Tag: clinical

New CMS policy could change inpatient rehab denial trend

In the past, Medicare contractors have been allowed to deny a claim for inpatient rehab if the required three-hour minimum of direct care mark was missed by mere minutes, even if the additional minutes were made up on a subsequent day. Now, however, due to new guidance released by CMS, this denial trend could change. […]

The transition to a unified payment system for PAC facilities could start as early as 2019, suggests MedPAC

In response to a Congressional mandate, in 2016 The Medicare Payment Advisory Commission (MedPAC) recommended design features of a unified payment system, the post-acute-care (PAC) prospective payment system (PPS), to pay for services in the four post-acute care settings (home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals). In a meeting […]

CMS’ new infection control requirements: What you need to implement a successful antibiotic stewardship program

The Centers for Disease Control (CDC) report that roughly 40–50% of antibiotics are prescribed incorrectly, with the possibility that nearly 50% of antibiotics are given for too long in nursing homes. These numbers highlight the shortfalls that may exist in long-term care staff education when it comes to antibiotic usage. In the past two years, […]

Which Phase 2 requirements do you need help with?

What Phase 2 requirement does your facility need help with in 2017? Choose an answer from our polling question located on the sidebar to the right of this post. If you need help with Phase 2 requirements that are not listed there, leave your questions/challenges in the comments box. Let us know how we can […]

Facilities with a full-time nurse providing direct care to residents may have better chance of reducing avoidable hospitalizations

CMS’ final evaluation report of phase one of their Initiative to Reduce Avoidable Hospitalizations among Nursing Facility (NF) Residents found that intervention sites with a full-time nurse at each facility providing direct care to residents had the strongest improvements in both cost and quality. These models demonstrated greater changes in facility culture, greater support for […]

The essential role of MDS 3.0 in RCS-1

Written by Steven Littlehale, MS, GCNS-BC, executive vice president & chief clinical officer for PointRight. The full article originally appeared in the October issue of PPS Alert for Long-Term Care. The clinical and technical eligibility requirements for skilled care coverage in a SNF are unchanged under the proposed RCS-1 system—and frankly, those are just about […]

Test your infection control knowledge

Editor’s note: This sample test was taken from HCPro’s title Infection Control: How to Implement an Effective Approach for Long-Term Care by Brian Garavaglia, PhD. This one-stop resource offers staff quick and convenient access to procedures, policies, and forms to create an effective infection prevention and control program, as well as in-service training to help your […]

Individualized strategies for managing dysphagia

Editor’s note: This post is an excerpt taken from the full article published in the August issue of PPS Alert for Long-Term Care. Not a subscriber? Sign up today! The act of swallowing, for those who do not have difficulty with it, can feel like second nature. But when this ability starts to diminish—a common […]

USPSTF removes recommendation for falls prevention based on new evidence

Studies show that in 2014, approximately 2.8 million older adults sought treatment in emergency departments for falls; roughly 800,000 older adults who experienced a fall were hospitalized; and more than 27,000 older adults die as a result of a fall. Based on evidence from 62 trials, the U.S. Preventive Services Task Force (USPSTF) recently shared […]

Understanding the evolution of care planning sets the stage for improvement

Editor’s note: This post is an excerpt taken from HCPro’s popular title, MDS Care Plans: A Person-Centered Interdisciplinary Approach to Care by Debbie Ohl, RN, M.Msc, PhD. Looking back in time can help us understand the significance of care planning. Federal involvement in nursing homes began with the passage of the Social Security Act in […]