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MDS Alert

Quality of Care:
Use the MDS as a Safety Net to Catch Actual or Potential Decline in Time
Flag residents who may need rehab or restorative. The best patient safety and quality-of-... Read more
Hospice Care:
4 Ways to Get With the Hospice Program and Avoid Survey Woes
Find out how to deal with this challenging juggling act. When a nursing home patient elec... Read more
Coding Quizzer:
How Would You Code a Change in ADL Function (G9) in These 3 Resident Scenarios?
Scenario No. 1: Dr. B had been highly involved in self-care in most ADL activities. Seven... Read more
What Do You Think?:
When Can You Provide Part A SNF Care and Medicare Hospice?
Be careful with this tricky scenario. What requirements does a SNF have to follow to skil... Read more
Resident Safety:
Drill Down Fall Risk Assessment at Admission: The FIM May Do the Trick
Rehab provider finds cognitive impairment a pivotal risk factor. A one-size fits all asse... Read more
MDS 3.0:
How Might MDS 3.0 Lead to Improvements? Experts Are Still Counting the Ways
More accurate ADLs, opportunity for better care plans are on the list. You've no doubt he... Read more
Trends:
MDS 3.0 Delay: Truth or Rumor?
Experts identify glitches on the path to implementation. The official timeline for the MD... Read more
TOOL:
Draft MDS 3.0 Preferences for Customary Routine and Activities Can Help Personalize Care
Some facilities are incorporating these questions in their admission intake.... Read more
Quality of Care:
Be Alert to the Clinical and Regulatory Dangers of Sleep Aids
Make sure you're covering 4 bases for residents taking these meds. If you still have phys... Read more
MDS & Billing NEWS
Ready for a whole new diagnosis coding system? The Centers for Medicare & Medicaid Se... Read more
Medicare:
Not Able To Bill Even The Default Rate? Don't Be The One At Fault
Here's what you need to know and do to receive fair payment. The FY 2009 final SNF ... Read more
Medicare:
Know When You Can Bill The Default Rate Without An MDS Assessment
The Centers for Medicare & Medicaid Services allows these 5 scenarios. You can ... Read more
Quality of Care:
Keep F325 Tags Off Your Plate: Use The MDS As A Template For Nutritional Assessments
These expert strategies will improve resident and survey outcomes. Surveyors will be targ... Read more
Tool:
Use This Guide, Formula For Identifying Significant And Severe Weight Loss
The revised F325 survey guidance includes this handy chart and quick formula: The followin... Read more
Care Planning:
Know The Triggers For The Nutritional Status RAP
A malnutrition problem is suggested if one or more of the following is observed: • Weig... Read more
What Do You Think?:
Get Answers To Questions About Coding Weight Loss, The Role Of Prealbumin And Albumin Testing
Question: Should a nursing facility code significant weight loss in Section K if it's a p... Read more
Coding Quizzer:
Take A Turn At Coding A Turning/ Repositioning Program At M5c
Taking time to do this will help residents and staff rest easier. Shakespeare may have be... Read more
Resident Assessment:
A Sleep Assessment Can Be Key To Helping Residents Get Their Zs
Taking time to do this will help residents and staff rest easier. Shakespeare may have be... Read more
Resident Assessment:
Resident Going On Hospice? Be Aware Of RAI Manual Clarification About Doing An SCSA
Nursing homes, hospices should focus on coordinating care. When deciding whether to do a ... Read more
Quality Assessment:
Know And Show How Your SNF Is Doing In The Rehab Arena
Electronic data collection, analysis reveal utilization, outcomes and more. Two tools can... Read more
MDS NEWS TO USE
Get the height and weight right at K2. A recent MDS coding tip sheet clarifies coding K2.... Read more
Medicare:
Consolidated Billing: Prevent Major Fiscal Woes By Being In The Know
Cover these 4 bases and your SNF won't be paying unnecessarily. Ineffective Part A consol... Read more
Medicare:
Does Your Facility Have Agreements With Physicians And Ancillary Providers For Part A Consolidated Billing?
It should ... This advice will protect your SNF's bottom line and compliance record. A SN... Read more
Risk Management:
Ask Not And You'll Know Not Whether A Resident Is Suicidal
Tap these interview techniques and tools to do an accurate assessment. Picture this: A re... Read more
Practice Tip:
Provide A Quick Snapshot Of A Resident's Status And Progress
Capture what you need to know most. Unless you have a photographic memory, it can be diff... Read more
Staffing Management:
Humor Can Boost Your Team's Creativity, Reduce Conflict
2 exercises can get the good ideas rolling. If you're not laughing enough at work, your t... Read more
Coding Quizzer:
How Would You Code These Residents' Toileting Self-Performance?
Example No. 1: The resident received heavy assistance of two persons to transfer on/off t... Read more
Medication Management:
Get A Step Ahead Of Controversy Over Antipsychotic Use In Nursing Homes
Here's how to show you're doing the appropriate risk management. Not only have antipsycho... Read more
Documentation & Care Planning:
Coordinate Data Collection, Analysis For These 3 Related Areas Of Care And Outcomes
Save time, prevent payment recoupments and improve outcomes. What do restorative services... Read more
MDS 3.0:
MDS 3.0 Behavioral Assessment May Improve Care
New assessment model ditches negative labels, looks at behaviors' impact. Say the word "b... Read more
Behavioral Assessment:
Check Out The New And Improved Behavioral Assessment In The Draft MDS 3.0
Differentiate between behaviors that are problematic vs. those that aren't. Behavioral Sy... Read more
MDS & BILLING NEWS TO USE
The Centers for Medicare & Medicaid Services recently published the final FY 2009 SNF... Read more
Reimbursement:
The Stakes Are High For Avoiding These 3 Medicare Mistakes
Keep your SNF out of the fiscal pits with these coverage, ARD and billing management stra... Read more
QUALITY Management:
Develop Internal QMs That Show How Your Facility Is Shining In The Quality Arena
Hint: Having this information for consumers will soon become more important than ever. Co... Read more
MDS 3.0 Education And Preparation:
3 Ways You Can Prepare Now For The MDS 3.0
Don't let your facility fall behind the learning curve for this major change. The MDS 3.0... Read more
Career Management:
Be A Mover And Shaker: Ask These Key Questions To Achieve Optimal Performance
Clarifying this info can prevent numerous job-related woes. Before an MDS coordinator say... Read more
Post-Acute trends:
Stay In The Know About The Post-Acute Demo
Get the scoop on the CARE instrument and what it could mean for the MDS. The RUG-based pr... Read more
Tool:
Need Ideas For Tracking, Tackling The Quality Of Meal-Time Assistance?
CMS Webinar provides these suggestions. Proactive facilities don't wait for residents to ... Read more
MDS, Survey And Coding News
Be prepared to use new coding to report superbug MRSA. The Centers for Medicare & Med... Read more
READER QUESTION:
Should You Count ADL Assistance Provided By Rehab?
Find out if your facility is under- or overcoding ADLs. Can nursing facilities count ADL ... Read more
Survey Management:
5 Ways The MDS Coordinator Can Keep F Tags At Bay
If you're not doing this, your facility is wide open for survey woes. When surveyors have... Read more
Activities of Daily Living:
2 Tips Help You Capture Residents' ADL Requirements On The MDS And Care Plan
Improve care-plan instructions, flexibility for setting the ARD. Looking for a way to boo... Read more
Medicare:
Proposed SNF PPS Rule Keeps Providers On Their Toes: Here's What You Need To Know
CMS explains default rate billing, RUG recalibration. Be prepared: The FY 2009 proposed S... Read more
Rehabilitation Therapy:
To Project Or Not To Project Therapy Minutes In Section T
CMS addresses the issue in the FY 2009 proposed SNF PPS rule. The Centers for Medicare &a... Read more
In the Spotlight:
Step Up Your Fall Prevention And Management Program
Follow this facility's lead to improve resident safety and prevent F323 citations. If you... Read more
CODING QUIZZER:
Nail Down Nuances For Coding A Scheduled Toileting Plan
Compare your answers to these scenarios against CMS clarifications. Which of the followin... Read more
Clinical Management:
Use The MDS To Ease Parkinson's Disease-Related Problems
At second glance, these conditions may have something in common. The MDS assessment can p... Read more
Pain Assessment:
10 Questions Get To The Root Of Parkinson's Pain
As part of your pain assessment of a resident with Parkinson's disease, consider asking th... Read more
Tool
I. General Guidelines A. The Predisposition for Failing Assessment Tool is to be complete... Read more
MDS & Coding News
Proposed ICD-9-CM codes for Oct. 1 would allow you to identify pressure ulcer stage... Read more
Coding Accuracy:
These 5 Ways To Error-Proof ADL Coding Pay Off In Spades
Expert advice gets to the heart of practices that lead to miscoding. If you think ADL acc... Read more
Pain Management:
Perfect Your Pain Coding Prowess: Look For These Risk Factors In Cognitively Impaired Residents
Study sheds light on conditions most likely to cause pain. The nursing home resident who ... Read more
Staff Management:
Collaboration Between The DON And MDS Coordinator Best Bet For RAI Success
Achieve these 6 outcomes and your RAI process will be on the right track. Lack of teamwor... Read more
Pharmacy Review:
Anticipate This Quality-Of-Care Snag -- Meds That Can Add Up To An F314 Tag
When a resident has a decub, it may be time to do a med review. If you don't consider med... Read more
Clip And Save:
Boost Your ADL Coding Performance: Review The Definitions For Resident Self-Performance
Knowing the definitions cold can keep your facility out of hot water. Code the following ... Read more
CODING QUIZZER:
How Functional Is Your Coding For G4A And G4B?
Example No. 1: Mrs. X is a diabetic who sustained a CVA two months ago. She can only turn... Read more
Quality Reporting:
Master The Ins And Outs Of The Chronic Care And Post-Acute Pain Quality Measures
Know how the measures work and what you need to explain to surveyors. To get a handle on ... Read more
Clip And Save:
Nail Down The MDS Coding For The Chronic Care Pain Quality Measure
Knowing how the QM works helps you put it to work for your quality improvement efforts. 8... Read more
ADL Coding:
Brush Up On Coding Toileting Accurately
Beware: This ADL can get tricky -- here's what to look for. Not only does helping residen... Read more
Payment & Survey News
The proposed FY 2009 SNF payment rates represent a give-and-take proposition. The Centers... Read more
MDS Coding:
Cross The T's And Dot The I's In Coding, Treating UTI
3 best practices will shore up MDS coding and care. If your MDS team is overcoding UTI in... Read more
In The Spotlight:
Combo Of Assessment, Interventions And 'Wait And See' Reins In Inaccurate UTI Dx And Rx
Check out this protocol for residents with one potential symptom of UTI. Looking to drive... Read more
Diagnosis Coding:
Give Section I And The Resident's Care Plan A Checkup By Answering These 3 Critical Questions
If this section is ailing, your facility may be flailing. Getting Section I of the MDS ri... Read more
MDS Accuracy:
Keep I3 Right On The Money And Off The F Tags
Miscoding or omitting diagnosis codes here can hurt your facility. So many diagnoses ... ... Read more
ADL Coding:
These Pivotal Moves Will Keep Residents' Transfer Scores On Track
Transfer this know-how to your team and watch ADL accuracy gleam. Miscoding transfers pul... Read more
Compliance:
Lapsed Licenses, Certification Create A Hidden Liability Trap
The right risk management can help avoid this costly pitfall. Picture this: Unbeknown to ... Read more
Tool:
Calling The Doctor: Guidance For Nurses
Medical director provides suggested format for getting info in a row. Nurses who prepare ... Read more
Compliance:
Fail To Check This List At Your Own Facility's Risk
If you're not doing this as part of every background check and periodically, watch out. I... Read more
Coding Quizzer:
Know The Score For Coding Transfer At G1b
How would you code self-performance and support provided for transfer in these two scenari... Read more
Reader Question:
Dehydration Versus Volume Depletion
Question: What is the difference between 276.50 (Volume depletion, unspecified) and 276.5... Read more
Dining Assessment:
Dining Observation Tool Measures Amount, Quality Of ADL Assistance
This approach helps you identify residents at risk for weight loss. Staffing shortfalls c... Read more
What Do You Think?:
To Code Or Not To Code An Antidepressant Or Med-Related Dx
Question: Do you code an antidepressant in O4 if it's ordered as a sleep aid or for pain ... Read more
Target Residents Who Will Benefit From More Help With Meals
Know when to move to Plan B to prevent weight loss. A one-size-fits-all approach to provi... Read more
Medicare Payment:
Is Your Facility Really Following Supervision Requirements For Therapy Assistants?
Beware: compliance goes beyond the RAI user's manual instructions. Talk about a scenario ... Read more
Quality Assurance:
If Physicians Fail To Provide Supportive Documentation, Your SNF Will Be Ailing
Are your physicians covering these 3 essential bases? Getting attending physicians to pro... Read more
Management:
4 Ways To Make Physicians Key Players In The MDS Process
MDS education, QA, documentation triggers and promoting a 'win win' mentality are on the ... Read more
Tool:
Keep Your Eye On Section I: Does The Resident Have One Of These RUG Drivers?
Here's one list you want to check twice. • I1a, O3, P8 Diabetes mellitus and injection ... Read more
MDS & LTC Trends:
Are You In The Info Loop? Get The Latest Scoop On What's Coming Down The MDS, Payment And Compliance Pike
Speakers at AANAC, American Health Lawyers' LTC conference bring conferees up to speed. I... Read more
Coding Quizzer:
Code These 5 Examples Of How A Resident Walks In His Room (G1c)
Try your hand at coding various levels of assistance. How would you code the following re... Read more
Medicare Compliance:
RACs Have Racked Up Millions Already, But Proposed Legislation Calls For Moratorium
The Centers for Medicare & Medicaid Services recently announced that the agency had re... Read more
MDS 3.0 Update:
CMS Provides A Close Look At The MDS 3.0--Find Out What's In Store And More
The agency provides reasons MDS nurses may like this new instrument.Mastering the MDS 3.0 ... Read more
Resident Assessment:
Revamped MDS Aims To Improve Clarity, Eliminate Counterintuitive Items
Instrument omits reverse staging for decubs, streamlines ADL coding.In addition to several... Read more
MDS 3.0 Update:
The Countdown Is On For MDS 3.0 Implementation
Find out what the future likely holds for making this major switchover.The Centers for Med... Read more
Medicare Billing:
Know When To Submit Benefits Exhaust Claims And No-Pay Bills
Help your SNF stay on top of the billing do's and don'ts.Confused about when an SNF should... Read more
Coordination of Care:
Keep Close Tabs On Residents Who Continue To Receive Skilled Care After Exhausting Their 100-Day Benefit Period
If you don't, quality of care and payment may suffer.You don't want to let residents who a... Read more
Coding Quizzer:
How Would You Code This Resident's ADL Functional Rehab Potential At G8?
Mr. K has hemiplegia secondary to a CVA. He receives extensive assistance in bed mobility ... Read more
Quality Assurance:
Look At Each Resident's QI/QM Profile To See If It Fits The Bill For F Tags
Reviewing reports can tell if you may have trouble brewing.Looking at each resident's QI/Q... Read more
Behavioral Management:
Food For Thought--Dietary Issues Can Trigger Behavioral Symptoms That Lead To Altercations, Falls
Simple strategies can keep people on their feet and at peace with each other.Residents who... Read more
Risk Management Tool:
Rate And Track Fall-Related Injuries Using These Categories
Detect facility-wide trends or a resident with an escalating pattern of injuries.You can a... Read more
Medicare Compliance:
Differences Between Therapy Minutes In P1b And The Medical Record Can Lead To Payment Disputes
A quick audit in time can save you trouble down the line.Performing simple Part A rehab th... Read more
Continuing Education:
Audioconference
RUG Revolution: Winning Case Management Strategies For Better SNF Reimbursement When:... Read more
Clip and Save:
Check Out The MDS 3.0 Timeline For Deployment
Here's what's scheduled to happen before and after MDS 3.0 implementation.The Centers for ... Read more
MDS & Survey News
The Centers for Medicare & Medicaid Services has posted more lists of facilities targe... Read more
Reader Question:
How to Document Diarrhea for Coding Section H
Question: What type of support documentation do we need to code diarrhea in Section H? Ans... Read more
Reader Question:
What Diagnosis Codes Would You Use For This Scenario?
Question: Our new resident has hypertension and a blood pressure of 190/115. He also has c... Read more
Quality Improvement:
3 Savvy Strategies Will Take Your MDS Accuracy To New Levels
Is your facility using these often-overlooked approaches? Having inaccurately coded MDSs ... Read more
Medicare:
These Myth-Ridden Part A Coverage Scenarios Will Throw Your SNF For A Payment Loop
The right information can keep your facility fiscally on its feet. Misconceptions about t... Read more
Resident Care:
Restorative Nursing, ADL Care Techniques Can Stave Off Falls And Fractures
Bone up on these key pointers. Restorative nursing techniques can help prevent falls and ... Read more
Quality Assurance:
Tap The MDS To Ensure Rehab Outcomes, Documentation Are On Track
Detect unexpected decline, inconsistencies, missed care opportunities. If the fiscal inte... Read more
Quality Assurance:
Analyze This: Your SNF's Rehab Therapy Utilization
A simple calculation can offer a wealth of information. If you want to know how your SNF'... Read more
Compliance:
Medicaid Reviewers May Be Scrutinizing Your Facility's ADL Documentation -- Here's What You Need To Know
Hint: What's good for Medicaid can also pay off for Medicare. Beware: Medicaid agencies i... Read more
Risk Management:
Don't Let Rehab Progress Translate Into Accidents
Are therapy minutes in Section P adding up to falls, fractures in Section J? Talk about a... Read more
RAI Compliance:
2 Do's + 2 Don'ts Help Ensure Your Coding Won't Be Off The Mark At P7 And P8
Give your coding know-how a boost. P7 (physician visits) and P8 (physician orders) can be... Read more
Clip And Save:
A Quick Calculation Allows You To Rehab Your Utilization Patterns, If Needed
Source: Jane Belt, MS, RN, managing consultant, Plante & Moran in Columbus, OH.... Read more
Coding Quizzer:
Would You Code Supervision, Limited Or Extensive Assistance In This Scenario Involving Dressing?
A resident received supervision during dressing on one occasion, non weight-bearing assist... Read more
MDS News To Use
Have you checked out the January 2008 update to the RAI user's manual? The Centers ... Read more
Reader Questions:
To Reskill Or Not To Reskill This Resident In The 30-Day Window
Question: Our SNF admitted a 69-year-old resident for rehab after a hip repair. He had a ... Read more
Reader Questions:
Do You Have Enough Information To Code All These Diagnoses?
Question: How should I code for a patient with the following diagnoses: peripheral vascul... Read more
Medicare Compliance:
Rehab Consistently Falling Off After The MDS Assessment? Your Facility May Face A Compliance Tumble
Don't wait: Detect, head this trend off at the gate. In coding the MDS, the devil may be ... Read more
Quality Improvement Tool:
Quantify Rehab Therapy Utilization For Each Resident
This handy tool can easily identify patterns of rehab use. Source: Jane Belt, MSN, RN, co... Read more
Abuse and Neglect:
6 Strategies Protect The Integrity Of Your Investigation
Hint: Eliminate bias, focus on theories of causation. Who doesn't like putting on their C... Read more
Abuse and Neglect:
Get The MDS On The Case To Identify, Investigate Potential Abuse And Neglect
Put these key sections and items under the forensic lens. The MDS can provide key clues w... Read more
Risk Assessment:
Check Out This List Of Risk Factors For Osteoporosis
Certain conditions, meds up the odds of a resident having the condition. One risk for ost... Read more
Quality Assurance:
Let OSCAR 4 Shore Up QA And Survey Management
Survey report lets you know how the facility stacks up against the averages. The OSCAR 4 ... Read more
Survey Management:
An Inaccurate CMS 672 = An OSCAR 4 Report That Can Lead Your QA And Survey Astray
Don't let the MDS drive this form in the wrong direction. A facility's OSCAR 4 reports wi... Read more
Medicare Payment:
Give Physician Visit/Order Changes Coding A Checkup With This Quick Quizzer
Knowing the answers to these 4 scenarios helps avoid payment recoupments. On the 14-day M... Read more
MDS Coding Tip:
Know Where, How To Code A Skin Tear On The MDS
Are you documenting this critical difference? Frail elders can easily suffer a skin tear.... Read more
Coding Quizzer:
How Do You Code A Dying Resident's Discharge Potential?
The answer isn't as straightforward as you might think. Mrs. D is a 67-year-old widow wit... Read more
Reader Questions:
Would This Half Bedrail Count As A Restraint?
Question: Would you count a half rail as a restraint if the resident uses it to pull up i... Read more
Reader Questions:
Can You Code Services On The MDS Provided By The Transferring SNF?
Question: Our SNF admitted a resident with a diagnosis of pneumonia and a stage 3 pressur... Read more
Medicare Payment:
Good News: You Can Bill The Default Rate For Missing MDS Assessments
CMS representative addresses the issue at SNF/LTC Open Door Forum. Omissions happen: Some... Read more
Quality Reporting:
Do You Know How The Quality Indicators/Measures Really Work?
Learn the rest of the story about this quality reporting system. Misinformation about th... Read more
Quality Management:
Fall And Fracture Assessment Tool Takes Risk Prediction To A New Level
The right info keeps you a step ahead of injuries. Ever wish you had a crystal ball to pr... Read more
Tool:
Check Out Some Of The Leading Risk Factors For Fracture Coded On The MDS
Researchers provide odds ratios for males, females. Risk Factors    &... Read more
Best Practices:
Osteoporosis Is A Major Red Flag For Fracture Risk … But Is It Flying In Section I?
Study shows shortfalls in diagnosing, treating this crippling disease. When you see an os... Read more
Quality of Care:
Use The MDS To Boost Compliance With PASRR Requirements And Meet Residents' Mental Health Needs
CMS suggests the RAI process can improve care for mentally ill residents. To avoid a slat... Read more
Coding Quizzer:
Code These Restorative Nursing Scenarios
How many days and what restorative intervention would you code at P3? Scenario No. 1: Exp... Read more
Clip And Save:
Section P2 Offers Template For Mental Health Services
But before you code, check the definitions. Reviewing Section P2 helps you identify servi... Read more
MDS News:
The MDS 3.0 Is On Its Way, CMS Says -- Here's What To Expect
Agency provides 'high level' view of what's new. The countdown for MDS 3.0 implementation... Read more
MDS 3.0 Implementation Plans And Timeline:
CMS Rolls Out Milestones For Revamped Assessment
TASK              &... Read more
Quality Improvement:
Residents Too Busy To Attend Rehab? Beware These 7 B's
Rehab expert spells out common things that derail therapy. The best-laid rehab plans will... Read more
MDS & Billing News
Brace yourself for the RACs. The Recovery Audit Contractors (RACs), which receive a bonus ... Read more
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