COVID-19 Effects on Dementia

by | Jan 4, 2022 | MDS Data Elements, Reimbursement

Explore More Posts from MDS Consultants

Known Impact of COVID-19 on Dementia Patients

As we start to shift our attention to the long term effects that this pandemic has had on our residents, a key area of focus is dementia outcomes.  Early on, many quick decisions were made to protect one of our most vulnerable patient populations. Recent studies have found that residents with dementia who contract COVID-19 have a higher risk of behaviors, depression, anxiety, impaired sleep, and worsening cognition long after the infection has cleared. Studies also show that isolation increases health risks for residents with dementia.

COVID-19 screening techniques are less effective for older adults as they do not present with the typical COVID-19 symptoms. Not recognizing a resident who has an active infection is contributing to the spread of COVID-19 in skilled nursing facilities. So far we know that it is the inflammatory and vascular effects of the infection that contribute to this increased risk of long term psychiatric and medical effects.

Do improved isolation policies prevent widespread infections? While CMS and the CDC continue to encourage social distancing policies as a way to minimize the spread of COVID-19 in those with active infections, residents with dementia have suffered adverse outcomes in the setting of isolation. Residents in isolation may be at increased risk for:

  • hypertension
  • cardiac disease
  • cognitive decline
  • dementia/cognitive decline
  • low mood
  • anxiety
  • agitation
  • behaviors
  • increased caregiver burden

For this reason, CMS and CDC have modified visitation policies, recommending that nursing facilities should not restrict the amount of visitors or visitation times.

Use the RAI to Improve Dementia Care

Accurate care planning and utilization of the RAI process is necessary for ensuring that facilities appropriately address all of their resident’s mental and physical health concerns. Accurate coding on the MDS will help you to identify changes in your residents over time. It may be your first clue that something is different and requires a new intervention. Sections that cover diagnoses, behaviors, cognition and mood are particularly helpful in addressing psychiatric concerns. Care area assessments should include a resident’s history of COVID- 19 infection or social isolation and how that is influencing the resident’s presentation.

Addressing behavioral care issues promptly and appropriately in care planning will allow your facility to shine above the rest, leading the way in progressive dementia care.

Care plans should include a plan for accommodating visitors and infection prevention programs to promote socialization and meaningful activities. Studies in dementia have long shown that social interactions and meaningful activities slow the decline of dementia. This will lead to decreased mortality and better outcomes in resident, despite the risks associated with a COVID 19 infection.

For staff, this will prevent complexities in care and burnout. For the facility, this will improve staff retention, improve quality measures, and lead to regulatory excellence.

Additional Resources:

Explore More Posts from MDS Consultants

Reimbursement Concerns

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

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 everyone has a fair and...

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 optional MDS assessment...

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 an OSA from the...

Read more on Toolbox Essentials

Focused Infection Control Surveys and Directed Plan of Correction

It's a dreary Monday morning, and the state surveyors walk into your facility to conduct a Focused Infection Control survey. You and your team have been trying your hardest to comply with infection control procedures throughout the pandemic. At the end of the survey,...

New Advanced Beneficiary Notice

Is your facility using the proper ABN form? The Centers for Medicare & Medicaid Services (CMS) recently updated the Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The new ABN will be mandatory for use on 1/1/2021, but the new form can be...

Covid-19 and Skilled Status

In late June, CMS addressed two issues and posted MDS 3.0 Final Item Sets (V1.17.2).  The two edits were changes to facilitate the calculation of Patient-Driven Payment Model payment codes on OBRA assessments for states that wish to have this calculation performed. ...

Mind Your PHQs

Some skilled nursing facilities (SNFs) are concerned about accurate payment when a resident unexpectedly discharges and the Brief Interview for Mental Status (BIMS) has not yet been completed.However, they should be just as concerned about the PHQ-9. The PHQ-9...

MDS in the Emergency Preparedness Plan

The COVID-19 pandemic has highlighted the need for skilled nursing facilities to have an effective Emergency Preparedness Plan - one that includes sheltering-in-place. The Centers for Medicare and Medicaid Final Rule requires that participating providers have an...

MORE from MDS Experts

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 MDS. CMS states in...

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 everyone has a fair and...

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 and preferences in...

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 the full...

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 appropriate use of...

Webinars & Training

Grow your knowledge with our MDS education

MDS Guides & Forms

Exclusive resources & tools we use every day

Ask an Expert Forum

Members can get 1:1 advice from our MDS experts

Let's Meet in Person

Get more info on our training & conference schedule

News for MDS Experts

Browse our blog & get news alerts on MDS changes

MDS Completion

Get your MDS' done ASAP with short-term, expert help

Remote Floater

Fill gaps on your team when & where you need

Case Mix Index

Improve your complex case mix calculations

MDS System Mgt

Best practices for MDS schedules & workflow

+ More Services

Get help on PDPM, ICD-10, quality, schizoph. audits ++