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MDS Alert

ICD-10 Focus:
Coding for PDPM Goes Against Some Conventions
Hint: A Z code may paint a more accurate picture of why a resident enters a facility than ... Read more
Reimbursement Spotlight:
See How PDPM is Shaking Out
Use the reflections from this report to better understand how PDPM is affecting facilities... Read more
Care Planning:
Try This Tool to Care Plan Boxed Warnings
Hint: Focus care plan on any aberrations staff should look out for. One aspect of managin... Read more
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Understand the Role of Z Codes
Know what makes Z codes different from other ICD-10 codes. Residents are admitted to nurs... Read more
Surveys and Compliance:
Prioritize Protection of Resident Belongings
Educate staff on how to keep residents safe. Helping residents feel at ease in their home... Read more
Coding Quiz:
Test Your Diagnosis Code Knowledge
Hint: None of the answers are in the ‘Return to Provider' category. Understanding which... Read more
Reader Question:
Submit MDS Corrections Within This Timeframe
Question: How much time do I have to submit a correction for an MDS that was submitted and... Read more
Reader Question:
Know This Guidance for SSNs
Question: I cannot find any record of a Social Security number for a newly admitted reside... Read more
Reader Question:
Be Wary of Targeted Job Advertisements
Question: Can we utilize the targeted marketing tools on social media sites to limit our j... Read more
CMS Updates:
Know These QM Adjustments, and Survey and Agency Updates
CMS aims to ensure safety and quality of nursing homes and increase transparency about how... Read more
Surveys and Compliance:
Determine Resident Representative Status With These Measures
Residents' representatives can hold a lot of control over residents' assets and health, so... Read more
Surveys and Compliance:
Understand What Surveyors Use to Determine Representative Status
Take a deeper dive into real citations to understand how a resident's representative statu... Read more
Best Practices:
Avoid Repetitive Motion Injuries With These Tips
These facility-wide tips can help nursing home staff avoid some workplace injuries, regard... Read more
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Know Your Workplace Rights
OSHA wants nursing home employees to know which rights they're guaranteed in the workplace... Read more
ICD-10 Focus:
Look to This Guidance for Residents with Gout
Understanding the terminology surrounding gout is the beginning of your path to coding suc... Read more
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Develop Your Knowledge Surrounding PHI
Though not all of these elements are applicable to nursing facility residents, you may be ... Read more
Reader Question:
Record IV Fluids Here
Question: I have a resident who is receiving 750 mL of fluids weekly, intravenously. Do I ... Read more
Reader Question:
Understand Who 'Physician Order' Refers To
Question: One of my residents receives frequent evaluations by various clinicians, but I'm... Read more
Reader Question:
Distinguish Intolerance from Allergy
Question: With the prevalence of food allergies these days, I know it's just a matter of t... Read more
Section I:
Prioritize Language as Key to PDPM Accuracy
Know which diagnoses CMS believes appropriate for a nursing facility stay. The fact that ... Read more
ICD-10 Practice:
Coding Migraines Need Not Be A Headache
This debilitating condition has many code variations. You may feel overwhelmed by the she... Read more
Cybersecurity:
Don't Fall Prey To These Device Mistakes
Innocent mistakes are just as problematic as nefarious action. With everything increasing... Read more
Emergency Preparedness:
Don't Neglect Water Supply Needs
Water is crucial for life, especially in a nursing facility accommodating multiple residen... Read more
Staffing and Best Practices:
Dress For MDS Success
Nurses who focus on MDS instead of floor work may still benefit from wearing scrubs. Nurs... Read more
You Be the Coder:
Make Physician Query a Primary Tool in Coding Toolbox
Question: I have a resident admitting from the hospital with multiple diagnoses: dementia,... Read more
Reader Question:
Look to SSA to Code for MBI Answers
Question: Which sex do I select for a Medicare Part A beneficiary who is transgender? Col... Read more
Reader Question:
UTI Caused by Diabetes May Need This Code
Question: I have a resident who is being admitted to our facility due to a urinary tract i... Read more
Reader Question:
Know These Conditions to Determine Interrupted Stay
Question: How would a resident qualify for an interrupted stay? Iowa Subscriber Answer: ... Read more
Reader Question:
Medicare Part A Discharge May Not Determine Physical Discharge
Question: My facility has a Medicare Part A resident whose Medicare Part A stay has ended,... Read more
PDPM:
Use These Tips for PDPM Implementation Workflow
The countdown to Oct. 1 is getting shorter every day, and regardless of how many factsheet... Read more
Compliance:
Give Your Grievance Policy Another Look
Letting grievances fall through the cracks may mean failing residents. The requirement of... Read more
ICD-10 Focus:
Know These Tricks to Code Heart Failure
Hint: Clinical knowledge will help you choose the right ICD-10 code. Knowing how to navig... Read more
Administration and Security:
Keep On Top Of HIPAA Compliance
Play 20 questions to make sure you're on the right side of protected health information. ... Read more
HR and Staffing:
Focus on Team Cohesion
Periods of upheaval have a silver lining: increased team solidarity. With the Patient-Dri... Read more
Therapy:
Revitalize Respiratory Therapy
Revamping a respiratory therapy program could be a wise investment in care — and reimbur... Read more
MDS Coding:
Understand New Section J Item
Know how recent surgery impacts care, versus other medical conditions. The recently relea... Read more
Reader Question:
This Assessment Stands Alone
Question: If a resident is admitted on September 29, can I do both an interim payment... Read more
Reader Question:
No RN Necessary for IP
Question: What nursing credentials does a facility staff member need to serve as the ... Read more
Reader Question:
Care Plan Intentional Behaviors
Question: Like most people in long-term care, I think of “falls” as the only “f... Read more
CMS Updates:
Check Out These Proposed Changes to RoP
Hint: Generally, CMS plans to ease burdens on facilities and physicians. For the past cou... Read more
CMS Updates:
See 2020 Final Rule Published
CMS continues shift “from volume to value.” The Centers for Medicare & Medicaid S... Read more
Resident Care:
Prime Staff for Trauma-Informed Care
Understand how trauma impacts residents and the care they receive. Individual facilities ... Read more
Compliance:
Don't Let Pests Plague Your Facility
Surveyors are looking — and residents could be at risk. Nursing facilities end up being... Read more
Diagnosis Spotlight:
Use These Tips to Code MS
Understand these aspects of the disease to code it successfully. Coding multiple sclerosi... Read more
ICD-10 Focus:
Look to New Cardiology Codes Now
Get the scoop on the nearly here 2020 ICD-10-CM changes. CMS recently released the new IC... Read more
Reader Question:
Beware These Conditions During Mealtimes
Question: Many of our residents request to eat their meals in their rooms. Do I recor... Read more
Reader Question:
Know What Sets This Condition Apart
Question: How does secondary Parkinsonism differ from Parkinson's disease, and what I... Read more
Reader Question:
Don't Confuse Cognition with Continence
Question: One of the residents at my facility has a very high brief interview for men... Read more
Reader Question:
These GI Symptoms May Point to This Dx
Question: I am doing my best to prepare for the ICD-10 coding changes, but I'm still ... Read more
Security and Compliance:
Taking MDS Work Home May Be Possible
See whether you can complete your ‘second shift' at home instead of staying late. Nursi... Read more
Expert Q + A:
Understand Embolism Coding
Hint: Make your motto ‘Code the diagnosis, not the symptoms.' With fewer than 100 days ... Read more
Policies and Protocols:
Conduct Regular HIPAA Security Rule Risk Analyses
The OCR is stepping up its enforcement. With cybercriminals becoming smarter, long-term c... Read more
Industry Updates:
See This Report Clearly
SFFs and SFF candidates may face big changes to their buffer of secrecy. Industry chatter... Read more
CMS Response Still Vague:
CMS Releases List of Special Focus Facilities, Candidates
The Centers for Medicare & Medicaid Services (CMS) has agreed to release a list identi... Read more
ICD-10 Focus:
Code Spinal Stenosis Like This
Know regions of the spine to choose appropriate Dx code. Spinal stenosis can be considere... Read more
Government Updates:
Pay Attention to These CMS, OIG Changes
New rules and announcements affect nondiscrimination requirements and rights enforcement. ... Read more
Reader Question:
Understand 'Alternative Sleep Furniture'
Question: One of our residents has chronic obstructive pulmonary disease (COPD) and was sl... Read more
Reader Question:
CBD Oil Does Not Belong in this MDS Section
Question: I haven't seen any mention of cannabidiol (CBD) oil before in terms of work, eve... Read more
Reader Question:
Consider This Safety Device A Restraint
Question: One of the residents at my facility recently had a tracheotomy and is restless a... Read more
Reader Question:
Flu Season Different for Different Places
Question: I'm still in my first year of doing MDS. When residents are admitted outside of ... Read more
PDPM:
Start These PDPM Preparations ASAP
Check your readiness for PDPM by covering these bases. With the patient-driven payment mo... Read more
PDPM:
Know How Section GG Will Become More Significant
Pay attention to the changes involved in utilizing Section GG. You've had nearly three ye... Read more
Government Updates:
Look for New RAI Manual, OIG Briefing
CMS is continually focusing on facilities improving resident safety and health. If you ar... Read more
ICD-10 Focus:
Understand Arrhythmia to Distinguish Fibrillation From Flutter
Hint: Knowing these particulars will make coding easier. Atrial fibrillation and atrial f... Read more
Surveys and Compliance:
Learn These QAPI-Related Ftags To Ensure Compliance
Make sure you have these policies and procedures down pat before Phase III of ROP hits in ... Read more
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Know These Important Regulations Surrounding QAPI Ftags
Fully understand these expert tips so you can play by surveyors' rules. If a facility has... Read more
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Ground Yourself with This Exercise
Battle burn-out with these suggestions from a fellow nurse. All of your responsibilities ... Read more
Reader Question:
Understand this Acronym to Code Heart Failure Successfully
Question: A resident presented with dyspnea and peripheral edema and her clinical record n... Read more
Reader Question:
Forgetting This MDS Item May Mean Rejection
Question: I recently submitted an MDS assessment with my facility's software and received ... Read more
Reader Question:
This Metric Follows for Months
Question: A couple of residents in my facilities have fallen in the past six months, some ... Read more
Reader Question:
Catch this New Name for Common Bacterium
Question: I don't often think about the full name of C. diff but with all of the new infec... Read more
Reader Question:
Don't Make This Correction Mistake
Question: In our facility, certified nurse assistants (CNAs) do a lot of the charting for ... Read more
Proposed Rule:
Understand Social Determinants for Fiscal Year 2022 QRP PPS Proposed Rule
Hint: Don't worry, because the new elements are mostly related to data collection. Though... Read more
ICD-10 Focus:
Sort Through Multitude of Causes to Code Pneumonia
Hint: Narrow down the options by organism. With the triple whammy of the Centers for Medi... Read more
Surveys and Compliance:
CMS Provides New Guidance on 'Immediate Jeopardy'
Streamlined guidance intended to keep residents safer. The Centers for Medicare and Medic... Read more
Facility Staffing:
Do Your Part for Supportive Workplace Culture
Leading by example can have a huge effect. Nursing facilities are inherently stressful pl... Read more
Reader Question:
Know Whether Melatonin Counts as Medication
Question: One of the residents in my facility uses melatonin a few times a week. Do I code... Read more
Reader Question:
Use 'None of the Above' For this Situation
Question: I am trying to fill out item L0200 (Dental) for a resident who is missing a lot ... Read more
Reader Question:
Judge Partial Blindness by Visual Ability
Question: One of my residents is blind in one eye but has lived for decades using only the... Read more
Reader Question:
Assess Usage Based on Application
Question: One of the residents in the facility where I work needed a fentanyl patch during... Read more
Reader Question:
Make Documentation Easier With This Update
Question: How often should we change our passwords for our computers? Right now our i... Read more
You Be the Coder:
Anatomy Matters for Bronchitis Coding
Question: A resident has been diagnosed with bronchiolitis, but I want to make sure t... Read more
Care Planning:
Ensure Facility Protocols for Implementing PASRR Recs
Assure person-centered care and avoid citations by following through on PASRR recommendati... Read more
ICD-10 Focus:
Understand Diabetes Coding
Use these hints to navigate diabetes complications and treatments. With the Patient-Drive... Read more
Looking Forward:
Care for Obese Residents with More Staff
More nursing and care staff can be a balm for obese residents. The U.S. population is agi... Read more
Ratings and Reputation:
CMS Adjusts Five-Star Ratings System, Nursing Home Compare
Take note of these major takeaways in how your facility will be evaluated. The Centers fo... Read more
Learning Opportunity:
CMS Announces Free Infection Preventionist Training
The 19-hour course is nonregulatory but covers matters crucial to RoP Phase III. Although... Read more
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Know These Definitions for QM Fluency
Hint: Figuring out which days count as a stay is crucial. The Centers for Medicare and Me... Read more
Reader Question:
Look to Additional Signs, Symptoms with Anxiety Dx
Question: A 74-year-old resident is complaining to aides that she is experiencing difficul... Read more
Reader Question:
Code This Test as an Injection
Question: Colleagues and I have been having an intense discussion on whether a tuberculosi... Read more
Reader Question:
Out with HICNs, In with MBIs
Question: We have a few Medicare residents and I am a little confused by the switch to the... Read more
Reader Question:
Two Will Do for SCSA
Question: One of my residents has improved mobility and no longer needs extensive ass... Read more
Compliance:
Get the Skinny On Foot Care
Though F687 Foot Care has been a citation in effect since November 2017, it's worth diggin... Read more
Item Focus:
Follow These Steps for Stroke as Primary Dx
Hint: Where the resident has the stroke doesn't matter if it's during the lookback period.... Read more
Avoiding Burnout:
Use These Tips to Advocate For Your Own Office
If a shared office affects your work, see if you can bargain your way into a better office... Read more
ICD-10 Focus:
Perfect Your Physician Query Skills With 6 FAQs
A comprehensive querying program can save you headaches now and in the future, too. With ... Read more
ICD-10 Practice:
Utilize These Tips for Coding Urinary Tract Infections
Your search for the correct code may be more involved than you hoped. If you're still get... Read more
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Learn Acronyms Necessary for MDS Coordinator Role
Keep this table handy to more easily navigate the CMS and MDS maze of acronyms. Save this... Read more
Reader Question:
HIPAA Protections Last Beyond Resident Death
Question: What are our responsibilities for protecting or distributing private health info... Read more
Reader Question:
Palliative Care Isn't Always Hospice Care
Question: My colleague and I disagree about whether palliative care automatically equals h... Read more
Reader Question:
Does 'Where Applicable' Apply to Smoking Status?
Question: At the beginning of the J section in the ICD-10-CM manual, there is a note ... Read more
Reader Question:
Even Sneaky Pressure Ulcers Still Count
Question: One of our residents was admitted with a cast. When the cast was removed, s... Read more
PDPM Focus:
PDPM May Affect HIV/AIDS Reimbursement Adjustment
Will switch from therapy billing in RUG-IV to include nursing in PDPM adequately cover the... Read more
Section I:
Be Careful How You Document HIV/AIDS
Hint: Defining illnesses may be key. If you are caring for a resident with HIV/AIDS and w... Read more
MDS Best Practices:
MDS Section Assignment: Who Does What
See how different facilities across the country assign different sections of the MDS and f... Read more
Long-Term Care Industry at Large:
Battling Grief in the Workplace
Death is part of life in the long-term care industry, and acknowledging it can help everyo... Read more
See How Other Facilities Honor Resident Deaths
Individual facilities and staff members respond differently to resident deaths. If you bel... Read more
ICD-10 Focus:
Code Pressure Ulcers Like This
Sequence, then specify site, side, and severity for success. When residents spend a lot o... Read more
Reader Question:
You Can Utilize 'Medically Complex' for Primary Diagnosis
Question: I have a resident who has numerous chronic diseases, some of which are better ma... Read more
Reader Question:
Include Care Plan When Transferring Resident
Question: I work for a skilled nursing facility and we have a resident transferring to ano... Read more
Reader Question:
Implement Data Safety Plan Before Terminating Employees
Question: With so much turnover at our facility, I worry about residents' protected health... Read more
Reader Question:
Have a Plan for Decommissioning Old Devices
Question: Our facility is purchasing new smartphones for some key employees, including som... Read more
Care Planning:
Focus on Vision For Quality Of Life
Don't miss a key element of preserving quality of life. Vision is a sense most of us take... Read more
HIPAA Compliance:
Texting Makes for Risky Business
Understand why texting is dangerous before you craft policies or train staff. MDS coordin... Read more
Industry Updates:
Illinois Appellate Court Rules Nursing Facilities Cannot Determine Sexual Consent
Cognitively impaired residents cannot consent; learn from this facility's “immediate jeo... Read more
CMS Updates:
Keep Up to Date With CMS Regs, News
Access Information on PDPM Resources. Did you miss the Medicare Learning Network Dec. 11 ... Read more
ICD-10 Focus:
Increase Your ICD-10-CM Fluency by Understanding 'Excludes1'
Get a grip on Excludes1 note and jump ahead on your coding knowledge. This month, you'll ... Read more
ICD-10 Coding Quiz:
Can You Code This COPD Scenario Correctly?
Test your ICD-10 skills with this scenario. Chronic health conditions plague many residen... Read more
Reader Question:
Telehealth Won't Replace Provider Visits
Question: My facility is in a rural region and we have a dearth of physicians or even nurs... Read more
Reader Question:
'Continence' Defined by Intention, Not Location
Question: We have a resident who is fairly immobile and used to use a handheld urinal when... Read more
Reader Question:
Healed Surgical Sites are not Wounds
Question: One of our residents recently returned from an operation and has a peripherally ... Read more
Reader Question:
Different States Require Different Employee Vaccinations
Question: I just moved to a new state and am working at a new long-term care facility. I h... Read more
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