Five Star & Quality

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Aug 01 2022

Stars for Staffing

Updates to the Staffing Five Star CMS released revisions to the staffing methodology in July through an updated Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users’ Guide July 2022. The staffing star rating includes expanded from two to six compenents and introduced a new scoring calculation. The updated Five Star rating is calculated from the following six staffing measures: Case-mix adjusted total nurse (RN, LPN/LVN, aide) staffing levels (hours per resident...
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Jun 17 2022
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What’s New from CMS?

WHAT’S NEW FROM CMS? As the world tries to find a new normal, long-term care (LTC) professionals are watching what changes will come down from various White House initiatives. These initiatives to improve nursing homes include: CMS modifications for reimbursement and Continued changes related to COVID-19 reporting and care in the facilities. LTC professionals seeking to improve care, deal with staff crisis, and simple ways to implement required changes heard a recent talk by Ellen M. Berry, PT...
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May 09 2022

What’s up with the Five-Star Quality Rating System

What’s up with the Five-Star and Care Compare? The Nursing Home Compare Five-Star Quality Rating System was developed by the Centers for Medicare & Medicaid Services (CMS) to assist residents and their families with information to “understand assessment of nursing home quality.”  The domains of the Five-Star Quality Rating System are State Health Inspections Staffing and Quality Measures Recently CMS upgraded and renamed Nursing Home Compare to Care Compare - but many places still refer to...
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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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Apr 01 2021
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The Struggle with Antipsychotic Reduction

Since CMS began to monitor antipsychotic use in 2011, skilled nursing facilities have done well to reduce the use of antipsychotic medications from the original rate of 23.9%. However, over the past few years, the rate has remained around 14%. Some facilities believe they have done everything possible and this 14% represents residents that truly need antipsychotic medications. Is your facility doing all it can to keep antipsychotic use low? What if there is a better approach? The quality...
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Jan 20 2021

Five-Star Preview: Not All Good News

The transition from Nursing Home Compare to Care Compare and unexpected Five Star Quality Rating updates brought disappointment to some Skilled Nursing Facilities. Due to the public health emergency (PHE), the rating system's three domains had previously been held constant.  Centers for Medicare and Medicaid Services (CMS) announced that the Five Star Quality Rating system would resume all updates with the January 2021 refresh.  At the same time, CMS also released the new Care Compare site,...
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Nov 22 2020
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Five Star Updates

The Centers for Medicare & Medicaid Services (CMS) recently released the October 2020 version of the Five-Star Quality Measure System Technical Users' Guide. It includes several revisions and updates for the Staffing, Quality Measure, and Health Inspection ratings in response to the Public Health Emergency (PHE). Health Inspection Since the Nursing Home Compare (NHC) refresh in April 2020 and until further notice, the health inspection domain of the rating system is being held constant to...
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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 May 13, 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 April 8, 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 April 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 in...
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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 February 15, 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 February 7, 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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Sep 07 2022
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MDS Changes Raise Medicaid Payment Questions

Tim Mullaney | September 7, 2022 | Excerpted from Skilled Nursing News The removal of a key section from the Minimum Data Set (MDS) will have massive repercussions, particularly for the future of nursing home reimbursements by states. ... The fate...
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Aug 01 2022

Stars for Staffing

Updates to the Staffing Five Star CMS released revisions to the staffing methodology in July through an updated Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users’ Guide July 2022. The staffing star rating...
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Jul 06 2022

Disorganized Diagnoses

Disorganized Diagnoses in Section I Section I is often a source of inaccurate coding. Inaccurate coding may cause loss of reimbursement, poor quality ranking, and poor resident care. The RAI Manual describes active diagnoses as:...
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Jun 17 2022
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What’s New from CMS?

WHAT’S NEW FROM CMS? As the world tries to find a new normal, long-term care (LTC) professionals are watching what changes will come down from various White House initiatives. These initiatives to improve nursing homes include: CMS modifications...
Keep Reading
May 09 2022

What’s up with the Five-Star Quality Rating System

What’s up with the Five-Star and Care Compare? The Nursing Home Compare Five-Star Quality Rating System was developed by the Centers for Medicare & Medicaid Services (CMS) to assist residents and their families with information to “understand...
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Apr 06 2022
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Pulling the MDS nurse to the Floor

Pulling the MDS nurse Onto the Floor: Minimum Nursing Staffing Levels CMS is now showing consumers staff turnover and weekend staffing levels on Nursing Home Care CompareThese added metrics show families the history of staffing levels and staff...
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Mar 03 2022
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Are You Paying Attention to Resident Discharge?

Are you Paying Attention to Resident Discharge? CMS & OIG Are In 2017, CMS put into effect the final rule that focused on discharge planning for residents from the nursing home setting. From monitoring deficiencies data, we know some facilities...
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Feb 03 2022

OIG Report Cites Challenges

Top SNF Challenges from the OIG Report OIG released a report of the 2021 Top Management and Performance Challenges Facing the Department of Health and Human Services (HHS). The report from the Office of Inspector General (OIG) is titled, “2021 Top...
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Jan 04 2022
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COVID-19 Effects on Dementia

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...
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