O0100: Learn Potential Coding Issues With This High-Impact MDS Item

MDS item O0100 (Special Treatments, Procedures, and Programs) has 12 sections with two columns (24 total subitems) that identify specific services the resident received either while not a resident (column 1) or while a resident (column 2) during the 14-day lookback period. These O0100 items play a significant role in two …

COVID-19 Discharges: Keys to Preventing Hospital Readmissions

While data on hospital readmissions of skilled nursing facility (SNF) residents who have had COVID-19 following SNF discharge currently remains scarce, at least one study indicates the need for careful management of the discharge planning process for these residents. Discharge to a SNF from the acute-care hospital, age greater than …

The NTA Component of PDPM: Best Practices for Accurate Scoring

Skilled nursing facilities now have more than a year of experience with the Patient-Driven Payment Model (PDPM), the updated case-mix classification system used in the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) that includes five case-mix-adjusted payment components: physical therapy (PT), occupational therapy (OT), speech-language pathology …

Don’t Delay Using Health Literacy in Your Care Planning and Discharge Planning Process

Mrs. Elderberry is ready to go home. It’s been five long weeks of rehabilitation following a broken hip from that clumsy slip on a rug. Home. She’s wondering if her son actually watered her house plants that she proudly kept vibrant for years. Home. The nurse called her attention back …

MDS Section L and Care Planning: Insights From a Speech-Language Pathologist

MDS item L0200 (Dental) often gets limited attention even though it fuels the Dental Care care area assessment (CAA), one of 20 CAAs that can be triggered in response to MDS coding (i.e., care area triggers or CATs) and then must be analyzed by the interdisciplinary team (IDT) to help …

Advance Care Planning: How to Have the Conversation

Editor’s note: This is the third article in a multipart series about advance care planning and how to operationalize an effective program in nursing homes. Find the first article explaining the basics of what it is and why it matters here and the second article explaining how to use advance …

Part A Physician Certs/Recerts: CMS Confirms How to Count Days

To bill under traditional fee-for-service Medicare Part A, skilled nursing facilities (SNFs) must obtain appropriate, timely physician certifications and recertifications of posthospital inpatient extended-care services. The physician cert/recert policy did not change with the implementation of the Patient-Driven Payment Model (PDPM) on October 1, 2019. However, the Centers for Medicare …

3 Simple Ways Nurse Assessment Coordinators (NACs) Can Help Support Staff Retention

By Jessica Kunkler, MA Staff turnover is everyone’s problem, and in facilities across the United States, it’s a big one. One in four  nursing assistants and one in five home health aides report that they are actively looking for another job, according to the Recruitment and Retention Guide For Employers by …

Get Back to Nursing Basics to Determine Skilled Services

With the rush to understand the Patient-Driven Payment Model (PDPM) under the Skilled Nursing Facility Prospective Payment System (SNF PPS), it’s easy to get caught up in meeting the technical criteria for payment—and not pay enough attention to the clinical criteria for meeting a Medicare skilled level of care, says …

Sexual Expression/Intimacy Requires a Person-Centered Approach

The Centers for Medicare & Medicaid Services (CMS) makes clear that nursing homes should have a sexual expression/intimacy program that supports sexually intimate relationships when possible. Specifically, F607 (Develop/Implement Abuse/Neglect, etc. Policies) in Appendix PP of the State Operations Manual states:   The facility must have and implement written policies and procedures to prevent …