• New NAC: Five Tips for Successful Orientation

    By Jessie McGill, RN, RAC-MT, RAC-MTA - February 24, 2021

    One year. When asked how long it takes a new nurse assessment coordinator (NAC) to fully learn the job, AAPACN curriculum development specialist, Jessie McGill says at least one year. The volume and complexity of information NACs must master can make orientation a challenge. However, the right orientation plan can pave the way to a long, satisfying MDS career.

     

    For those tasked with orienting a new NAC, read this article for five tips that will help guide the process.

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  • MDS Item C1310: Keys to Navigating the CAM

    By Caralyn Davis, Staff Writer - February 24, 2021

    The Confusion Assessment Method (CAM) is a standardized cognitive assessment that determines whether a resident has signs and symptoms of delirium. “Understanding that delirium is serious and treatable is critical,” says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC. “This section requires the assessor to really drill down into whether there has been an acute change in cognitive status and whether the behaviors seen fluctuate or are always there."

     

    Read this article for steps NACs can take to help ensure this MDS items and all subitems are coded accurately.

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  • National Healthcare Safety Network (NHSN) Long-term Care Facility COVID-19 Reporting Module Website UPDATED (2/21)

    By CDC - February 21, 2021

    CDC’s NHSN provides healthcare facilities, such as long-term care facilities (LTCFs), with a secure reporting platform for reporting outcomes and process measures in a systematic way. Reported data are immediately available for use in strengthening local and national surveillance, monitoring trends in infection rates, assisting in identifying resource insecurities, and informing progress toward infection prevention goals.

    The NHSN Long-term Care Facility Component supports the nation’s COVID-19 response through the LTCF COVID-19 Module. Facilities eligible to report data to NHSN’s COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted living facilities.

    Data reported into the LTCF COVID-19 Module Surveillance Reporting Pathways facilitate assessment of the impact of COVID-19 through facility reported surveillance data. Examples of data reported in the pathways include:

    ·         Counts of residents and facility personnel newly positive for COVID-19 based on viral test results.

    ·         COVID-19 vaccination status of residents newly positive for COVID-19.

    ·         Re-infections in residents and facility personnel previously infected with COVID-19.

    ·         COVID-19 related death counts among residents and facility personnel.

    ·         Staffing shortages.

    ·         Availability and surge capacity use of personal protective equipment (PPE) and alcohol-based hand rub.

    ·         Monoclonal therapeutic availability and use.

    ·         Ventilator capacity and supplies for facilities with ventilator-dependent units.

    The Point-of-Care (POC) Test Reporting Tool is a separate reporting option for LTCFs to report SARS-CoV-2 test results provided by a POC device. NHSN routes reported POC laboratory test result data to the public health agency at the local or state level with jurisdictional authority and responsibility for receiving those data. Important: the reporting of POC test result data in this tool does not take the place of answering POC related questions in the Resident Impact and Facility Capacity surveillance reporting pathway.

    Weekly reporting of COVID-19 vaccination data for residents and healthcare personnel is another option available to LTCFs. Additional information about surveillance and vaccination reporting, please visit the Weekly HCP & Resident COVID-19 Vaccination webpage.

    LTCF data submission options include manual data entry, CSV file submission by individual facilities or bulk CSV file upload for multiple facilities, and/or NHSN DIRECT CDA Automation for the Point-of-Care (POC) Test Reporting Tool.

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  • SNF Healthcare-Associated Infections Requiring Hospitalization for the SNF QRP Technical Report (2/21)

    By CMS - February 21, 2021
    The Improving Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the Secretary to specify resource use measures, on which post-acute care (PAC) providers, including skilled nursing facilities, are required to submit necessary data specified by the Secretary. The Centers for Medicare and Medicaid Services (CMS) has contracted with Acumen, LLC and RTI International to develop the SNF HAI measure under the Quality Measure & Assessment Instrument Development & Maintenance & QRP contract (75FCMC18D0015, Task Order 75FCMC19F0003).

    This report presents the SNF HAI technical measure specifications. Section 2 provides an overview of the measure and is a high-level summary of the key features of the measure that are described in detail in the remaining sections of the document. Section 3 describes the methodology used to construct the SNF HAI measure including its data sources, study population, measure outcome, regression model, and steps for calculating the final measure score. Section 4 discusses SNF HAI measure testing including the measure’s reportability, variability, reliability, and validity testing results. Appendix A displays the ICD-10 codes used to identify HAI conditions included in the measure. Appendix B presents the results of the risk adjustment model. Lastly, Appendix C details a flow chart for calculating the measure. 
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  • CMS Updates SNF PPS Legislative History (2/21)

    By CMS - February 20, 2021
    Historically, each rule or update notice issued under the annual Skilled Nursing Facility (SNF) prospective payment system (PPS) rulemaking cycle included a detailed reiteration of the various individual legislative provisions that have affected the SNF PPS over the years, a number of which represented temporary measures that have long since expired. This document now serves to provide that discussion.
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  • CMS COVID-19 Emergency Declarations and Specific SNF/NF Flexibilities UPDATED (2/21)

    By CMS - February 19, 2021

    COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) UPDATED (2/19/21)

    Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities) (PDF) UPDATED (02/03/21)

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  • COVID-19 Medicare FAQs Updated (2/21)

    By CMS - February 19, 2021

    Documents include: 

    • Frequently Asked Questions to Assist Medicare Providers
    • Medicare Telehealth Frequently Asked Questions (PDF) (now included in all-inclusive FAQs) 
    • Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction
    • Frequently Asked Questions (FAQs), CLIA Guidance During the COVID-19 Emergency

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  • Five-Star Helpline Open Feb. 22 - 26

    By QTSO - February 17, 2021

    The Five Star Preview Reports were available on February 15, 2021. To access these reports, select the CASPER Reporting link located on the CMS QIES Systems for Providers page. Once in the CASPER Reporting system, select the 'Folders' button and access the Five Star Report in your 'st LTC facid' folder, where 'st' is the 2-character postal code of the state in which your facility is located and 'facid' is the state-assigned Facility ID of your facility.

    Nursing Home Compare will update with the February Five Star data on February 24, 2021.

    Important Note: The 5 Star Help Line (800-839-9290) will be available February 22 through February 26, 2021.

    Please direct your inquiries to BetterCare@cms.hhs.gov  if the Help Line is not available.

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  • SNF Consolidated Billing: COVID-19 Monoclonal Antibody Treatment (2/21)

    By CMS - February 16, 2021
    CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment·

    COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing

    Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction

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  • CDC Strategies for Optimizing the Supply of PPE and Other Equipment (12/20)

    By CDC - February 15, 2021

    The Centers for Disease Control and Prevention (CDC) offers strategies for optimizing the supply of:

    N95 respirators

    Face masks

    Isolation gowns

    Eye Protection

    Gloves

    Powered Air-Purifying Respirators (PAPRs)

    Elastomeric respirators

    Ventilators

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  • CMS Section N: Medications – Drug Regimen Review Web-Based Training (2/21)

    By CMS - February 14, 2021

    The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course that provides an overview of the assessment and coding of the Drug Regimen Review standardized patient assessment data elements (SPADEs) found in the Medications Section of the guidance manuals.

    This 45-minute course is intended for providers in Home Health Agencies (HHAs), Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNFs), and is designed to be used on demand anywhere you can access a browser.

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  • CMS QSO Memo: Enhanced Enforcement Actions Based on Nursing Home COVID-19 Data and Inspection Results (2/21)

    By CMS - February 08, 2021

    DATE: June 1, 2020

    REVISED 01/04/2021

    TO: State Survey Agency Directors FROM: Director Quality, Safety & Oversight Group

    SUBJECT: Revised COVID-19 Survey Activities, CARES Act Funding, Enhanced Enforcement for Infection Control deficiencies, and Quality Improvement Activities in Nursing Homes

    CMS is committed to taking critical steps to protect vulnerable Americans to ensure America’s health care facilities are prepared to respond to the CoronavirusDisease2019(COVID-19) Public Health Emergency (PHE).

    • CMS has implemented a new COVID-19 reporting requirement for nursing homes, and is partnering with CDC’s robust federal disease surveillance system to quickly identify problem areas and inform future infection control actions.

    • Following the March 6, 2020 survey prioritization, CMS has relied on State Survey Agencies to perform Focused Infection Control surveys of nursing homes across the country. We are now initiating a performance-based funding requirement tied to the Coronavirus Aid, Relief and Economic Security (CARES) Act supplemental grants for State Survey Agencies. Further, we are providing guidance for the limited resumption of routine survey activities. CMS has revised the criteria requiring states to conduct focused infection control surveys due to the increased availability of resources for the testing of residents and staff and factors related to the quality of care.

    • CMS is providing Frequently Asked Questions related to health, emergency preparedness and lifesafety code surveys

    • CMS is also enhancing the penalties for noncompliance with infection control to provide greater accountability and consequence for failures to meet these basic requirements. This action follows the agency’s prior focus on equipping facilities with the tools they needed to ensure compliance, including 12 nursing home guidance documents, technical assistance webinars, weekly calls with nursing homes, and many other outreach efforts. The enhanced enforcement actions are more significant for nursing homes with a history of past infection control deficiencies, or that cause actual harm to residents or Immediate Jeopardy.

    • Quality Improvement Organizations have been strategically refocused to assist nursing homes in combating COVID-19 through such efforts as education and training, creating action plans based on infection control problem areas and recommending steps to establish a strong infection control and surveillance program.

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  • LTCSP Survey Resources: Surveyor Tools Updated (2/21)

    By CMS - February 07, 2021

    This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP).

     

     

    02/05/2021 Survey Resource folder update: 

     

    LTCSP Procedure Guide

    • Expansion of complaints/FRIs in LTCSP during recertification survey

    LTCSP 11.9.5 User Guide

    • Expansion of complaints/FRIs in LTCSP during recertification survey

     

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  • LTCSP Procedure Guide - Updated (2/21)

    By CMS - February 07, 2021

    The LTCSP Procedure Guide provides instruction on the procedural and software steps necessary for completing the Long-term Care Survey Process. Surveyors use the Procedure Guide for all standard surveys of SNFs and NFs, whether freestanding, distinct parts, or dually participating. The LTCSP steps are organized into seven parts: 1) offsite preparation; 2) facility entrance; 3) initial pool process; 4) sample selection; 5) investigation; 6) ongoing and other survey activities; and 7) potential citations.

    2/5 update

    1. LTCSP Procedure Guide: Expansion of complaints/FRIs in LTCSP during recertification survey

     

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  • Check Your Data: Updated Data Process Will Impact CASPER/SNF QRP Provider Demographic Data (2/21)

    By QTSO - February 06, 2021

    CMS will be transitioning to a new data source for a provider’s demographic data for all five Post-Acute Care (PAC) provider types (Skilled Nursing Facilities / Nursing Facilities (SNF/NFs), Home Health Agencies (HHAs), Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs) and Hospices).  These demographic data include such items as the provider name, provider-mailing address, provider physical address, State, ZIP Code, etc.  These provider demographic data are displayed on the Provider and Quality Measure reports generated from the Quality Improvement and Evaluation System (QIES) Certification and Survey Provider Enhanced Reports (CASPER) Reporting application for SNF/NF and Hospice providers and reports generated from Internet Quality Improvement and Evaluation System (iQIES) for HHA, IRF, and LTCH providers.  Additionally these same demographic data are displayed on the public reporting websites such as the Provider Data Catalog (PDC).

    Historically provider demographic data have been maintained in the Automated Survey Processing Environment or ASPEN software; however, CMS will be transitioning to use the demographic information from Provider Enrollment, Chain and Ownership System (PECOS).  While this transition is underway, a final date when all demographic data will be obtained from PECOS has not been identified.  During this transition, all PAC providers will be responsible to ensure their latest demographic data are updated and available in both the ASPEN and PECOS systems. 

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