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QM Deep Dive: How Does ADL Coding Impact Quality Measures?
You may have heard that Section G of the Minimum Data Set (MDS) was going away; however, that will not be happening anytime soon. While it is true that Section G may eventually be eliminated, this change has been pushed back due to stakeholder concerns as well as the...
PDPM Coding Question – A resident had a fall and suffered a traumatic brain injury. Should we be using the 169 codes for deficits following other nontraumatic intracranial hemorrhage if the deficits are related to the fall with traumatic brain injury?
Q: A resident had a fall and suffered a traumatic brain injury. Should we be using the 169 codes for deficits following other nontraumatic intracranial hemorrhage if the deficits are related to the fall with traumatic brain injury? A: S06.9- is the appropriate...
Nursing PDPM Documentation Suffering Due to COVID-19?
Has nursing documentation and internal auditing suffered due to COVID-19 prevention or outbreak efforts? Many facilities have had to prioritize staff and resources in order to meet the challenge of the public health emergency and the many additional responsibilities...
Facility Assessment Updates related to COVID-19 PHE
Federal regulations require each facility to conduct and document a facility-wide assessment to determine what resources are necessary to care for its residents competently during both day-to-day operations and emergencies. The intent of the facility assessment is to...
Quality Measure Coding Deep Dive: Falls with Major Injury
Falls management presents one of the greatest challenges to the long-term care profession. Preventing and managing falls in the facility is difficult enough without adding the increased complication of QM data that might not accurately reflect the true facility...
PDPM Coding Question – Why am I receiving this error message for submitted OBRA assessments on my Final Validation Report?
Q: Why am I receiving this error message for submitted OBRA assessments on my Final Validation Report? MDS 3.0 Item(s): Z0100B, RECALCULATED_Z0100B Item Values: 1.0007, 1.0008 Message Number: -3935b WARNING Message: Incorrect RUG/PDPM Version: The submitted...
AHRQ No-Cost Nursing Home COVID-19 Networking Opportunities with $6000 PRF Incentive
Supported by the Agency for Healthcare Research and Quality (AHRQ), and in collaboration with the Institute for Healthcare Improvement (IHI), Project ECHO is launching an interactive and collaborative community of practice for nursing homes around the country to...
Percent of Residents Who Have Depressive Symptoms (Long Stay)
Percent of Residents Who Have Depressive Symptoms (Long Stay) Background The Long Stay Quality Measure, Percent of Residents Who Have Depressive Symptoms reports the percentage of long-stay residents – those whose stay is 101 days or more – who have had...
PDPM Coding Question – Our IDT team writes a progress note for section GG collaboration. Can the note generally state, “Section GG codes vary but IDT team have collaborated to decide on appropriate GG coding for MDS?”
Q: Our IDT team writes a progress note for section GG collaboration. Can the note generally state, "Section GG codes vary but IDT team have collaborated to decide on appropriate GG coding for MDS?” A: This statement may need to be more detailed for usual...
PDPM Coding Question – Recently, we’ve had several new admissions who have a diagnosis of major depression. Just by talking with some residents in my rounds, I would think depression would be captured on the MDS assessment. I’m told that we almost never capture depression, but our residents seem depressed. What are we missing?
Q: Recently, we’ve had several new admissions who have a diagnosis of major depression. Just by talking with some residents in my rounds, I would think depression would be captured on the MDS assessment. I’m told that we almost never capture depression, but our...
Compliant Baseline Activity Care Plans
We are now all familiar with the 48-hour baseline care plan that was implemented with the Requirements of Participation (ROP). One of the often overlooked or under developed components of this care plan is the resident activity needs. While the comprehensive MDS and...
PDPM Coding & Documentation Top Risks: Tips from an Auditor (Part 2 of 2)
As we began discussing in part 1 of this article last week, the accuracy of coding, documentation and data monitoring is vital as we prepare for the inevitable start of PDPM medical review audit activity. Provider data outliers will trigger audits, and any coding...
New Details on Incentive Based Provider Relief Funds
CARES Act Provider Relief Fund The U.S. Department of Health and Human Services (HHS) Provider Relief Fund has made $50 billion available for distribution to Medicare fee-for-service providers as financial relief during the coronavirus (COVID-19) pandemic. Phases of...
PDPM Coding Question – Can I use M codes as primary diagnosis?
Q: Can I use M codes as primary diagnosis? A: M codes can be used as long as they are not "return to provider" codes. Recommend utilizing the CMS ICD-10 Mapping Tool listed under the resources below to determine if diagnosis can be considered as primary....
PDPM Coding & Documentation Top Risks: Tips from an Auditor (Part 1 of 2)
CMS announced that Medicare Fee for Service medical review (which was temporarily suspended due to the public health emergency,) may now resume beginning August 3, 2020. CMS has expressed their intent to examine provider behavior, patterns of therapy provision and...
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