facility receives multiple admissions in a shift. …
Now that the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are in play, there are still steps that nurse assessment coordinators can take to ensure that MDS processes are as efficient as possible under the new system. These include the …
