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 …
Antimicrobial medications are used to treat infections (and sepsis) caused by bacteria, parasites, viruses, and fungi. Antimicrobial resistance (AR)—when germs conquer the drugs that are supposed to kill them and instead keep growing—occurs naturally. However, exposure to antibiotics and other antimicrobial drugs builds resistance mechanisms in germs, speeding up the …
Many residents take opioids to relieve pain, and each of these residents is at risk for overmedication, overdose, or even death. According to the University of California, Los Angeles (UCLA), by 2021, 1 in 370 senior deaths stemmed from overdoses. Seventy-five percent of senior overdose deaths involved opioids, and this …
Backdating, or placing an earlier date than the actual date on a document, is only permissible in limited Minimum Data Set (MDS) scenarios. Has anyone asked the nurse assessment coordinator (NAC) to change the assessment reference date (ARD) of a 5-Day prospective payment system (PPS) assessment after day 8? Is …
MDS items GG0130 (Self-Care) and GG0170 (Mobility) are a common source of headaches for both the nurse assessment coordinator (NAC) and the interdisciplinary team (IDT). While there is no one-size-fits-all approach for obtaining accurate documentation to support functional status coding, there are steps that the NAC can take in conjunction …
Section GG has greatly evolved since 2016. It was first introduced as just a few functional items completed only for Medicare Part A residents, but now it requires 26 functional tasks for all long-term care residents. The accuracy of section GG not only impacts reimbursement but also plays a fundamental …
Effective communication with residents in skilled nursing facilities (SNFs) is essential to understand their needs and preferences. In accordance with Appendix D of the Long-Term Care Facility Resident Assessment 3.0 User’s Manual (RAI User’s Manual) and the principles outlined in the Center for Medicare & Medicaid Services (CMS) Video on …
Identifying and dealing with a suspected change in condition before a clinical crisis occurs is a critical aspect of caring for fragile, elderly nursing home residents. To achieve that goal, nursing staff must think critically about the residents in their care. The director of nursing services (DNS) can take steps …
Over the last decade, a strong orientation and onboarding process has been linked to higher levels of knowledge, critical thinking skills, and job satisfaction among nursing staff—leading to lower staff turnover and improved retention. Conversely, an inadequate onboarding process can quickly turn new hires into former employees, forcing providers to …
Fall is here, and respiratory virus season is around the corner. Nursing leaders must take proactive steps to protect residents from these viruses, which carry the potential for serious illness and can lead to hospitalization. This article will spotlight areas to focus on for respiratory virus prevention and control, as …
