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Nov 04 2022

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 core pillars: 1. Strengthen System Capacity 2. Connect Americans to Care3. Support Americans by Creating Healthy Environments While the HHS Roadmap does not specifically address Skilled Nursing Facilities, it requires efforts throughout the...
Jan 10 2021

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, you are issued several citations and the state is requiring the facility to institute a Directed Plan of Care (DPOC). What should you do now? I recently discussed this question with Barbara Bates, RN, MSN, RAC-CT, QCP-MT, DNS-MT...

Recent Blogs in All Topics

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...

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...

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...

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...

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...

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...

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...

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...

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...

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....

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...

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...

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...

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...

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...

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,...

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...

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...

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....

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...

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...

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...

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...

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...

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...

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...

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...

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...

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 &...

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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