Documentation Power Tools
25 years experience in long term care
Documentation Power Tools
25 years experience in long term care |
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News MDS 3.0 Implementation Date Postponed for 2 Years During the SNF Open Door Forum on October 25, CMS gave a new timeline for MDS 3.0. The final draft of MDS 3.0 will be published in October, 2008. Long term care facilities will have until October, 2009 to implement and be in compliance with the new form and related regulatory changes.
Nursing Home Room Cost Averages $78,000 per year The costs of private and semi-private rooms rose 3% nationwide during the last year. The average cost of a private nursing home room jumped to $213 per day, or $77,745 annually. The average cost of a semi-private room hit $189 daily, or $68,985 per year. McKnight’s ArticleCMS to Look Closer at MDS and Care Plan Accuracy in 2008 CMS stated that as part of the 2008 OIG Work Plan: “We will review nursing homes’ use of the MDS and RAPs to develop plans of care and guide the provision of appropriate and necessary care. Prior OIG reports revealed that approximately one quarter of residents’ needs for care, as identified through the RAI, were not reflected in the residents’ care plans and that nursing home residents did not receive all psychosocial services identified on care plans." OIG Workplan for FFY 2008 At Many Homes, More Profit and Less NursingThe New York Times analyzed trends at more than 1,200 nursing homes purchased by large private investment groups since 2000, and more than 14,000 other homes. The analysis compared investor-owned homes against national averages in multiple categories. The investors and operators are earning millions of dollars a year. Residents fare less well.
News Revised Paid Feeding Assistant Regulations Released States must approve training programs for feeding assistants using federal requirements as minimum standards. Feeding assistants must successfully complete a State-approved training program and work under the supervision of a registered nurse or licensed practical nurse. The new surveyor guidance became effective September 28, 2007. Advance Copy of Regulations Facilities will be Charged for Survey Revisits Revisit surveys fees were effective on September 19, 2007. The final fee schedule for revisit surveys in skilled nursing facilities and nursing facilities is $168 per offsite revisit survey and $2,072 per onsite revisit survey. Complete CMS Final Rule pdf New CPR Promises Better Results by Compressing AbdomenA biomedical engineer at Purdue University has developed a new method to perform cardiopulmonary resuscitation that promises to be more effective than standard CPR because it increases nourishing blood flow through the heart by 25 percent over the current method. Proof Still Needed for Flu injections There is not enough evidence to support the effectiveness of immunizing older people against flu, fresh research in the US has concluded. Researchers from George Washington University say the benefits in reducing deaths among over 70s have been "greatly exaggerated". BBC Article At Many Homes, More Profit and Less NursingThe New York Times analyzed trends at more than 1,200 nursing homes purchased by large private investment groups since 2000, and more than 14,000 other homes. The analysis compared investor-owned homes against national averages in multiple categories. The investors and operators are earning millions of dollars a year. Residents fare less well. News Revised Guidance for Accidents and Supervision is Effective August 6 The new surveyor guidance covers the main areas of: Altercations, Assistive Devices and Equipment, Chemicals and Toxins, Electrical Safety, Entrapment Risks, Falls, Lighting, Smoking, Wandering, and Water Temperature. Accidents and Supervision, Revised Guidance New Regulation Specifies that Therapy Evaluations Must be Done in the SNF to Qualify for Coverage The recent CMS transmittal states: The services must be directly and specifically related to an active written treatment plan that is based upon an initial evaluation performed by a qualified physical therapist after admission to the SNF and prior to the start of physical therapy services in the SNF that is approved by the physician after any needed consultation with the qualified physical therapist. In those cases where a beneficiary is discharged during the SNF stay and later readmitted, an initial evaluation must be performed upon readmission to the SNF, prior to the start of physical therapy services in the SNF. A link to the Complete Transmittal Document (pdf) can be found on this CMS Page. After Long Wait, CDC Releases Revisions to Its Isolation Precautions The Centers for Disease Control and Prevention finally released a long-awaited set of guidelines on Monday that updates and expands the isolation precautions it recommends for hospitals and other healthcare settings. HealthLeadersArticleSummarizingChanges A link to the 219-page guideline can be found on the CDC’s page. CMS Releases DAVE Tip Sheet for MDS Item K5aThe tip sheet was developed to clarify coding for IV Fluid Therapy, and gives definitions, examples, and exclusions. View the entire document with this link:DAVE 2 - MDS Tip sheet: Item K5a Parenteral/Intravenous (IV) - May 2007 (pdf)Terms Defined for Recent Restraint RegulationsThe memorandum to State Survey Agency Directors sent by CMS clarifies the restraint regulation terms “remove easily”, “freedom of movement”, and “medical symptom”. CMS MemorandumSurvey Fees Proposed for Facilities Not in Compliance Health care facilities deemed out of compliance with federal quality-of-care standards could be required to pay user fees to cover the costs of survey and certification revisits to address cited deficiencies, according to a proposed rule scheduled to appear in the June 29 Federal Register. Bureau of National Affairs Article Links Annual Update of ICD-9 Codes, effective October, 2007
LTCS Directory of Nursing Resources
Articles Keeping Patients’ Details Private, Even From KinNew studies have found that some health care providers apply HIPPA regulations overzealously, leaving family members, caretakers, public health and law enforcement authorities stymied in their efforts to get information. Article by Jane Gross, from the New York Times, July 3, 2007 News OSHA to Target Nursing HomesSome nursing homes may soon receive an unexpected visitor from the U.S. Department of Labor's Occupational Safety and Health Administration.McKnight’s ArticlePressure Ulcer Stages Revised by NPUAPThe National Pressure Ulcer Advisory Panel has redefined the definition of a pressure ulcer and the stages of pressure ulcers, including the original 4 stages and adding 2 stages on deep tissue injury and unstageable pressure ulcers. Updated Staging SystemSeniors Unfairly Stereotyped as Grouchy and Frail A study of caregivers of Alzheimer's patients and non-caregivers done by the University of Alberta in Edmonton, Canada revealed that seniors are being stereotyped as grouchy, inflexible to change, and mostly living in nursing homes, when the opposite is true. University of Alberta Article Report Projects Future Need for Long-Term Care About 10 million people 65 and older now depend on long term care services, and that number is expected to double by 2040. NewsWise ArticleRNs Number More Than 2 Million in 2006, Report Finds The ranks of registered nurses numbered 2.4 million last year, making them members of one of the largest occupations in the country, according to a report from the Bureau of Labor Statistics. McKnight’s Article Links Advancing Excellence in America’s Nursing Homes A two year, coalition-based campaign concerned with how we care for elderly and disabled citizens. This voluntary campaign: Monitors key indicators of nursing home care quality, Promotes excellence in caregiving for nursing home residents, Acknowledges the critical role nursing home staff have in providing care
Supports models where elders live in open, diverse, caring communities. Works toward transformational system change by both evolutionary and revolutionary means, using Pioneer values and principles as the foundations for change. Articles 10 Signs Your QA Efforts for Pressure Ulcers May Not Be Working
News Nursing Home Oversight Lax, Report Shows Federal health officials impose only minimal penalties on nursing homes repeatedly cited for mistreatment of patients, congressional investigators say in a new report. Contra Costa Times Article Nursing Home Resident Falls Don't Increase With Bed-Rail RemovalCutting back on the use of restrictive side rails on nursing home residents' beds does not appear to increase the risk of falls, according to a new study in the Journal of the American Geriatrics Society.
May 13-19 is National Nursing Home WeekSponsored by the American Health Care Association (AHCA), the week is designed as a community outreach effort to familiarize the public with long-term care facilities and related services. Through education and awareness, the stereotypes associated with nursing homes and long-term care can be eliminated, and the value and benefits highlighted. Press Ganey ArticleLinks Medicinal Herbs, Vitamins, and Supplements The use of herbs and supplements is increasing. While many of these substances are harmless and even beneficial, they can also have serious side effects such as decreasing the action of warfarin or raising blood pressure.
Merck Guide to Medicinal Herbs and Nutraceuticals
Herb-Drug Interactions, University of Michigan Health System
Articles 10 Signs Your QA Efforts for Pressure Ulcers May Not Be Working
News Revisions to the RAI User’s Manual for MDS 2.0, Effective March 2007 Sections revised include: H3 - Appliances and Programs, P1 - Special Treatments and Procedures, and W3 – Pneumococcal Immunization. A link to the complete revisions is below. RAI Manual Revisions CMS Releases 2007 Work Plan for Medicare Nursing According to the work plan, CMS will examine methods the State survey agencies use in identifying assessments and care plans that do not address individualized needs. Other areas of focus will include Infusion Therapy Services, Consecutive Inpatient Stays, and Payments for Day of Discharge. OIG Workplan 2007 Links March is National Nutrition Month Medicare provides coverage for Medical Nutrition Therapy for eligible Medicare beneficiaries. Is your facility up to date on what the coverage provides? Read an overview of the covered services at the link below: Medical Nutrition Therapy Services
AllNurses.com’s Long Term Care Forum This site is always worth a look. Virtually every nursing home topic is discussed here. Read unedited opinions, stories, and shared resources from LPNs, RNs, DONs, and MDS Coordinators working in long term care facilities. Articles Definitely not the Solution to the Nursing Shortage - Bush to Cut Funding for Nursing Education in 2008 Budget Along with other nursing organizations such as the American Nurses Association, the National League for Nursing will be calling upon nurses in the U.S. to contact their legislators to respond to President Bush's recent budget proposal for 2008. In this proposed budget, President Bush calls for a 29.7% decrease in funding of Title VIII - Nursing Workforce Development Programs. To achieve the goal of cutting $44.4 million dollars from these funds, the "Advanced Education Nursing" line item will be zeroed out; essentially cutting all funding for advanced education for nurses. This will dramatically impact the number of nurses continuing their education to become nurse educators. The nursing shortage will not be solved without first addressing the issue of the shortage of nurse educators. You can contact your legislators at Congress.org.
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