OIG Risk Areas: Comprehensive Care Plans, Restorative/Personal Care Services & Medication Management

Size: px
Start display at page:

Download "OIG Risk Areas: Comprehensive Care Plans, Restorative/Personal Care Services & Medication Management"

Transcription

1 OIG Risk Areas: Comprehensive Care Plans, Restorative/Personal Care Services & Medication Management Presented by: Nan Impink, Esq. Kelly Priegnitz, Esq. Harvey Tettlebaum, Esq.

2 Where We ve Been & Today s Topics Review of prior webinar topics Mechanics of compliance programs OIG Risk Areas to date Today: Comprehensive Care Plans Nan/Kelly Restorative / Personal Care Services Nan/Kelly Medications Management Harvey

3 OIG Risk Area: Comprehensive Care Plans

4 Key Focus Areas in OIG Compliance Supplemental Guidelines (CSG) Comprehensive Care Plans

5 Comprehensive Care Plans are: OIG Focus Area Survey and Enforcement Focus Area Failure to demonstrate an effective care planning process could be the basis for fraud and abuse or false claim actions!

6 How it all works together RAI Process Care Planning MDS Assessment Quality Care, Quality of Life Survey Outcomes RUGS Customer Satisfaction Pay for Performance Claims Improved 5-Star Rating Payment

7 Care Plans must meet needs of Residents: Medical Needs Nursing Needs Mental Needs Psychosocial Needs

8 Care Plans must have Reasonable Objectives Based on specific resident diagnosis/medical psychosocial Based on resident preferences, needs and goals Timelines Must be reasonable Must be attainable

9 Key Factors Interdisciplinary Approach All disciplines must be involved and must provide input based on discipline specific needs/goals Must include documentation of disciplinary approach

10 Basic Steps for a successful care planning process: Scheduling meetings to accommodate full IDT Completing all clinical assessments before meeting Open lines of communication to direct care providers and IDT Involvement of resident and family, POA or guardian Documentation of length and content of meeting

11 Meeting Scheduling IDT must commit to care planning process by attending prescheduled meetings Don t make excuses for absences Identify backup in the event of an emergency Don t schedule other meetings/events that could interfere with participation Be prepared and make sure appropriate information is available Care planning must be a priority. It certainly is an area of focus by federal/state enforcement agencies!

12 PRIOR to the meeting IDT members should review assessments and medical record documentation (including ADL documentation, MARS, TARS, nurses notes, therapy notes, activities/social services notes, consults, labs, etc.) Speak with direct care staff, physicians, physician extenders, other providers to obtain input and information. Speak with family members/residents in advance of the meeting to better understand goals and objectives. This will help to keep the meeting on track. Assemble and organize all necessary documentation. Develop an agenda to assure all areas are addressed. Alert staff and receptionist not to interrupt during the meeting.

13 Communicate Communicate Communicate Encourage/invite direct care staff to participate at appropriate times to provide input and insight Encourage/invite other ancillary providers to participate at appropriate times to provide input and insight Encourage/invite resident and family members to actively participate to express wishes, preferences, goals and objectives An organized and well-planned agenda will assist with timing and meeting flow.

14 Document Document Document Keep minutes of care plan meetings and have all parties review and sign. Minutes should include start/top times, attendees, content of meeting. Develop and document care plan goals during the meeting. Make sure goals are specific, detailed, and understandable Include time frames and expected outcomes Update nurse assignment sheets immediately following meeting to assure timely communication.

15 Key Factors (cont.) The OIG/Enforcement Agencies are looking for: Physician Involvement Physicians must be active in the care planning process Documentation must evidence physician input and participation

16 Steps to facilitate physician involvement: Develop policies / procedures to require, accommodate, and encourage physician participation Provide advance notice of meetings Arrange for alternative approaches for participation Telephonic Attendance at the Meeting Post-meeting debriefing

17 Physician Involvement (cont.) Circulate minutes post-meeting Circulate Care Plan drafts postmeeting Solicit additional comments/suggestion Communicate final plan to physicians, other providers, direct care staff, etc.

18 The tricks to successful care planning are: Participation Communication Documentation

19 Key Facts in OIG Compliance Supplemental Guidelines (CSG) Restorative and Personal Care

20 Restorative and Personal Care OIG Goals: To improve areas such as Avoiding pressure ulcers Improving passive range of motion Improving ambulation Fall prevention Incontinence management Enhance bathing, dressing and grooming activities

21 WARNING!! Failure to provide restorative services, yet submitting claims for such services = risk of liability under Fraud and Abuse and False Claim Statutes

22 Key Strategies for Risk Avoidance: Engage in resident / staff interviews Consult with attending physicians and medical directors Consult with consulting pharmacists Make personal observation of care provided Assure complete and contemporaneous documentation of services

23 Resident/Staff Interviews Are residents receiving restorative services? What types of restorative services? Active/Passive Range of Motion Ambulation Stationary/In-bed exercises How often are services provided? Who provides services? Are the services successful? NOTE: Check documentation post-interview to assure consistency

24 Physician Involvement Contact physicians periodically to request further instruction on restorative opportunities Explain current services and progress to date Request that additional residents be included in trials to determine whether they are appropriate for restorative services Request education/consultation on new or different approaches to restorative services Document conversations as appropriate

25 Consultant Pharmacist Involvement Contact pharmacist to discuss how medications can benefit or interfere with restorative services Pain Relief vs. Lethargy Request periodic drug holidays to determine whether restorative services can serve as an alternative to pharmacologic approach Explore options for reducing pain and stiffness to enhance opportunities for participation Document conversations as appropriate

26 Observe Restorative Services as they are provided Randomly observe services based on input from resident/staff interviews Are services provided as stated? Is staff competent to provide needed service? Are residents actively participating? Do barriers exist that impede active participation? Signs of pain Failure by staff to actively engage with resident Interruptions Lack of equipment Staff pulled to other tasks

27 Document Document Document Conduct random/periodic audits of restorative services documentation. Base audits on interviews/observations Assure documentation is consistent and contemporaneous with observations Assure that documentation includes progress over time or the basis for discontinuing restorative services Assure that documentation is sufficient to support payment for services.

28 Education + Monitoring / Observation + Communication + Documentation = Effective Compliance Programs

29 OIG Risk Area: Medication Management

30 F (1) Unnecessary Drugs General. Each resident s drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used: In excessive dose (including duplicate therapy); or For excessive duration; or Without an adequate monitoring; or Without adequate indications for its use; or In the presence of adverse consequences which indicate the dose should be reduced or discontinued; or Any combinations of the reasons above.

31 The intent of (l): The medication regimen helps promote or maintain the resident s highest practicable mental, physical, and psychosocial well-being, as identified by the resident and/or representative(s) in collaboration with the attending physician and facility staff;

32 The intent of (l): Each resident receives only those medication, in doses and for the duration clinically indicated to treat the resident s assessed condition(s); Non-pharmacological interventions (such as behavioral interventions) are considered and used when indicated, instead of, or in addition to, medication;

33 The intent of (l): Clinically significant adverse consequences are minimized; and The potential contribution of the medication regimen to an unanticipated decline or newly emerging or worsening symptom is recognized and evaluated, and the regimen is modified when appropriate.

34 Some definitions: Adverse consequence is an unpleasant symptom or event that is due to or associated with a medication, such as impairment or decline in an individual s mental or physical condition or functional or psychosocial status. It may include various types of adverse drug reactions and interactions (e.g., medication-medication, medication-food, and medication-disease). Adverse drug reaction (ADR) is a form of adverse consequences. The term side effect is often used interchangeably with ADR; however, side effects are but one of five ADR categories, the others being hypersensitivity, ideosyncratic response, toxic reactions, and adverse medication interaction. A side effect is of expected, well-known reaction that occurs with a predictable frequency or may not constitute an adverse consequence. There are other definitions.

35 SOM Overview: Proper medical selection in prescribing (including dose, duration, and type of medication(s) may help stabilize or improve a resident s outcome, quality of life and functional capacity. Any medication or combination of medication or the use of a medication without adequate indications, in excessive dose, for an excessive duration, or without adequate monitoring may increase the risk of a broad range of adverse consequences such as medication interactions, depression, confusion, immobility, falls, and related hip fractures.

36 Under the regulations medication management includes consideration of: Indications for use of medication (including initiation or continued use of antipsychotic medication); Monitoring for ethicacy and adverse consequences; Dose (including duplicate therapy); Duration;

37 Under the regulations medication management includes consideration of: Tapering of a medication dose/gradual dose reduction for antipsychotic medication; and Prevention, identification, and response to adverse consequences.

38 There are circumstances that warrant evaluation of resident and his or her medications which include the following: Admission or re-admission; A clinically significant change in condition/status; A new, persistent, or recurrent clinically significant symptom or problem; A worsening of an existing problem or condition;

39 There are circumstances that warrant evaluation of resident and his or her medications which include the following: An unexplained decline in function or cognition; A new medication order or renewal of orders; and An irregularity identified in the pharmacist s monthly medication regimen review.

40 Monitoring: Monitoring of the resident s response to any medication(s) is essential to evaluate the ongoing benefits as well as risks of various medications. It is important, for example, to monitor the effectiveness of medications used to address behavioral symptoms (e.g., behavioral monitoring) or to treat hypertension (e.g., periodic pulse and blood pressure). Monitoring for adverse consequences involves ongoing vigilance and may periodically involve objective evaluation (e.g., assessing vital signs may be indicated if a medication is known to affect blood pressure, pulse rate and rhythm, or temperature). Using quantitative and qualitative monitoring parameters facilitates consistent and objective collection of information by the facility.

41 Re-evaluating and updating monitoring approaches: Modification of monitoring may be necessary when the resident experiences changes, such as: Acute onset of signs or symptoms or worsening of chronic disease; Decline in function or cognition; Addition or discontinuation of medications and/or non-pharmacological interventions;

42 Re-evaluating and updating monitoring approaches: Modification of monitoring may be necessary when the resident experiences changes, such as: Addition or discontinuation of care and services such as enteral feedings; and Significant changes in diet that may affect medication absorption or effectiveness of increase adverse consequences.

43 Re-evaluating and updating monitoring approaches: Additional examples of circumstances that may indicate a need to modify the monitoring include: changes in manufacture s specifications, FDA warnings, pertinent clinical practice guidelines, or other literature about how and what to monitor.

44 Dose (Including Duplicate Therapy): A prescriber orders medication(s) based on a variety of factors including the resident s diagnoses, signs and symptoms, current condition, age, coexisting medication regimen, review of lab and other test results, input from the interdisciplinary team about the resident, the type of medication(s) and therapeutic goals being considered or used.

45 Factors influencing the appropriateness of any doses: These include the resident s clinical response, possible adverse consequences, and other resident and medication-related variables. Often, lab test results such as serum medication concentrations are only a rough guide to dosing. Significant adverse consequences can occur even when the concentration is within the therapeutic range. Serum concentrations alone may not necessarily indicate a need for dose adjustments, but may warrant further evaluation of a dose or the medication regimen.

46 Duplicate Therapy: Duplicate therapy is generally not indicated, unless current clinical standards of practice and documented clinical rationale confirm the benefits of multiple medications from the same class or with similar therapeutic effects.

47 Duplicate Therapy: Some examples of potentially problematic duplicate therapy include: Use of more than one product containing the same medication can lead to excessive doses of a medication, such as concomitant use of acetaminophen/hydrocodone and acetaminophen, which may increase the risk of acetaminophen toxicity; Use of multiple laxatives to improve or maintain bowel movements, which may lead to abdominal pain or diarrhea;

48 Duplicate Therapy: Some examples of potentially problematic duplicate therapy include: Concomitant use of multiple benzodiazepines such as lorazepam for anxiety and temazepam for sleep, which may increase fall risk; or Use of medications from different therapeutic categories that have similar effects or properties, such as multiple medications with anticholinergic effects (e.g., oxybutynin and diphenhydramine), which may increase the risk of delirium or excessive sedation.

49 Duplicate Therapy: Documentation is necessary to clarify the rationale for and benefits of duplicate therapy and the approach to monitoring for benefits and adverse consequences. This documentation may be found in various areas of the resident s clinical record.

50 Duration: Periodic re-evaluation of the medication regimen is necessary to determine whether prolonged or indefinite use of a medication is indicated. The clinical rationale for continued use of a medication(s) may have been demonstrated in the clinical record, or the staff and prescriber may present pertinent clinical reasons for the duration of use.

51 Duration: Common considerations for appropriate duration may include: A medication initiated as a result of a timelimited condition (for example, delirium, pain, infection, nausea and vomiting, cold and cough symptoms, or itching) is then discontinued when the condition has resolved, or there is documentation indicating why continued use is still relevant. Failure to review whether the underlying cause has resolved may lead to excessive duration.

52 Duration: Common considerations for appropriate duration may include: A medication is discontinued when indicated by facility stop order policy or by the prescriber s order, unless there is documentation of the clinical justification for its extended use. A medication administered beyond the stop date established in the prescriber s order or by facility policy, without evidence of clinical justification for continued use of the medication, may be considered excessive duration.

53 Tapering of a Medication Dose/Gradual Dose Reduction (GDR): The requirements underlying this guidance emphasize the importance of seeking an appropriate dose and duration for each medication and minimizing the risk of adverse consequences. The purpose of tapering a medication is to find an optimal dose or to determine whether continued use of the medication is benefiting the resident. Tapering may be indicated when the resident s clinical condition has improved or stabilized, the underlying causes of the original target symptoms have resolved, and/or non-pharmacological interventions, including behavioral interventions, have been effective in reducing the symptoms.

54 Opportunities to Evaluate: Opportunities during the care process to evaluate the effects of medications on a resident s function and behavior and to consider whether the medication should be continued, reduced, discontinued or otherwise modified can include the following:

55 Opportunities to Evaluate: Can include the following: During the monthly medication regimen review, the pharmacist evaluates resident-related information for dose, duration, continued need, and the emergence of adverse consequences for all medications;

56 Opportunities to Evaluate: Can include the following: When evaluating the resident s progress, the practitioner reviews the total plan of care, orders, the resident s response to the medication(s), and determines whether to continue, modify, or stop a medication; and During the quarterly MDS review, the facility evaluates mood, function, behavior, and other domains that may be affected by medications.

57 Adverse Consequences: Any medication or combination of medications can cause adverse consequences. Adverse consequences may become evident at any time after the medication is initiated. When reviewing medications used for a resident, it is important to be aware of the medication s recognized safety profile, tolerability, dosing, and potential medication interactions. Although a resident may have an unanticipated reaction to a medication that is always preventable, many ADRs can be anticipated, minimized, or prevented.

58 Some adverse consequences may be avoided by: Following relevant clinical guidelines and manufacturer s specifications for use, dose, administration, duration, and monitoring of the medication; Defining appropriate indications for use; and

59 Some adverse consequences may be avoided by: Determining that the resident: Has no known allergies to the medication; Is not taking other medications, nutritional supplements or foods that would be incompatible with the prescribed medications; and Has no condition, history, or sensitivities that would preclude use of that medication.

60 Pain and Other Medications: Commonly used medications are those to reduce pain or to thin the blood. With respect to each, note the following: With respect to pain medication, the CMS and the state survey agencies have made this an extremely high priority. Frequently, physician orders for pain medications are PRN (as needed). When charted that way, it can be confusing to the caregivers. You may wish to consider requesting physicians to order these types of medications for routine administration so they are more likely to be given on a regular schedule even if it is for a limited period of time to take care of the interim problem.

61 Pain and Other Medications: Commonly used medications are those to reduce pain or to thin the blood. With respect to each, note the following: Blood thinners such as Coumadin can have serious side effects and because they are used so frequently in nursing facilities staff should be educated and reeducated on some of these side effects and the need to have the resident s physician check the time it takes for the blood to start the clotting process (post-trothrombin time).

62 Conclusion: Do you have a medication administration system in place? Is it an accountable system? Is it tested and evaluated?

DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES

DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Use for a resident who has potentially unnecessary medications, is prescribed psychotropic medications or has the potential for an adverse outcome to determine whether facility practices are in place to

More information

The CMS State Operations Manual Overview and Changes

The CMS State Operations Manual Overview and Changes The CMS State Operations Manual Overview and Changes Omnicare, Inc. Page 1 Overview of the CMS State Operations Manual Executive Summary Historical Perspective The Requirements Pharmacy Services Labeling

More information

Pharmacy Services. Division of Nursing Homes

Pharmacy Services. Division of Nursing Homes Pharmacy Services Division of Nursing Homes 1 483.45 Pharmacy Services Overview The Pharmacy Services section of Appendix PP contains all Pharmacy Services requirements and interpretive guidelines (IG)

More information

Form CMS (5/2017) Page 1

Form CMS (5/2017) Page 1 Use this pathway for a resident who has pain symptoms or can reasonably be expected to experience pain (i.e., during therapy) to determine whether the facility has provided and the resident has received

More information

3/6/2017. CMS nursing home requirements have not been comprehensively updated since 1991 despite significant changes in the industry.

3/6/2017. CMS nursing home requirements have not been comprehensively updated since 1991 despite significant changes in the industry. Debra Brown, PharmD Pharmaceutical Consultant II Specialist Licensing and Certification QCHF/CAHF Spring Legislative Conference March 2017 1 Describe impact of 2016 CMS Final Rule on SNF pharmacy services

More information

Pain: Facility Assessment Checklists

Pain: Facility Assessment Checklists Pain: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to pain management in the facility, in order to identify areas

More information

Hospice and End of Life Care and Services Critical Element Pathway

Hospice and End of Life Care and Services Critical Element Pathway Use this pathway for a resident identified as receiving end of life care (e.g., palliative care, comfort care, or terminal care) or receiving hospice care from a Medicare-certified hospice. Review the

More information

MDS Essentials. MDS Essentials: Content. Faculty Disclosures 5/22/2017. Educational Activity Completion

MDS Essentials. MDS Essentials: Content. Faculty Disclosures 5/22/2017. Educational Activity Completion MDS Essentials MDS Essentials: Introduction to Care Area Assessments and Care Plans 4 Faculty Disclosures I have no financial relationships to disclose I have no conflicts of interests to disclose I will

More information

Notes from CMS Final Rule Document Pertinent to Culture Change and Person-directed Care

Notes from CMS Final Rule Document Pertinent to Culture Change and Person-directed Care Notes from CMS Final Rule Document Pertinent to Culture Change and Person-directed Care Page 594 Prepared by Cathy Lieblich, Director of Network Relations, Pioneer Network G. Benefits of Final Rule: This

More information

Psychotropic Drug Use To Medicate or Not to Medicate?

Psychotropic Drug Use To Medicate or Not to Medicate? Psychotropic Drug Use To Medicate or Not to Medicate? Presented by: Lydia Restivo, RN CDONA Regulatory Compliance Consultant West & Restivo Quality Consulting Cell: 516 318-9088 Email: lydrestivo@verizon.net

More information

Pain: Facility Assessment Checklists

Pain: Facility Assessment Checklists Pain: Facility Assessment Checklists A facility system assessment is a starting point for a quality improvement project. The checklists included in this booklet will be most useful if you take a critical

More information

Wyoming State Survey Agency

Wyoming State Survey Agency LeadingAge Wyoming September 6, 2018 Wyoming State Survey Agency Laura Hudspeth, MSc, RD, LD, Director Pat Davis, PE, LEED AP, Life Safety and Construction Branch Chief Julia Van Dyke, RN, Healthcare Surveillance

More information

Medication Related Changes Phase 1&2

Medication Related Changes Phase 1&2 Medication Related Changes Phase 1&2 Medicare and Medicaid Programs Reform of Requirements for Long-Term Care Facilities Published January 23, 2017 Medication- Related Changes* Changes will be implemented

More information

Monitoring Medication Storage & Administration

Monitoring Medication Storage & Administration Monitoring Medication Storage & Administration Objectives Review F-Tags pertaining to medication management Discuss proper medication storage and administration Understand medication cart and medication

More information

Based on the comprehensive assessment of a resident, the facility must ensure that:

Based on the comprehensive assessment of a resident, the facility must ensure that: 7. QUALITY OF CARE Each resident must receive, and the facility must provide, the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial wellbeing,

More information

The Consultant Pharmacist: The IDT Approach to Pharmacotherapy Care and Compliance with the CMS Final Rule

The Consultant Pharmacist: The IDT Approach to Pharmacotherapy Care and Compliance with the CMS Final Rule The Consultant Pharmacist: The IDT Approach to Pharmacotherapy Care and Compliance with the CMS Final Rule Dr. William G. Day Continuing Education Information 1.0 contact hours of continuing education

More information

Reviewing regulatory requirements for top ten federal Nursing Home Tags issued in Minnesota. Eva Loch, MDH Nursing Evaluator

Reviewing regulatory requirements for top ten federal Nursing Home Tags issued in Minnesota. Eva Loch, MDH Nursing Evaluator Reviewing regulatory requirements for top ten federal Nursing Home Tags issued in Minnesota. Eva Loch, MDH Nursing Evaluator F282- Comprehensive Care Plans Regulatory language (SOM): 483.21(b)(3) Comprehensive

More information

Critical Thinking Steps

Critical Thinking Steps CAA s = Critical Thinking CAROL SIEM, MSN, RN, BC, GNP Clinical Educator/Team Leader for QIPMO Critical Thinking Steps Recognition/Assessment Gather essential information about the individual Problem definition

More information

Part 1: Overview of AHCA/NCAL Clinical Considerations of Antipsychotic Management Toolkit

Part 1: Overview of AHCA/NCAL Clinical Considerations of Antipsychotic Management Toolkit Part 1: Overview of AHCA/NCAL Clinical Considerations of Antipsychotic Management Toolkit Dr. Cathy Lipton, MD Dr. Anna Fisher, PhD Holly Harmon, RN, MBA, LNHA Introduction Holly Harmon 1 Objectives Summarize

More information

MDS 3.0: What Leadership Needs to Know

MDS 3.0: What Leadership Needs to Know MDS 3.0: What Leadership Needs to Know especially prepared for CANPFA Ann Spenard RN, MSN History of the MDS and RAI Process The Resident Assessment Instrument (RAI) was part of a set of reforms enacted

More information

CMS s RAI Version 3.0 Manual October 2016

CMS s RAI Version 3.0 Manual October 2016 Presented by: CMS s RAI Version 3.0 Manual October 2016 RAI SOM CAAs MDS Resident Assessment Instrument Utilization Guidelines from the State Operations Manual Care Area Assessments Minimum Data Set Affinity

More information

CNA OnSite Series Overview: Understanding Restorative Care Part 1 - Introduction to Restorative Care

CNA OnSite Series Overview: Understanding Restorative Care Part 1 - Introduction to Restorative Care Series Overview: Understanding Restorative Care Part 1 - Introduction to Restorative Care Administering the Program Read the Guide View the Video Review the Suggested Questions Complete Post-Test Answer

More information

Appendix B: Restorative Care Training Presentation. Audience: All Staff Release date: December

Appendix B: Restorative Care Training Presentation. Audience: All Staff Release date: December Appendix B: Restorative Care Training Presentation Audience: All Staff Release date: December 17 2010 Objectives At the completion of this session, participants will be able to: Understand the principles

More information

COMMONWEALTH OF KENTUCKY OFFICE OF INSPECTOR GENERAL AND MYERS AND STAUFFER LC PRESENT MDS CODING AND INTERPRETATION ANSWER SLIDES

COMMONWEALTH OF KENTUCKY OFFICE OF INSPECTOR GENERAL AND MYERS AND STAUFFER LC PRESENT MDS CODING AND INTERPRETATION ANSWER SLIDES COMMONWEALTH OF KENTUCKY OFFICE OF INSPECTOR GENERAL AND MYERS AND STAUFFER LC PRESENT MDS CODING AND INTERPRETATION ANSWER SLIDES WOULD YOU COMPLETE A SIGNIFICANT CHANGE IN STATUS ASSESSMENT? Example

More information

Tube Feeding Status Critical Element Pathway

Tube Feeding Status Critical Element Pathway Use this pathway for a resident who has a feeding tube. Review the Following in Advance to Guide Observations and Interviews: Most current comprehensive and most recent quarterly (if the comprehensive

More information

Observations: Observe the resident at a minimum of two meals:

Observations: Observe the resident at a minimum of two meals: Use this pathway for a resident who is not maintaining acceptable parameters of nutritional status or is at risk for impaired nutrition to determine if facility practices are in place to identify, evaluate,

More information

Organization: Solution Title: Program/Project Description, including Goals: What is this project? Why is this project important?

Organization: Solution Title: Program/Project Description, including Goals: What is this project? Why is this project important? Organization: Hebrew Home of Greater Washington (The Charles E. Smith Life Communities) The Hebrew Home provides post-acute services and long-term care to a daily average census of 500 residents. The Home

More information

Medications: Defining the Role and Responsibility of Physical Therapy Practice

Medications: Defining the Role and Responsibility of Physical Therapy Practice This article is based on a presentation by Matt Janes, PT, DPT, MHS, OCS, CSCS, Division AVP, Therapy Practice and Quality, Kindred at Home, and Diana Kornetti, PT, MA, HCS-D, President, Home Health Section

More information

Nursing Assistant Curriculum Application Process and Form

Nursing Assistant Curriculum Application Process and Form Nursing Assistant Curriculum Application Process and Form Curriculum Application Instructions 1. Complete and submit the Curriculum Application Form. 2. Complete and submit the Curriculum Evaluation Form.

More information

ACTIVITIES OF DAILY LIVING (ADL) DECLINE Facility Assessment Checklists

ACTIVITIES OF DAILY LIVING (ADL) DECLINE Facility Assessment Checklists ACTIVITIES OF DAILY LIVING (ADL) DECLINE Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to activities of daily living

More information

HOW WE GOT HERE 1935: Social Security Act Private nursing homes

HOW WE GOT HERE 1935: Social Security Act Private nursing homes 1 LeadingAge Oklahoma Annual Conference March 8, 2017 CMS Revised Pharmacy Regulations: Lessons Learned from Phase 1, Guidance for Phase 2 William M. Vaughan RN, BSN Vice President, Education and Clinical

More information

MDS 3.0/RUG IV OVERVIEW

MDS 3.0/RUG IV OVERVIEW MDS 3.0/RUG IV Distance Learning Series January - May 2016 OVERVIEW In keeping with the success of their previous highly-rated distance learning education offerings, LeadingAge state affiliates and Plante

More information

Interim Final Interpretive Guidelines Version 1.1

Interim Final Interpretive Guidelines Version 1.1 Interim Final Interpretive Guidelines Version 1.1 Big Changes from November 2008 to January 2009 418.54 Condition of participation: Initial and Comprehensive assessment of the patient L522 418.54(a) Standard:

More information

The policy applies to all SHS employees involved in direct patient care and medical staff.

The policy applies to all SHS employees involved in direct patient care and medical staff. Restraints Use of Violent - System Introduction Restraints, Use of Violent System Introduction SCOPE The policy applies to all SHS employees involved in direct patient care and medical staff. Implementation

More information

Federal Requirements of Participation for Nursing Homes Summary of Key Changes in the Final Rule Issued September 2016 Phase 2

Federal Requirements of Participation for Nursing Homes Summary of Key Changes in the Final Rule Issued September 2016 Phase 2 Federal Requirements of Participation for Nursing Homes Summary of Key Changes in the Final Rule Issued September 2016 Phase 2 On September 28, 2016, the Centers for Medicare & Medicaid Services (CMS)

More information

Activities of Daily Living (ADL) Critical Element Pathway

Activities of Daily Living (ADL) Critical Element Pathway Use this pathway for a resident who requires assistance with or is unable to perform ADLs (Hygiene bathing, dressing, grooming, and oral care; Elimination toileting; Dining eating, including meals and

More information

DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SKILLED NURSING SERVICES

DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SKILLED NURSING SERVICES DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SCOPE: All Ascension At Home, LLC colleagues. For purposes of this policy, all references to colleague or colleagues include temporary, part-time

More information

Nursing Home Pearls or

Nursing Home Pearls or Nursing Home Pearls or How to Enjoy Practicing in Skilled Nursing Facilities Lowell C. Dale, MD November 11, 2016 2016 MFMER slide-1 DISCLOSURE Relevant Financial Relationship Medical Director Golden Living

More information

Professional Student Outcomes (PSOs) - the academic knowledge, skills, and attitudes that a pharmacy graduate should possess.

Professional Student Outcomes (PSOs) - the academic knowledge, skills, and attitudes that a pharmacy graduate should possess. Professional Student Outcomes (PSOs) - the academic knowledge, skills, and attitudes that a pharmacy graduate should possess. Number Outcome SBA SBA-1 SBA-1.1 SBA-1.2 SBA-1.3 SBA-1.4 SBA-1.5 SBA-1.6 SBA-1.7

More information

Improving Resident Care: A look at CMS quality of care initiatives

Improving Resident Care: A look at CMS quality of care initiatives Improving Resident Care: A look at CMS quality of care initiatives W H I T E P A P E R by Diane L. Brown dbrown@hcpro.com What do reduction in rehospitalization, caring for dementia patients and preventing

More information

WakeMed Rehab Hospital Stroke Rehabilitation Scope of Service

WakeMed Rehab Hospital Stroke Rehabilitation Scope of Service WakeMed Rehab Hospital Stroke Rehabilitation Scope of Service WakeMed Rehab Hospital provides an integrated, comprehensive delivery of rehabilitation services utilizing evidenced-based practice directed

More information

Recognizing and Reporting Acute Change of Condition

Recognizing and Reporting Acute Change of Condition Recognizing and Reporting Acute Change of Condition Welcome to the Elizabeth McGowan Training Institute Cell Phones and Pagers Please turn your cell phones off or turn the ringer down during the session.

More information

Stage 2 General Critical Element Pathway Facility Name: Facility ID: Date: Surveyor Name:

Stage 2 General Critical Element Pathway Facility Name: Facility ID: Date: Surveyor Name: Facility Name: Facility ID: Date: Surveyor Name: Resident Name: Resident ID: Initial Admission Date: Care Area(s): Interviewable: Yes No Resident Room: Use Use this General Investigative Protocol to investigate

More information

Home Health Eligibility Requirements

Home Health Eligibility Requirements Presented By: Melinda A. Gaboury, COS-C Chief Executive Officer Healthcare Provider Solutions, Inc. healthcareprovidersolutions.com Home Health Eligibility Requirements Meets eligibility for home health

More information

What s Happening in the Nursing Home? Cherry Meier, RN, MSN, NHA Vice President of Public Affairs

What s Happening in the Nursing Home? Cherry Meier, RN, MSN, NHA Vice President of Public Affairs What s Happening in the Nursing Home? Cherry Meier, RN, MSN, NHA Vice President of Public Affairs Objectives Describe the benefits of partnering with hospice Explain the regulations for the interface between

More information

OASIS-B1 and OASIS-C Items Unchanged, Items Modified, Items Dropped, and New Items Added.

OASIS-B1 and OASIS-C Items Unchanged, Items Modified, Items Dropped, and New Items Added. Items Added. OASIS-B1 Items UNCHANGED on OASIS-C OASIS-C Item # M0014 M0016 M0020 M0030 M0032 M0040 M0050 M0060 M0063 M0064 M0065 M0066 M0069 M0080 M0090 M0100 M0110 M0220 M1005 M1030 M1200 M1230 M1324

More information

Restorative Nursing: The NHA s Role and Organizational Outcomes

Restorative Nursing: The NHA s Role and Organizational Outcomes Restorative Nursing: The NHA s Role and Organizational Outcomes SUE LAGRANGE, RN, BSN, NHA, CDONA, CIMT DIRECTOR OF EDUCATION PATHWAY HEALTH 1 Objectives Upon completion of this program, attendees should

More information

UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016

UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016 UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS DEPARTMENT OF PHARMACY SCOPE OF PATIENT CARE SERVICES FY 2017 October 1 st, 2016 Department Name: Department of Pharmacy Department Director: Steve Rough, MS,

More information

Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities Proposed Rule

Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities Proposed Rule Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities Proposed Rule Summary of Major Provisions Summary adapted from Proposed Rule (with AHCA Comments) July 14, 2015 Updates

More information

Delirium management initiative: Guarding the minds of our patients

Delirium management initiative: Guarding the minds of our patients Delirium management initiative: Guarding the minds of our patients Introduction This past January (2014), in response to requests from a number of our physicians, a new effort began at Baptist Health,

More information

PHARMACY SERVICES/MEDICATION USE

PHARMACY SERVICES/MEDICATION USE 25.01. 10 Drug Reactions & Administration Errors & Incompatibilities. Drug administration errors, adverse drug reactions and incompatibilities must be immediately reported to the attending physician and

More information

Pain Transition Planning. University of Illinois at Chicago

Pain Transition Planning. University of Illinois at Chicago Pain Transition Planning University of Illinois at Chicago Purpose To present a transition plan for a participant with pain. Included examples of a plan that can be adapted for participants with pain.

More information

9/17/2015. Bed Rail Safety A Clinical Process Guideline. Background. Federal Nursing Home Reform Act

9/17/2015. Bed Rail Safety A Clinical Process Guideline. Background. Federal Nursing Home Reform Act Bed Rail Safety A Clinical Process Guideline Laura Funsch, RN, BSN, MS, Director of Regulatory Strategy Background Safety hazards related to bed rail use have been realized since 1990. Michigan s initial

More information

Bed Rail Safety A Clinical Process Guideline. Laura Funsch, RN, BSN, MS, Director of Regulatory Strategy

Bed Rail Safety A Clinical Process Guideline. Laura Funsch, RN, BSN, MS, Director of Regulatory Strategy Bed Rail Safety A Clinical Process Guideline Laura Funsch, RN, BSN, MS, Director of Regulatory Strategy Background Safety hazards related to bed rail use have been realized since 1990. Michigan s initial

More information

Behavioral Health Services. Division of Nursing Homes

Behavioral Health Services. Division of Nursing Homes Behavioral Health Services Division of Nursing Homes 483.40 Behavioral Health Services Overview F740 Introduction to Behavioral Health Services F741 Sufficient and Competent Staff F742 Treatment/Services

More information

Guidelines for Physiatric Practice and Inpatient Review Criteria

Guidelines for Physiatric Practice and Inpatient Review Criteria Guidelines for Physiatric Practice and Inpatient Review Criteria Table of Contents PART I: GUIDELINES Guidelines for Physiatric Practice PART II: INPATIENT REVIEW Instructions: Pre-admission or Admission

More information

CHAPTER 17 PHARMACEUTICAL SERVICES

CHAPTER 17 PHARMACEUTICAL SERVICES 17.A. Pharmaceutical Services Pharmaceutical services shall be conducted in accordance with currently accepted professional standards of practice and in accordance with all applicable laws and regulations.

More information

Hey Recruit? You Ready for This?

Hey Recruit? You Ready for This? Pharmacy Regulations 101: Understanding the good, the bad and the ugly within the Interpretive Guidelines. Presented By: Dr. William G. Day Hey Recruit? You Ready for This? 1 Objectives Participants should

More information

Outcome Based Case Conference

Outcome Based Case Conference Outcome Based Case Conference Are You On the Train or On the Tracks? Michelle Funk, RN BS, COS C 15 years RN 13 years Home Health Clinician Case Manager Program Coordinator Supervisor QA Coordinator Special

More information

CMS RULES FOR PARTICIPATION/LTC REGULATIONS: WHAT YOU NEED TO KNOW

CMS RULES FOR PARTICIPATION/LTC REGULATIONS: WHAT YOU NEED TO KNOW CMS RULES FOR PARTICIPATION/LTC REGULATIONS: WHAT YOU NEED TO KNOW SATURDAY/3:15-4:15PM ACPE UAN: 0107-9999-17-242-L04-P 0.1 CEU/1.0 hr Activity Type: Knowledge-Based Learning Objectives for Pharmacists:

More information

Pharmacological Therapy Practice Guidance Note Medicine Reconciliation on Admission to Hospital for Adults in all Clinical Areas within NTW V02

Pharmacological Therapy Practice Guidance Note Medicine Reconciliation on Admission to Hospital for Adults in all Clinical Areas within NTW V02 Pharmacological Therapy Practice Guidance Note Medicine Reconciliation on Admission to Hospital for Adults in all Clinical Areas within NTW V02 V02 issued Issue 1 May 11 Issue 2 Dec 11 Planned review May

More information

CGS Administrators, LLC Clinical Hospice Documentation from CGS Missouri Hospice & Palliative Care Assoc. October 3, 2016

CGS Administrators, LLC Clinical Hospice Documentation from CGS Missouri Hospice & Palliative Care Assoc. October 3, 2016 Missouri Hospice & Palliative Care Conference Reviewer s decision is reliant upon documentation Results in a full denial for the submission Documentation must be legible Medical necessity is always based

More information

CMS Mega Rule: Implications for Pharmacists and Pharmacies

CMS Mega Rule: Implications for Pharmacists and Pharmacies CMS Mega Rule: Implications for Pharmacists and Pharmacies Curt Wood, RPh, BCGP, FASCP Disclosure and Conflict of Interest Curt Wood declares no conflicts of interest, real or apparent, and no financial

More information

DEFINITIONS (c)(1) Discharge Planning : Home Health Agency (HHA) : Inpatient Rehabilitation Facility (IRF) : Local Contact Agency :

DEFINITIONS (c)(1) Discharge Planning : Home Health Agency (HHA) : Inpatient Rehabilitation Facility (IRF) : Local Contact Agency : F660 483.21(c)(1) Discharge Planning Process The facility must develop and implement an effective discharge planning process that focuses on the resident s discharge goals, the preparation of residents

More information

MEDICATION MONITORING AND MANAGEMENT Procedures

MEDICATION MONITORING AND MANAGEMENT Procedures MEDICATION MONITORING AND MANAGEMENT Procedures Waiver Programs Purpose To support persons served in their own homes with their medication needs. Scope This procedure applies to all Waiver employees who

More information

What do we promise people who are dying and those around them when we tell them about hospice care?

What do we promise people who are dying and those around them when we tell them about hospice care? Care Planning The Road to Meeting Patients and Families Where They Are Charlene Ross, MBA, MSN, RN Consultant/Educator R&C Healthcare Solutions & Hospice Fundamentals 602-740-0783 charlene@rchealthcaresolutions.com

More information

CMS Proposed Rule. The IMPACT Act. 3 Overhaul Discharge Planning Processes to Comply With New CoPs. Arlene Maxim VP of Program Development, QIRT

CMS Proposed Rule. The IMPACT Act. 3 Overhaul Discharge Planning Processes to Comply With New CoPs. Arlene Maxim VP of Program Development, QIRT Overhaul Discharge Planning Processes to Comply With New CoPs Arlene Maxim VP of Program Development, QIRT 1 CMS Proposed Rule Included discharge planning specifics However, when the CoPs were finalized,

More information

Caring in the Carolinas 11/5/2016

Caring in the Carolinas 11/5/2016 The Mega Rule: Reform of Requirements for Long- Term Care Facilities Robert Smith, Pharm D, BCPS, CGP, FASCP Director of Clinical Services Neil Medical Group Disclosures I have no conflicts of interest

More information

A Nurse Leader s guide to a successful Restorative Nursing Program PRESENTER: AMY FRANKLIN RN, DNS MT, QCP MT, RAC MT

A Nurse Leader s guide to a successful Restorative Nursing Program PRESENTER: AMY FRANKLIN RN, DNS MT, QCP MT, RAC MT A Nurse Leader s guide to a successful Restorative Nursing Program PRESENTER: AMY FRANKLIN RN, DNS MT, QCP MT, RAC MT Requirements for Successful Completion 1. 2.0 contact hours will be awarded for this

More information

OIG Risk Areas: Anti- Supplementation; Therapy Services, Physicial Self-Referral & Hospice

OIG Risk Areas: Anti- Supplementation; Therapy Services, Physicial Self-Referral & Hospice OIG Risk Areas: Anti- Supplementation; Therapy Services, Physicial Self-Referral & Hospice Presented by: Ken Burgess, Esq. Paul Pitts, Esq. Suzie Berregaard, Esq. Where We ve Been & Today s Topics Review

More information

BED RAIL SAFETY 9/15/2015. A Clinical Process Guideline. Background. Federal Nursing Home Reform Act

BED RAIL SAFETY 9/15/2015. A Clinical Process Guideline. Background. Federal Nursing Home Reform Act BED RAIL SAFETY A Clinical Process Guideline Laura Funsch, RN, BSN, MS Director of Regulatory Strategy, LeadingAge Michigan Background Safety hazards related to bed rail use have been realized since 1990.

More information

Proposed Standards Revisions Related to Pain Assessment and Management

Proposed Standards Revisions Related to Pain Assessment and Management Leadership (LD) Chapter LD.0001 Proposed Standards Revisions Related to Pain Assessment and Management 1 2 Leaders establish priorities for performance improvement. (Refer to the "Performance Improvement"

More information

POLICY AND PROCEDURE DEPARTMENT: Pharmacy Operations

POLICY AND PROCEDURE DEPARTMENT: Pharmacy Operations PAGE: 1 of 5 SCOPE: Centene Corporate Pharmacy Solutions, Centene Corporate Pharmacy and Therapeutics Committee, Health Plan Pharmacy Departments, Health Plan Pharmacy and Therapeutics Committees, Pharmacy

More information

QAPI: Driving Quality or Just Driving You Crazy

QAPI: Driving Quality or Just Driving You Crazy QAPI: Driving Quality or Just Driving You Crazy Julie Kueker, MBA, MT(ASCP) Nursing Home QIN-QIO Task Lead Objectives Review the Final Rule Changes and Updates for QAPI Describe the format of QAPI methodology

More information

CPAN / CAPA Examination Study Plan

CPAN / CAPA Examination Study Plan CPAN / CAPA Examination Study Plan Candidates should prepare thoroughly prior to taking the CPAN and/or CAPA examinations. This Study Plan is based on the CPAN and CAPA Test Blueprints and a weekly learning

More information

Survey Protocol for Long Term Care Facilities

Survey Protocol for Long Term Care Facilities Attachment B Survey Protocol for Long Term Care Facilities The provision of home dialysis treatments in a Long Term Care (LTC) facility place an increased burden on the LTC facility staff and may place

More information

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity

Using Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage

More information

Ambulatory Care Advanced Pharmacy Practice Experience Course Title: PHAR 9981

Ambulatory Care Advanced Pharmacy Practice Experience Course Title: PHAR 9981 Ambulatory Care Advanced Pharmacy Practice Experience Course Title: PHAR 9981 Preceptor: Office: Office Phone: Cell Phone: Email: Current Semester/Year: Office Hours: By arrangement with preceptor Credit

More information

NURSING FACILITIES: FRIENDS OR FOES? Marie C. Berliner Joy & Young, LLP Austin, Texas (512)

NURSING FACILITIES: FRIENDS OR FOES? Marie C. Berliner Joy & Young, LLP Austin, Texas (512) NURSING FACILITIES: FRIENDS OR FOES? Marie C. Berliner Joy & Young, LLP Austin, Texas (512) 330-0228 Program Overview Status of Hospice Nursing Facility Relationships Multiple contact points and transactions

More information

POLICY AND PROCEDURE DEPARTMENT: Pharmacy Operations

POLICY AND PROCEDURE DEPARTMENT: Pharmacy Operations PAGE: 1 of 6 SCOPE: Centene Corporate Pharmacy Department, Centene Corporate Pharmacy and Therapeutics Committee, Health Plan Pharmacy Departments, Health Plan Pharmacy and Therapeutics Committees, and

More information

Patient Centered Care Planning and Behaviors. Presented by: Pam Paulsen, RN/BC,RAC-CT Angela Johnson, PharmD, BCGP

Patient Centered Care Planning and Behaviors. Presented by: Pam Paulsen, RN/BC,RAC-CT Angela Johnson, PharmD, BCGP Patient Centered Care Planning and Behaviors Presented by: Pam Paulsen, RN/BC,RAC-CT Angela Johnson, PharmD, BCGP Objectives 1 2 3 Identify 3 ways to promote patient centered care throughout communication

More information

MEDICINE USE EVALUATION

MEDICINE USE EVALUATION MEDICINE USE EVALUATION A GUIDE TO IMPLEMENTATION JOHN IRELAND VERSION 1 2013 Posi%ve Impact www.posi%veimpact4health.com Email: ji@icon.co.za Ph: 0823734585 Fax (086) 6483903, Melkbosstrand, South Africa

More information

Medication Management: Therapy Scope Versus Comfort Level

Medication Management: Therapy Scope Versus Comfort Level Medication Management: Therapy Scope Versus Comfort Level Presented By: Cindy Krafft MS PT President Home Health Section APTA Director of Rehabilitation Consulting Services August 17, 2011 243 King Street,

More information

Site: Lovelace Health System Title: PATIENT CARE - Restraints Approved Date: 08/28/2015 Effective Date: TBD

Site: Lovelace Health System Title: PATIENT CARE - Restraints Approved Date: 08/28/2015 Effective Date: TBD Approved Date: 08/28/2015 Effective Date: TBD 08/01/2018 Document Number P-NS-1063.6 Document Type: Policy Page 1 of 11 1. Policy: All patients have the right to be free from physical or mental abuse,

More information

The Changing Role of Physicians in LTCF

The Changing Role of Physicians in LTCF The Changing Role of Physicians in LTCF David Gifford MD MPH Boise ID Feb 9 th, 2017 CMS Changes to SNF Regs New rule makes extensive changes to SNF Requirements of Participation (RoP) Last major update

More information

Attachment A - Comparison of OASIS-C (Current Version) to OASIS-C1 (Proposed Data Collection)

Attachment A - Comparison of OASIS-C (Current Version) to OASIS-C1 (Proposed Data Collection) Attachment A - Comparison of OASIS-C (Current Version) to (Proposed Data Collection) OASIS-C M0010 CMS Certification Number S M0010 CMS Certification Number M0014 Branch State S M0014 Branch State S M0016

More information

Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now!

Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now! Adopting Standardized Definitions The Future of Data Collection and Benchmarking in Alternate Site Infusion Must Start Now! Connie Sullivan, RPh Infusion Director, Heartland IV Care Lyons, CO CE Credit

More information

OASIS-C Home Health Outcome Measures

OASIS-C Home Health Outcome Measures OASIS-C Home Measures 1 End Result Grooming groom self. (M1800) Grooming 2 End Result Grooming same in ability to groom self. (M1800) Grooming 3 End Result Upper Body Dressing dress upper body. (M1810)

More information

MLN Matters Number: MM6699 Related Change Request (CR) #: 6699

MLN Matters Number: MM6699 Related Change Request (CR) #: 6699 News Flash Medicare will cover immunizations for H1N1 influenza also called the "swine flu." There will be no coinsurance or copayment applied to this benefit, and beneficiaries will not have to meet their

More information

Section 6: Referral record headings

Section 6: Referral record headings Section 6: Referral record headings Referral record standards: the referral headings are primarily intended for recording the clinical information in referral communication between general practitioners

More information

MINNESOTA. Downloaded January 2011

MINNESOTA. Downloaded January 2011 MINNESOTA Downloaded January 2011 4658.1300 MEDICATIONS AND PHARMACY SERVICES; DEFINITIONS. Subpart 1. Controlled substances. "Controlled substances" has the meaning given in Minnesota Statutes, section

More information

POLICY. Use of Antipsychotic Medications in Nursing Facility Residents. Preamble. Background

POLICY. Use of Antipsychotic Medications in Nursing Facility Residents. Preamble. Background Preamble POLICY Use of Antipsychotic Medications in Nursing Facility Residents The Office of Inspector General of the U. S. Department of Health and Human Services issued a report in May 2011 finding that

More information

Patient Driven Payment Model (PDPM) and the MDS: A Total Evolution of the SNF Payment Model

Patient Driven Payment Model (PDPM) and the MDS: A Total Evolution of the SNF Payment Model Patient Driven Payment Model (PDPM) and the MDS: A Total Evolution of the SNF Payment Model By Devin Kassi, PT, DPT, and Melissa Keiter, RN, RAC-CT, DNS-CT, DON Centers for Medicare & Medicaid Services

More information

Today s educational presentation is provided by. The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE

Today s educational presentation is provided by. The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE Today s educational presentation is provided by The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE At Kinnser, we believe post-acute care businesses need the right software solution for

More information

NURSING FACILITY ASSESSMENTS

NURSING FACILITY ASSESSMENTS Department of Health and Human Services OFFICE OF INSPECTOR GENERAL NURSING FACILITY ASSESSMENTS AND CARE PLANS FOR RESIDENTS RECEIVING ATYPICAL ANTIPSYCHOTIC DRUGS Daniel R. Levinson Inspector General

More information

NURS 147A NURSING PRACTICUM PSYCHIATRIC/MENTAL HEALTH NURSING CLINICAL EVALUATION CRITERIA. SAN JOSE STATE UNIVERSITY School of Nursing

NURS 147A NURSING PRACTICUM PSYCHIATRIC/MENTAL HEALTH NURSING CLINICAL EVALUATION CRITERIA. SAN JOSE STATE UNIVERSITY School of Nursing SAN JOSE STATE UNIVERSITY School of Nursing NURS 147A - Nursing Practicum IVA - 2 Units Psychiatric/Mental Health Nursing Based on Scope and Standards of Psychiatric-Mental Health Nursing Practice (AP,

More information

Attachment C: Itemized List of OASIS Data Elements

Attachment C: Itemized List of OASIS Data Elements Attachment C: Itemized List of OASIS Data Item Description Number of Data SOC ROC FU TOC DTH DIS M0010 CMS Certification Number 1 1 M0014 Branch State 1 1 M0016 Branch ID Number 1 1 M0018 National Provider

More information

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer

*Your Name *Nursing Facility. radiation therapy. SECTION 2: Acute Change in Condition and Factors that Contributed to the Transfer Gaining information about resident transfers is an important goal of the OPTIMISTC project. CMS also requires us to report these data. This form is where data relating to long stay transfers are to be

More information

QAPI - What Is It All About? Rebecca McMinn, RN, BSN, MBA New Century Hospice

QAPI - What Is It All About? Rebecca McMinn, RN, BSN, MBA New Century Hospice QAPI - What Is It All About? Rebecca McMinn, RN, BSN, MBA New Century Hospice CMS Quality Initiatives CMS has encouraged Healthcare to monitor itself and gather data Standard measures of quality care are

More information

CMS RAI MANUAL ERRATA DOCUMENT

CMS RAI MANUAL ERRATA DOCUMENT CMS RAI MANUAL ERRATA DOCUMENT SECTION I UTI S In Chapter 3, page I-9, under Coding Tips in I: Active Diagnoses in the Last 7 Days, a third bullet has been added: If the diagnosis of UTI was made prior

More information