Advanced Search

MDS Alert

MDS 3.0 Coding:
Get the Latest Lowdown on Pressure Ulcers, Isolation, and More
CMS official explains rationale for coding stance on POA pressure ulcers. A resident with ... Read more
Compliance Trends:
Beware Audits Targeting Part A Rehab RUGs
If you get notice of a ZPIC audit, make sure to do this. What auditors can pack a major pu... Read more
MACs/Intermediaries Won't Field ZPIC Questions
They will take your ZPIC appeals. To get an idea of how the FIs and MACs fit in the ZPIC p... Read more
Payment:
Keep Your Eye on Medicare SNF Part A Fee-For-Service Requirements
Expect the 'practical matter' requirement to be a bigger focus, says expert. Reviewing th... Read more
What Do You Think?
Can a Facility Maintain MDSs Electronically if It Doesn't Use Electronic Signatures? Answ... Read more
MDS 3.0 Coding Quizzer:
Section I: Would You Code This Resident's Previous Hip Fracture at I3900 Due to His Residual Impairment?
The answer may surprise you. Scenario: "Mr. J fell and fractured his hip 2 years ago. At ... Read more
Quality of Care:
These MDS Indicators Could Augment Mood Assessment in Section D
Find out which behavioral symptom has the strongest association with risk for a new depres... Read more
Quality Improvement:
Find Out How Nursing Homes and Hospitals Are Collaborating to Combat Pressure Ulcers
This simple strategy can alert providers in both settings to patients at risk. A number of... Read more
Quality Assurance:
Identify Quality Concerns During the MDS 3.0 QM Blackout
Make sure your MDS coding is on the mark. To stay on top of quality issues without the han... Read more
MDS & Compliance News:
MDS & Compliance News:
CMS has issued a survey & cert memo instructing surveyors to cut nursing homes some s... Read more
CODING QUIZZER ANSWER (see question on page 139).
Answer: Don't check the hip fracture item (I3900) on the MDS. Rationale: "Although the re... Read more
MDS 3.0 Update:
Got MDS 3.0 Questions? CMS Officials Shed Light on These Key Areas
The agency plans to analyze providers' suggestions for eliminating duplication. The MDS 3.... Read more
Pressure Ulcer Coding:
MDS 3.0 RAI Manual Instructions for Coding Decubiti Trump NPUAP Guidelines
But you can use both systems, as some facilities did for the MDS 2.0. The MDS 3.0 did awa... Read more
M0300G:
Unstageable Pressure Ulcers Related to Suspected Deep Tissue Injury
Check out these 4 coding tips. Once suspected deep tissue injury has opened to an ulcer, r... Read more
Know the Ins and Outs of the Short-Stay Assessment for Rehab Patients
Your SNF could lose $$ big-time if you are unaware of this key point. Section T is histor... Read more
Payment Trends:
2 Reasons Why Use of Medicare Short-Stay Assessment May Be Limited
The short-stay policy is no Section T. The short-stay assessment for rehab patients may no... Read more
Compliance:
Beware: The OIG Work Plan Is Chock-Full of Compliance Hot Spots
The list includes MDS accuracy, hospitalizations, potential False Claims Act actions, and ... Read more
Best Practices:
Make Activities a Key Part of Behavioral Care Plans
Find out how potatoes helped put an end to a resident's aggression. If you don't include ... Read more
Compliance Tip:
Rehab Low May Be a Good Clinical Fit In This Scenario
Meet residents' needs and sidestep potential medical review woes. Medicare has always had ... Read more
Test Yourself:
When Are Antipsychotics Indicated?
Find out how people watching a CMS surveyor training webinar answered this question. Anti... Read more
What Do You Think?
How Does the Clinical Change Assessment Compare to the Significant Change in Status Asses... Read more
Survey & Compliance News
CMS has updated survey forms to reflect the MDS 3.0. The CMS-802 (roster/sample matrix) f... Read more
Answer and Poll Results to Test Yourself Question on Page 130
Correct answer: D (none of the above): 70 percent of people watching the CMS surveyor trai... Read more
Risk Management:
Resident Taking These Meds? Keep This Potential Problem on Your Risk Management List
These behavioral symptoms can be an early warning sign of a serious medication problem. Th... Read more
MDS 3.0 Coding:
Be Aware of These Mid-September Changes to the MDS 3.0 RAI User's Manual
Revision clarifies when it's OK to code isolation for infection. Wondering whether you can... Read more
Case Study:
Keep Residents' Skin Intact and Put Pressure Ulcers on the Fast Track to Healing
Are your staff or residents' families unwittingly undermining this common pressure-ulcer ... Read more
Section Q:
Don't Miss This Safety Net for Identifying Residents Who May Be Able to Return to the Community
Consider this proactive strategy to help residents access the resources they need. Section... Read more
Compliance:
Be on the Lookout for These 2 Part B Rehab Therapy Issues
Your Medicare and Medicaid payment could be at stake. If these two potential problematic p... Read more
Care Planning:
Figure Out the Underlying Cause(s) of an Aggressive Episode
This simple approach can provide the solution. Suppose a resident becomes aggressive towar... Read more
MDS 3.0 Coding Tipster:
4 Tips for Coding Behavioral Symptoms (E0200)
RAI manual provides parameters for what to capture. To capture a resident's behavioral sym... Read more
Tool:
Computerized Tool Allows You to Track Pressure Ulcers and Healing
Monthly pressure Ulcer Tracking Form (with sample date)... Read more
What Do You Think?:
Do Nursing Homes and Hospices Need a Single Plan of Care for Residents Receiving Medicare Hospice Care?
Answer: "While the hospice and facility need to develop a coordinated plan of care, it do... Read more
Stress Management Tip :
Tune Out Work-Related 'To Do' Lists and Ruminations With This Simple Strategy
This works well for some busy nurses, says expert. You have a zillion things to do at work... Read more
MDS, Clinical & Coding News:
MDS, Clinical & Coding News:
Do your residents or their families have questions about returning to the community? CMS ... Read more
Medicare:
CMS Walks SNFs Through the Move From RUG-III to RUG-IV
Know the options for doing PPS assessments for residents with covered days spanning Septe... Read more
MDS 3.0 Implementation:
RAI Manual Undergoes More Changes as MDS 3.0 Countdown Continues
One strategy can help you stay on top of the revisions. CMS made more changes to the RAI ... Read more
MDS 3.0:
Tap These 3 Section M Assessment, Risk Management Advantages
Follow these instructions for differentiating a stage 2 pressure ulcer from suspected DTI... Read more
Wound Assessment Tip:
This Wound May Look Just Like a Pressure Ulcer But It Isn't
Your SNF can take a simple step to prevent this serious problem. Before you conclude that... Read more
Document Management:
Before You Go the Paper- or Electronic-Storage Route for the MDS 3.0, Consider These Key Points
If you're not doing this, surveyors will be on your case. Once the MDS 3.0 rolls out, fac... Read more
Hospice:
MDS 3.0 Changes Rules for Sig Change Assessments, Boosts Assessment in These 2 Key Areas
The rules have changed in a way that allows easier tracking of hospice recipients. True o... Read more
Medicare Billing:
SNFs Now Have More Leeway for Timely Claims Filing
Check out this key billing change. Good news: The one-year filing deadline for Medicare c... Read more
Tool:
Check Out This Pressure Ulcer Form
A picture can augment your documentation -- and memory.... Read more
What Do You Think?
Don't Miss the Compliance Boat When Coding Part B Therapy Question: What are the requirem... Read more
Coding, Compliance & Research News
Get ready for these new flu ICD-9 codes. Come October 1, you will have more detailed flu ... Read more
MDS 3.0 Preparation:
Master the Care Area Assessment Process Faster by Covering These Essential Bases
Check out this survey management tip. Come October, you'll be able to call it a wrap for ... Read more
Rehabilitation Therapy:
Sharpen Therapy Documentation Skills to Support Skilled Rehab
MDS 3.0 RAI manual focuses on difference between non-skilled and skilled rehab. Documenti... Read more
MDS 3.0 Section O:
Be Aware of These Clarifications for Start and End Dates for Therapy
The manual walks you through what day to count as the first day after therapy ends. CMS c... Read more
Clinical Care:
Promote Optimal Bowel Health With These Easy Strategies and Tips
Providing more fiber can correct constipation or diarrhea. When you do bowel assessments ... Read more
MDS 3.0:
Know the MDS 3.0 Coding Ropes for Bowel Problems
The rules are definitely different from the MDS 2.0. True or false? The MDS 3.0 form does... Read more
What Do You Think?
Can You Count T herapy Student Involvement in Concurrent T herapy Under Part A ? The answ... Read more
Billing & Compliance News to Use
CMS is attempting to pull the reins in on how much bounty the RACs can keep. During the R... Read more
Care Planning Tip:
Simplify, Individualize Care Planning by Drilling Down With Why Questions
Sometimes the solution costs just pennies a day. Suppose a person fell and broke his hip ... Read more
MDS 3.0:
Check Out These Key Changes in the Finalized MDS 3.0 RAI User's Manual
UTI proved to be a surprise. CMS went on a roll this spring in posting revised MDS 3.0 RA... Read more
Data Management:
Using Hand-Held Computerized Devices Can Capture Therapy Minutes Accurately
With this system, no one can accuse a SNF of rounding up Part A minutes. Losing track of ... Read more
HIPAA Compliance:
Real-World Cases Highlight Escalating Dangers of Privacy Noncompliance
Nurses take the heat for alleged online privacy violations. Looking for cautionary scenar... Read more
Professional Strategies:
Boost Your Batting Average for Getting What You Want From Administration
This communication technique can hold the key to success. Sometimes it's not so much abou... Read more
Medication Safety Tip:
Be Aware of Meds That Can Turn Summer Activities Into a Medical Emergency
Check Section O of the MDS 2.0 to see if a resident is taking these 2 types of drugs. All... Read more
Diagnosis Coding:
Write the 2013 ICD-10 Start Date in Pen
The government also wants to freeze ICD-9 coding changes after next year. CMS just can't ... Read more
Tool:
Tool:
... Read more
MDS, Coding & Billing News to Use
CMS recently clarified how to do an MDS 3.0 discharge assessment for unplanned discharges... Read more
Case Management:
Plan to Manage RUG-IV Rehab Payment Realities With These 4 Strategies
Experts suggest concurrent therapy has a role in these scenarios. RUG-IV changes the play... Read more
Reader Question:
Does This Resident Appear to Require a Skilled Level of Care?
Question: Our facility has a patient who had been on SNF Part A for rehab. The patient is... Read more
Compliance:
3 Ways MDS Nurses Can Keep F Tags at Bay
Find out how one facility gets charts in tip-top shape for survey day. When MDS nurses st... Read more
Payment Trends:
Beware: RACs May Be Triggering MAC Attacks
If you do get a notice of a probe review, don't do this. SNF providers may not be the onl... Read more
Compliance:
Be On Your Toes When Handling MAC/FI Probes
Failing to include the right MDSs can cost you big time. What you don't know can hurt you... Read more
Case Study:
Avoid Pitfalls Identified in This SNF's Probe Review
Shore up these 4 areas before it's too late. The best time to prevent payment recoupments... Read more
MDS 3.0:
Show Physicians the Benefits of Participating in the MDS 3.0
A medical director highlights where physician input can improve the RAI process. The MDS ... Read more
Pain Management:
Don't Let Wound Pain Be a Drain on Resident and Survey Outcomes
Identify and address these underlying causes, including 2 psychosocial factors. There's n... Read more
Medicare Part C:
Make Sure You're on the Same Page With Medicare Advantage Plans
Take heed: Some plans may require frequent recertifications for skilled care. Failing to ... Read more
MDS 3.0 Training:
Benefit From These Inexpensive Training Tips for MDS 3.0 Interviews
Tap these knowledgeable resources. Mastering the MDS 3.0 interviews will help ensure your... Read more
What Do You Think?:
ASNF Resident Without a 3-Day Qualifying Hospital Stay Goes O ff a Medicare Advantage Plan -- Now What?
Question: What should a SNF do when a patient covered by a Medicare Advantage plan (witho... Read more
Diagnosis Coding:
Get a Sneak Peek at the New ICD-9 Codes
Check out these new codes for cognitive problems. If you're hoping the new slate of diagn... Read more
Care Plan Tool:
Consider This Risk-Driven Pressure Ulcer Prevention Tool
Link strategies to the various risk factors identified by the Braden scale. Braden I nter... Read more
MDS, Payment & Research News to Use
CMS recently provided a heads up on its plans for managing the legislated RUG-IV delay. I... Read more
TEST YOURSELF Answers:
(Surgical Wound Care Coding and RUGS cores)
Here are the answers to the "Test Yourself" feature in MDS Alert, Vol. 8, No 4: 1. Circle ... Read more
Strategic Planing:
Looking for a Smooth Transition to MDS 3.0? Move These Tasks to the Top of Your 'To Do' List
Be prepared to transmit more quickly and deal with this new assessment. The countdown to ... Read more
Healthcare Reform:
Get Up to Speed With These Key Provisions in the Healthcare Reform Legislation
Beware: A tighter Medicare billing timeline is already in effect. The healthcare reform l... Read more
Payment:
Healthcare Reform Legislation Delays RUG-IV for a Year
The delay includes a difficult twist. The healthcare reform bill delayed RUG-IV implement... Read more
Care Planing:
Beat These Parkinson's Disease-Related Problems
Experts share inside tips for combating dysphagia, pain, falls, and more. Parkinson's dis... Read more
Rehab Therapy:
Ease Parkinson's Disease-Related Voice Changes With This Simple Strategy
Nursing staff can help the resident maintain this skill after therapy ends. If a resident... Read more
Survey Management Tip:
Fine-Tune Risk Management With This Shift in Mindset
Are you including these issues in your risk-management meetings? Perspective can be every... Read more
Tool:
Score Residents' Fall Risk Using This Tool
Make sure you're capturing these key risk factors.... Read more
What Do You Think? Check Out These Q&As From the March CMS MDS 3.0 Training
CMS sheds some light on common coding quandaries. Will A DL Data Collection Forms Meet T ... Read more
MDS 3.0 Tip:
Be Ready to Incorporate Resident Voice in Care Planning When MDS 3.0 Goes Live
Surveyors may target this omission. Translating the MDS 3.0 resident interviews into a pe... Read more
Diagnosis Coding:
ICD-10 Implementation Poses a Good News, Bad News Scenario
CMS, AHIMA reps combat myths about the expanded diagnosis system. ICD-10 implementation i... Read more
MDS 3.0:
Beware: The MDS 3.0 Requires You to Answer Whether Residents Are Receiving This Mandated Evaluation
Here's what you need to know and code about the PASRR. The MDS 2.0 doesn't alert you to t... Read more
MDS & Clinical News to Use
CMS has completed its MDS 3.0 train-the-trainer sessions. In March, the agency conducted ... Read more
What Do You Think? To Bill or Not to Bill Medicare Fee-For-Service for Medicare Advantage Patients
Question: If a resident is receiving skilled care covered by his Medicare Advantage plan,... Read more
MDS 3.0:
Ready to Ramp Up Discharge Planning Under Section Q?
This one simple strategy can help reduce rehospitalization. The MDS 3.0's Section Q spell... Read more
MDS 3.0 Provides a Template for Discharge Instructions
Don't forget to include advance directives. If you're in the market for a "to do" list fo... Read more
ASSESSMENT:
The Medi-Cog Can Identify Residents' or Family Caregivers' Ability to Set Up a Pillbox
Find out what it could mean if someone passes the cognitive screen but fails the medicati... Read more
QUALITY IMPROVEMENT:
Rehab Therapy Home Visits Can Be the Ticket to Improving Discharge Safety
Consider using a 'book end' approach. "Have therapist, will do home visits" may become th... Read more
Risk Assessment:
Find Out How the MDS 3.0 Defines the Severity of Fall-Related Injuries
3 categories can help everyone get on the same page. The MDS 3.0 Section J1900 asks you t... Read more
QUALITY ASSURANCE:
Tap the MDS 3.0's Heightened Risk Prediction Powers
Coding for falls and behaviors can give you an edge in heading off problems. The MDS 3.0 ... Read more
WOUND CARE TIPS:
3 Strategies Can Improve Surgical Wound Outcomes
If a resident has a dehisced surgical wound, consider this approach. Pressure ulcers and ... Read more
Test Yourself:
What You Don't Know Can Hurt Your Surgical Wound Care Coding and RUG Scores
1. Which of the following constitutes surgical wound care for purposes of coding it in Se... Read more
MEDICARE:
Don't Rack Up Unfair RAC Denials: Follow These 6 Rules for Appealing Payment Recoupments
Even if you're dead wrong on an issue, check out this often overlooked escape hatch. RAC ... Read more
MEDICARE, SURVEY & CLINICAL NEWS TO USE
Worried That Lack of Bona Fide 3-Day Hospital Stays Could Pull the RUGs Out From Under Yo... Read more
READER QUESTION:
Would This Physician's Initial Certification for SNF Care Fly With the FI/MAC?
Question: Can a hospitalist sign the initial cert for Part A SNF services? Our SNF is a f... Read more
MDS 3.0 PREPARATION:
Ramp Up for the MDS 3.0 Interviews Now -- Here's How
2 tips help residents participate more fully. The MDS 3.0 resident interviews will play a... Read more
RESOURCE:
Interview 202: Take These Cues for Effective Interviewing From the RAI Manual for MDS 3.0
Find out how to use echoing, probing, unfolding, and other techniques. Even the most expe... Read more
RAC READINESS:
Make Time to Target Untimed Codes on Part B Therapy Claims
Don't let the RACs bilk you out of this one example of appropriate billing. RACs are alre... Read more
QUALITY ASSURANCE:
Keep Your Eye Out for This IJ Citation Waiting to Happen
Just because a resident doesn't have an identified risk doesn't mean you can't get penali... Read more
2 More Areas That RACs Could Target for Part B Therapy
The supporting Part B documentation should identify the decline in function. If your RAC ... Read more
ACTIVITIES OF DAILY LIVING:
Could an Enabler Improve a Resident's Bed Mobility?
A small rail or trapeze could get the resident moving. Looking for ways to help prevent p... Read more
Clinical Tip:
Teach the Resident the Best Way to Sit Up When in Bed
Restorative can help the resident with this technique. Not all strategies for sitting up ... Read more
Risk Management :
Don't Let These Key Elopement Risk Factors Escape Your Assessment
Critical: Identify this combination of conditions at admission. As you know, elopement ca... Read more
COMPLIANCE NEWS:
CMS to Medicare Contractors: Target These Potential Problem Areas Identified by the OIG
Consolidated billing for ambulances is on the list, as is hospice for nursing home reside... Read more
What Do You Think? Does Medicare Ever Cover Wheelchair Vans, Medi-vans, Etc.?
Can you bill Part A-stay residents or their responsible parties for this service? A priva... Read more
TEST YOURSELF:
RAC READINESS
1. The RACs are responsible for auditing which of the following (select one correct answer... Read more
READER QUESTION:
Does Family and Rehab Therapist Assistance Count in Coding ADLs on the MDS 3.0?
Question: What counts as ADL help that can be coded on the MDS 3.0? Are we still going to... Read more
QUALITY ASSURANCE:
Keep the Spotlight on Quality Assurance During the MDS 3.0 QI/QM 'Blackout'
Consider using these 2 CMS survey forms to manually track quality issues. Think of it as ... Read more
Survey Management:
How the MDS 3.0 Transition QI/QM 'Blackout' Impacts the Survey Process
For facilities receiving a traditional survey, it won't be business as usual. Wondering h... Read more
COMPLIANCE:
RAC-Proof Your Claims Without Reinventing the Wheel or Breaking the Bank
Having these 2 departments act in tandem provides a tough first-line defense. With RACs r... Read more
TOOL:
Use the CMS 802 as a Quality Management Tool
Completing this form accurately will take on new importance during the MDS 3.0 transition... Read more
MEDICARE:
The Right 'Triple Check' Method Can Put an End to Unpaid Claims
Address these 6 elements before they add up to big payment denials. What's the best way t... Read more
QUALITY IMPROVEMENT:
How Risky Is Your Pressure-Ulcer Prevention and Related MDS Coding and Documentation?
Close these 4 common gaps in the assessment and implementation areas. Prevention is the n... Read more
Clinical Corner:
A One-Size-Fits-All Approach to Fecal Stoma Care Can Pave the Way for Skin Breakdown
2 tips stave off decubs and related F tags. If your nursing facility orders the same osto... Read more
RISK MANAGEMENT:
18 Risk Factors That Could Make or Break Your Pressure Ulcer Prevention Efforts
Do a careful assessment to see if  a resident has any of the following risk factors f... Read more
ASSESSMENT AND CARE PLANNING:
Use This 5-Step Assessment to Identify the Root Cause of a Resident's ADL Resistance
2 types of communication techniques may help nonverbal residents. Residents who resist or... Read more
Test Yourself:
Knowing the Right Facts Can Put You a Step Ahead of the RACs
See if you know the score for how RACs operate. To find out if your RAC know-how is on th... Read more
MDS, PAYMENT & ALZHEIMER'S RESEARCH NEWS
RUG-IV's rollout date is still somewhat up in the air due to legislative efforts in play ... Read more
READER QUESTION:
Who Signs the Attestation Statement (AA9) on the MDS 2.0 and What Date Should the Person Use?
Question: If the MDS nurse completes the entire MDS but uses data collected/documented by... Read more
MDS 3.0:
Check Out These 3 Highlights of MDS 3.0 Instructions
ADL examples clear up what a code of '7' entails. With chapter 3 of the MDS 3.0 RAI User'... Read more
Manual Instructions Define Isolation as Provided in a Private Room
Some experts, however, think it may not be crystal clear. Before the final MDS 3.0 and RA... Read more
COMPLIANCE:
Don't Let 'Phantom Orders' Come Back to Haunt Your Professional License or Facility
An AMDA survey identifies orders being written without physician authorization -- he... Read more
Risk Management:
Just What the Risk Manager Might Order: Systems to Address These 2 Physician-Order Related Issues
Sidestep nursing board actions, IJ citations and payment recoupments. With RACs on the l... Read more
MEDICARE:
Good News on the RAC Front: SNFs May Not Have to Worry About Hospital Denials as Much as They Think
SNFs' payment fate may hang on this key manual language. As the Recovery Audit Contractor... Read more
MANAGEMENT:
Start Thinking Through How to Make RUG-IV Work for You
Consider these key principles, including options for rehab case management. When the new ... Read more
WHAT DO YOU THINK?:
Is CMS Going to Limit the Amount of Concurrent Therapy That Counts Toward a Rehab RUG?
Question: Has CMS already indicated that it plans to cap the amount of concurrent therapy... Read more
TOOL:
Take a Look at How Medicare Residents in RUG-III Would Fit Into RUG-IV
The change in distribution provides a wake-up call about shifting trends. CMS provides a ... Read more
RAI TRENDS:
AANAC Survey Quantifies How Much Time MDS Nurses Typically Spend on Different Types of Assessments
Find out how you might use this data for your own facility. If you are wondering how much... Read more
MEDICAL PRIVACY:
Got Electronic Health Records? Brush Up on Privacy Basics Before Your Next Survey
CMS directs surveyors to look for these 2 common privacy missteps. The best advice for st... Read more
What Are the Top Challenges for Those Working in Nursing Homes?
It's not salaries or job security, according to a recent AANAC survey. If you view survey... Read more
PAYMENT & CLINICAL NEWS:
PAYMENT & CLINICAL NEWS:
CMS recently announced its decision to pay for HIV screening for Medicare beneficiaries a... Read more
Available Years:  2010  2009  2008  2007  2006  2005  2004  2003