CAA & Care Plans

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Nov 04 2021
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Section F Drives Better Quality Care

Section F is critical to creating a patient-centered care plan. The RAI Manual states, “A lack of attention to lifestyle preferences can contribute to depressed mood and increased behavior symptoms.”  However, are we utilizing the interview for daily and activity preferences appropriately to ensure that we reduce depression and behavior symptoms? Remember that behavior does directly corelate with two quality measures: Percentage of long-stay residents who have symptoms of depression....
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Jul 22 2021
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Can I interrupt? Understanding the Interrupted Stay Policy

According to the RAI Manual, chapter 6: "The interruption window is a 3-day period, starting with the calendar day of Part A discharge and including the two immediately following calendar days, ending at midnight. In other words, the resident must return to the same SNF by 11:59 p.m. at the end of the third calendar day. The interruption window begins on the first non-covered day following a Part A-covered stay and ends at 11:59 p.m. on the third consecutive non-covered day following a Part...
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May 30 2021
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SNF QRP Changes are Coming

The Proposed Rule for Fiscal Year (FY) 2022 for the Skilled Nursing Facility Prospective Payment System was released early April 2021. Now that providers have had a chance to digest the proposed SNF payment updates and the PDPM parity adjustment, attention turns to the quality initiatives that have been updated. Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. (difference of NE-NF and NA-NB). The SNF QRP quality initiative is a pay-for-reporting program. SNFs...
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Jan 24 2019
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7 Baseline Care Plan Myths

By Caralyn Davis | Jan. 24, 2018 | Excerpted from: AANAC Baseline care plans have been required since late November 2017, but nurse assessment coordinators (NACs) and other interdisciplinary team (IDT) members are still navigating through a lot of misinformation to learn the rules of the road for F655 (Baseline Care Plans) as detailed in Appendix PP of the State Operations Manual. Here are seven common myths that need to be vanquished: Myth: The resident needs to sign the baseline care plan...
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Apr 01 2024

Section GG Documentation – Questions Still Abound

Section GG remains a popular discussion topic among the Nurse Assessment Coordinator (NAC) and other members of the interdisciplinary team (IDT). Many have questioned their own practices and processes, designed to support coding this section of the...
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Mar 01 2024

Social Determinants of Health (SDOH) – A Global Initiative Important to Skilled Nursing Providers

The Centers for Medicare & Medicaid Services’ (CMS) Office of Mental Health report CMS Framework for Health Equity 2022 and 2032 states that health equity is defined by the attainment of the highest level of health for all people, where...
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Feb 01 2024

Trauma and the MDS – A Sneak Peak

Trauma informed care has become an area of focus for Post Acute Care providers and survey agencies. Organizations are required to provide trauma-informed care that meets “professional standards of practice and accounting for residents’ experiences...
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Jan 01 2024

New Year….Same MDS Obstacle Course

As we ring in 2024, long term care professionals are still struggling to implement the October 2023 updates to the MDS. CMS is already talking about more changes in 2024, and the anticipation continues to create anxiety amongst PAC members. While...
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Dec 01 2023

Schizophrenia Diagnosis Audits

On January 18th, 2023, CMS announced they will be conducting off-site audits in nursing homes for assessment accuracy and coding of residents with a diagnosis of Schizophrenia. Along with auditing for appropriate diagnosis, the audits will review...
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Nov 01 2023

OSA or PDPM? A State-Level Decision

As of Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) has retired the A0300 Optional State Assessment (OSA) from the federally required MDS 3.0 v1.18.11 that is submitted by nursing facilities. The OSA is now a separate...
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Oct 02 2023

The Physician and “I”

The physician’s role in the nursing facility is essential to delivering skilled, quality care for Skilled and Long-Term Care residents. Physicians are our lead in providing clinical decision making and properly defining, clarifying, and verifying...
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Oct 01 2023

Coding UTIs on the MDS 3.0

Urinary Tract Infections (UTIs) are a commonly miscoded data element on the MDS. Are you over coding UTIs? Are you not coding them at all? Should you? Shouldn’t you? The MDS has historically left data collectors asking themselves these questions....
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Oct 01 2023
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Achieving Accurate ADLs with the OSA

Section G of the MDS 3.0 was retired October 1, 2023, yet the MDS nurse may still need to use the knowledge of accurately coding ADLs with an assessment called the Optional State Assessment (OSA).  State-Optioned OSA Although the option to choose...
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Jul 05 2023

What Is an MDS Coordinator?

It’s a bit odd that when asked what you do for a living most MDS coordinators struggle to come up with an answer. Who struggles to explain what they do every day? The reality is that MDS Coordinators fully understand what this multifaceted job...
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May 13 2023
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MDS 2023 Countdown Wrap-Up

This post is part of the MDS 2023 Countdown series.  Disclaimer: Current as of May 13, 2023.   What You Can Expect to See CMS released the first MDS draft item set (v1.18.11) in September 2022, which generated many questions for the long-term...
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May 13 2023
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Rx Reconciliation – New SNF QRP and QMs

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See The reconciled medication list will have a new documentation requirement that will go into effect with the October 1, 2023...
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May 13 2023
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Away with Q0300 and in with Q0310 – New Section Q Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of May 13, 2023 What You Can Expect to See This new Section Q update presents a key change to the wording: GOAL vs expectation. The Cambridge American Dictionary defines...
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Apr 08 2023
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Updated Entered From and Discharge Status options

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 Section A1800 "Entered From" and A2100 "Discharged Status" have Changed One of the changes you will see when coding section A of the MDS this October 1,...
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Apr 01 2023
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Transportation – New Item A1250

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See An additional item we will see in the upcoming MDS 3.0 v.1.18.11 in October 2023 is A1250 - Transportation. This is included...
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Mar 24 2023
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New 3-day Lookbacks | Assessment Periods

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of March 24, 2023 What You Can Expect to See New 3-day lookback/assessment periods are coming to the MDS world. There are different sections of the MDS that the Nurse...
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Feb 22 2023
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New Pain Interview in Section J

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 22, 2023 What You Can Expect to See The most noticeable changes to Section J are evident in the pain interview, specifically questions J0510, J0520 and J0530....
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Feb 15 2023
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Section B – Hearing, Speech and Vision Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section B on the MDS is a component of the Standardized Patient Assessment Data Elements (SPADEs), which is utilized across...
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Feb 07 2023
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Race and Ethnicity – Changes in Section A

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section A, Identification Information for Race/Ethnicity has expanded. One of the major changes is the deletion of section...
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Dec 23 2022
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The New Section N: Use and Indication of High-risk Drug Classes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 23, 2022 WHAT YOU CAN EXPECT TO SEE We will see changes in Section N of the MDS 3.0 effective on October 1, 2023.  Section N0410 (Medications Received) has been...
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Dec 16 2022
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Where did Physician Examinations and Orders Go?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 16, 2023 WHAT YOU CAN EXPECT TO SEE CMS does not require the completion of the physician examinations and orders, but they remain a requirement for some states...
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Dec 09 2022
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What’s New in Section O – Special Treatments, Procedures, Programs?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 9, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section O? When you first look at the draft of section O item O0110 special treatments, procedures, and...
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Dec 02 2022
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What to Expect in Section GG

  This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 2, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section GG? One of the major changes is the deletion of section G (Functional Status). What does...
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Nov 25 2022
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The New and Improved Section D

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of November 25, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section D? Many of us may have skipped over some changes in our rush to see what happened to section...
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Nov 18 2022
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Section G is Missing

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 7, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section G? MDS 3.0 changes for October 2023 removed section G completely. This leaves many questions...
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Nov 04 2022
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Pillars of Care

Reviewing the Behavioral Health Pillars The US Department of Health and Human Services (HHS) developed a roadmap for behavioral health integration to address a national mental health crisis.  The current Administration's strategy is based on three...
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Oct 07 2022
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MDS surprises fill new draft

Joe Bush | Oct 7, 2022 | Excerpted from McKnights Long-term care facilities, staff and more than half the states should prepare immediately for changes to the Minimum Data Set, experts said in early September. The Centers for Medicare &...
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Oct 04 2022

Section I and Schizophrenia

Changes to Section I and Schizophrenia In July 2022, CMS released an erratum to the RAI (Resident Assessment Instrument) Manual that included more detailed guidance on the use of diagnoses for section I, including the schizophrenia diagnoses that...
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Sep 07 2022

Achieving Accurate ADL’s

Achieving Accurate ADLs The MDS nurse faces challenges when ADL documentation is sparse or even conflicting.  Everyone wants accurate ADL’s, but how often do we fall short?  How have pandemic staffing issues affected ADL accuracy? The “Rule of...
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Sep 07 2022
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MDS draft sends sector, states scrambling to assess effects

Joe Bush | Sept 7, 2022 | McKnights Long-term care facilities, staff and more than half the states in the US should start preparing immediately for extensive changes to the Minimum Data Set, resident assessment experts said this week. The Centers...
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