Skilled Nursing Facility/Nursing Home
Last Updated: December 4, 2009 11:08 AM
Flu Season
For the purposes of coding the MDS during the upcoming flu season, Nursing Facilities should only code for the "Seasonal Influenza Vaccine." You should not code the MDS for the "H1N1 Influenza Vaccine." Nursing Facilities should follow guidance from the Centers for Disease Control and Prevention (CDC) for specific guidance for H1N1 Influenza. For the most up to date and accurate information it is recommended that you frequently check the CDC Influenza Website at http://www.cdc.gov/flu
If you have any additional questions about MDS coding, please contact the Washington State RAI Coordinator, Marge Ray at Rayma@dshs.wa.gov or (360) 725-2487. **Updated September 9, 2009- Information Sharing from Health & Human Services (HHS) on H1N1"
Source: http://www.cms.hhs.gov/OpenDoorForums/25_ODF_SNFLTC.asp
Aging and Disability Services Information for Professionals - 2009 MDS Training Now Available
Chart Orders and the DEA Issues Brief
AAHSA is part of a coalition effort led by the American Society of Consultant Pharmacists (ASCP), and including with a variety of other provider, pharmacy, and health professional groups to resolve the current concerns with DEA activities around the use of “chart orders” for providing timely access to Schedule II-V medications in nursing homes. Attached please find an issue brief explaining and summarizing these concerns. Link
Nursing Home Rules Being Amended
Aging Services is involved in current rulemaking as DSHS/ADSA seeks to amend the nursing home licensing WACs. According to a recent Dear Administrator letter, the purpose of amending these rules is to consider making editorial and clarifying changes, and to make it consistent with current laws and standards. For further details, contact Aging Services of Washington.
Health care reform legislation drafted in the House would eliminate the 2010 Medicare payment update nursing homes are scheduled to receive as of Oct. 1.
Similar provisions in the health care reform bill under development in the Senate Finance Committee are also expected. Medicare payment cuts would add to the Medicaid reimbursement reductions that skilled nursing facilities in many states have experienced as states grapple with growing budget deficits due to the recession.
Easily send a letter to your congressional representatives expressing your opposition to the cuts:
http://capwiz.com/aahsa/issues/alert/?alertid=13553841
New Infection Control Guidance for Nursing Home Surveys
Issuance of Revisions to nursing home Interpretive Guidance at F Tag 441, as Part of Appendix PP, SOM (8-14-09) has just been released. This CMS survey and certification letter includes the advance copy and training materials for new long-term care facility guidance to surveyors for F441-Infection Control.
For specific details:
www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09_54.pdf
Aging Services of Washington and AAHSA, in a coalition effort led by the American Society of Consultant Pharmacists (ASCP), and including with a variety of other provider, pharmacy, and health professional groups to resolve the current concerns with DEA activities around the use of “chart orders” for providing timely access to Schedule II-V medications in nursing homes. Attached please find an issue brief explaining and summarizing these concerns. Chart Order and DEA Issue
Also following is the link to a 1 hour webinar on DEA compliance issues being conducted by ASCP on September 2, 2009, at 12 noon EST. Ron Buzzeo, RPh., former Deputy Director for Diversion Control with the Drug Enforcement Administration and now Chief of Compliance for Cegedim Dendrite will answer frequently asked questions about how to comply with DEA rules for prescribing and dispensing controlled drugs for long term care and hospice patients. The Webinar Information is available on the ASCP website; registration can be completed online:
www.ascp.com/education/meetings/DEA-Audits-Webinar.cfm
CMS recently issued a survey and certification letter which clarifies provider and state agency/surveyor responsibilities for facilities using electronic health records (EHR). It is posted here: www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09_53.pdf
Among other items covered in the memo, providers/suppliers have the right to use whatever system of medical records they choose as long as that system complies with its Medicare participation requirements. And, while surveyors are expected to enforce the specific health and safety regulatory requirements for providers/suppliers to protect the confidentiality of medical records, they are not expected to assess EHRs to determine whether they satisfy the requirements of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules.
The HHS and the CMS said they are committed to the goal of most Americans having access to health care providers who use EHRs by 2014. CMS said it recognizes the importance of the use of EHRs and their benefits to better patient/resident care and reduced costs.
Post Fall Assessment sample form 7-2009
Survey Trends - Your Survey Reports Needed
Aging Services of Washington, at the request of many of its members, will now be analyzing assisted living inspection reports AND nursing home survey reports for the purposes of sharing finding/citation trends, assisting with Plans of Correction and identifying opportunities for continued staff training.
For those members who wish to participate, all identifying data will be kept confidential. Sharing of inspection or survey reports with Aging Services is voluntary, but we encourage you to consider joining our efforts so that we can all learn together.
Please SCAN your reports, making a .pdf document, then email the .pdf file to Julie at jpeterson@agingwa.org or Fax to (253) 964-8876. Bonnie Blachly and I will be working together on the ongoing analysis. We will post trends and other shared information on our blog as often as we have updates, so check back often. July 22
Five-Star Quality Rating System - July News
The Five-Star provider preview reports became available today, Wednesday, July 15, 2009. Providers can access the reports from the Minimum Data Set (MDS) State Welcome pages available at the State servers for submission of Minimum Data Set data. Provider Preview access information:
Visit the MDS State Welcome page available on the State servers where you submit MDS data to review your results. www.cms.hhs.gov/CertificationandComplianc/13_FSQRS.asp
To access these reports, select the Certification and Survey Provider Enhanced Reports (CASPER) Reporting link located at the bottom of the login page.
Once in the CASPER Reporting system,
- Click on the 'Folders' button and access the Five-Star Report in your 'st LTC facid' folder
- Where 'st' is the 2-digit postal code of the state in which your facility is located, and
- Facid' is the state assigned facid of your facility.
The Five Star helpline will be open from July 15, 2009 from 9 am to 5 pm EST through July 30, 2009 for questions and concerns about the July data.
If you’re still using EMS DNR forms in your resident files, you may wish to reconsider that policy. Standard policies and procedures for nursing homes and assisted living facilities now incorporate the POLST form. July 22
POLST Resources:
A link to the POLST resource page on the Wa. State Medical Association's web page: www.wsma.org/patient_resources/polst.cfm#download
Individual documents for your use and a greater understanding of the use of POLST in your community:
Sample POLST Nursing Home Policies - also use these for assisted living, edited as needed:
www.awphd.org/EndOfLife/NursingHomePOLSTPolicies.pdf
www.awphd.org/EndOfLife/MtBakerNursingHome.pdf
Sample POLST Flow Chart - amend as needed for assisted living:
www.awphd.org/EndOfLife/samplePOLSTflowCharts.pdf
Analysis of revisions to POLST form as of 12/2008:
www.wsma.org/files/Downloads/PatientResources/2008_polst_revisions.pdf
Revised POLST form 12/2008 - older versions are still accepted:
www.wsma.org/files/Downloads/PatientResources/polst_form.pdf
CMS UPDATES:
- NEW ~ Medicare Nursing Home Survey Guidelines on Quality of Life and Environment Requirements
http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf
- An important update/analysis on a possible Level K Citation in the area of locked doors
NEW ~ Fire Marshall - Life Saftey Codes; CMS Requirements Citation and Locking of Doors July 8th
Supporting Document from Denver CMS Office
Senior Skilled Nursing Home Providers now have a new resource for up-to-the minute news, rules and professional development opportunities.
Visit our BLOG through the link on our website, Aging Services of Washington, by clicking here: BLOG then choose 'Nursing Homes' on the left side of the page to be directed to Skilled Nursing-related news.
Last updated: December 4, 2009 11:08 AM