• Baseline Care Plans and the 48-Hour Rule: CMS Gives AANAC Some Insights

    By Caralyn Davis, Staff Writer - January 31, 2018

    Even industry experts are often confused by the rules for baseline care plans laid out in F655 in Appendix PP, “Guidance to Surveyors for Long-term Care Facilities,” of the State Operations Manual, particularly what exactly does—and doesn’t—have to be done within that initial 48-hour window post-admission. So AANAC asked the Centers for Medicare & Medicaid Services (CMS) to confirm or deny three suppositions. The responses provided by a CMS official answer quite a few questions, including how MDS item V0200C2 (Date of Care Planning) fits into the picture and the requirements for providing an updated baseline care plan. Here are their insights.

     

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  • 7 Baseline Care Plan Myths

    By Caralyn Davis, Staff Writer - January 24, 2018

    Baseline care plans have been required since late November 2017, but nurse assessment coordinators (NACs) and other interdisciplinary team (IDT) members are still navigating through a lot of misinformation to learn the rules of the road for F655 (Baseline Care Plans) as detailed in Appendix PP of the State Operations Manual.

    Here are seven common myths that need to be vanquished:

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  • Q&A: How do you develop the baseline care plan within 48 hours when a resident admits late on a Friday afternoon and there is no therapy coverage until Monday?

    By Scott Heichel, RN, DNS-CT, RAC-CT - January 24, 2018
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  • E0800: Does rejection of care mean what you think?

    By Caralyn Davis, Staff Writer - December 19, 2017
    MDS 3.0 item E0800 (Rejection of Care—Presence and Frequency) is a common source of miscoding, according to AANAC master teachers. This could be an issue for several reasons. First, E0800 is a covariate (i.e., risk-adjustment item) for three claims-based publicly reported quality measures (QMs) that are used in the Five Star Quality Rating System, according to the technical specifications:
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  • It’s Not Just a Desk Job: Improving Person-Centered Care Through the RAI Process

    By Emily Royalty-Bachelor, Staff Writer - November 14, 2017

    There is no one right or wrong way to be a nurse assessment coordinator. The role often varies by state, by facility, and by the individual filling the role.

     

    But, suffice it to say, there are certain elements of the job that are applicable across the board—like, say, completing the MDS, or scheduling assessments.

     

    Tasks like these usually require the quiet solitude of an office with a closed door, or at least a computer to access software. So it’s understandable why many people might associate the role of a NAC with a desk job.

     

    But the truth is, the RAI process is not something that can be completed from your work chair. And if you’re spending the majority of your workday sitting at a desk, you’re missing out on key elements of your roles and responsibilities. The role of the NAC involves a lot of face-to-face interaction, both with the interdisciplinary team and—especially—with the residents.

     

    NACs, like every other member of the facility staff, are in the business of providing person-centered care. The operative word here is “person.” If you’re not interacting with the people, how can you ensure they’re at the center of the care you’re delivering?

     

    The RAI process, just like every component of care provided at the facility, needs to incorporate the resident’s voice and resident’s choice. Here’s how to make sure you’re doing just that:

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  • Baseline Care Plan FAQs: Weekends, Required Revisions, and Other Issues

    By Caralyn Davis, Staff Writer - October 16, 2017

    The baseline care plan requirement under F-tag F655 (Baseline Care Plan) in §483.21 (Comprehensive Resident-Centered Care Plans) of the Code of Federal Regulations goes into effect Nov. 28, 2017. Officials with the Centers for Medicare & Medicaid Services (CMS) addressed common frequently asked questions (FAQs), as well as follow-up questions from callers, during a Sept. 7 National Provider Call. Topics covered during the call range from working weekends to revising the baseline care plan as needed prior to the development of the comprehensive care plan. Note: Access the call slides, as well as the transcript and audio recording when available, here

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  • Baseline Care Plan Tool

    By AANAC - September 07, 2017
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  • Is Your Facility Ready to Provide the Baseline Care Plan Summary?

    By Caralyn Davis, Staff Writer - August 01, 2017
    As part of the Phase 2 rollout of the Mega Rule, nursing homes that participate in the Medicare and/or Medicaid programs must provide residents (and their representatives when applicable) with a baseline care plan summary starting Nov. 28, 2017. The Centers for Medicare & Medicaid Services (CMS) laid out the approach surveyors will take toward assessing compliance in the recently released advance copy of Appendix PP, “Guidance to Surveyors for Long-term Care Facilities,” of the State Operations Manual.
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  • Baseline Care Plans: How NACs Can Prepare

    By Caralyn Davis, Staff Writer - July 26, 2017
    Effective Nov. 28, 2017, nursing homes that participate in the Medicare and/or Medicaid programs have to complete and implement a baseline care plan within 48 hours of a resident’s admission, as well as provide a baseline care plan summary to the resident (and representative if necessary) by the completion of the comprehensive care plan. On June 30, the Centers for Medicare & Medicaid Services released an advance copy of Appendix PP, “Guidance to Surveyors for Long-term Care Facilities,” of the State Operations Manual, offering some important details about the baseline care plan implementation requirements in F-tag 655. (See excerpt at the end of this article.)
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  • Baseline Care Plan and Summary for Phase 2

    By AADNS - May 23, 2017
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