Reliant Reveal Blog Archives

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MDS Changes Countdown – Day 2

COUNTDOWN DAY 2: Quality Measure Impact

Minimum data set (MDS) assessments provide the data foundation for many quality measures. The transition from MDS 3.0 version 1.17.2 to version 1.18.11 brings significant impacts to several quality measure specifications; one of the biggest changes being the shift from Section G: Functional Status to Section GG: Functional Abilities and Goals, as well as the inability to generate a RUG-IV grouper directly impacting staffing measures.

To account for these changes, CMS released Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual V16.0 and Nursing Home Five-Star Quality Rating System: Technical Users’ Guide last week.

Quality Measure Updates:
New Measures

  • SNF Discharge Function Score measure (CMS ID: S042.01) will replace Percent of Residents Who Made Improvements in Function (Short Stay) (CMS ID: N037.03)
  • Percent of Residents With Pressure Ulcers (Long Stay) (CMS ID: N045.01) will replace Percent of High-Risk Residents With Pressure Ulcers (LS) (CMS ID: N015.03)
  • Percent of Residents With New or Worsened Bowel or Bladder Incontinence (LS) (CMS ID: N046.01) will replace Percent of Low-Risk Residents Who Lose Control of Their Bowel or Bladder (Long Stay) (CMS ID: N025.02)

Re-specified Measures to utilize Section GG items due to the removal of Section G

  • Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (Long Stay) (CMS ID: N028.03)
  • Percent of Residents Whose Ability to Walk Independently Worsened (LS) (CMS ID: N035.04)

Starting in April 2024, CMS will freeze (hold constant) impacted quality measures on Nursing Home Care Compare.

Public reporting for these measures is scheduled to resume in January 2025 or as soon as technically feasible.

Nursing Home Five-Star Quality Rating Staffing Updates

  • In July 2024, CMS will post nursing home staffing measures based on the new staffing case-mix adjustment methodology derived from PDPM as outlined in the appendix: “Updated Case-Mix Adjustment Methodology for Staffing Level Measures”
  • CMS will revise the staffing rating thresholds to maintain the same overall distribution of points for affected staffing measures.
  • Beginning in April 2024, CMS will freeze (i.e., hold constant) the staffing measures for three months while they transition to a SNF payment PDPM replacing the RUG-IV methodology.

Resources

Be on the lookout for tomorrow’s blog: Interdisciplinary Communication

IN CASE YOU MISSED IT

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MDS Changes Countdown – Day 3

COUNTDOWN DAY 3: Impact to State Case Mix

Federal regulations mandate that all nursing facilities, regardless of the Medicaid system in their state, must conduct patient specific MDS assessments, known as OBRA assessments, at specific intervals for each resident, regardless of their payer. Many states utilize these federally mandated MDS assessments to inform and calculate the case mix index (CMI). For decades, case mix states have adopted models for the MDS assessment that are similar to the Prospective Payment System (PPS) of their time, such as RUGs III or IV. However, beginning 10/1/2023, federal support for the calculation of RUG scores will end. States who continue to apply RUG methodology will have to implement the Optional State Assessment (OSA) which can no longer be combined with any other assessment. The MDS v. 1.18.11 will only support PDPM determinations. In an effort to prepare for this change, states that implement a Case Mix system, may be transitioning or have already transitioned to PDPM.

While case-mix methodologies vary from state-to-state, there are universal strategies to enhance CMI, regardless of individual state practices:

  • Timing is everything: Ensure each member of the interdisciplinary team (IDT) has the most up to date calendar of quarterly and annual Assessment Reference Dates (ARDs).
  • Verify your state plan as of 10/1/2023 for Case Mix determination and whether the OSA will be required.
  • Ensure the IDT is trained to conduct interviews timely and accurately so that all relevant information is recorded (See Section GG Assessment Quick Card).
  • Plan, implement, communicate, and assess processes for effectiveness regularly.

In the event your state is continuing to require the use of the OSA, the OSA Manual provides these instructions/coding tips:

  • Not federally mandated, but may be mandated by state
  • Contact state for clarification
  • Must be a stand-alone assessment

Effective case mix management through thorough and complete MDS assessments are critical. Now more than ever, it is essential for each member of the IDT to be educated about the changes, enabling them to contribute their expertise accordingly. Navigating case mix management through evolving payment structures is challenging, but with effective systems in place, success can be both achievable and sustainable.

Resources

Be on the lookout for tomorrow’s blog: Quality Measure Updates

IN CASE YOU MISSED IT

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MDS Changes Countdown – Day 4

COUNTDOWN DAY 4:
Care Area Triggers and Care Area Assessments

The Care Area Assessment (CAA) process is designed to assist assessors in systematically interpreting the information recorded on the MDS. This process enables clinicians to focus on key issues identified during assessments so decisions as to whether and how to intervene can be explored with the resident.

The MDS information, coupled with the CAA process, forms the foundation upon which care plans are developed. Within this framework, there are 20 problem-oriented CAAs, each incorporating MDS-based “trigger” conditions that signal the need for additional assessment and review of the triggered care area.

Previously, Section G items were used to trigger Care Areas in the MDS; however, with the retirement of Section G, CMS has updated Appendix C (CAA Resources), placing a much larger emphasis on Section GG for the CAA process. In fact, 17 of the 20 Care Areas now utilize Section GG as triggers or indicators for the Care Area.

Therefore, accurate Section GG assessment is imperative to ensure precise mapping within the Care Area Assessment process. It serves as a crucial link between the MDS and the development of each resident’s care plan. Strong interdisciplinary collaboration should extend throughout the MDS assessment process and continue during the CAA process. By understanding the components and the importance of accurate assessment, healthcare professionals can ensure thorough resident-centered care plans are developed that promote each resident’s optimal outcomes.

Be on the lookout for tomorrow’s blog: Impact to State Case Mix

IN CASE YOU MISSED IT:

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MDS Changes Countdown – Day 5

COUNTDOWN DAY 5: Section D – Mood

Beginning October 1st, the depression screening tool in the Minimum Data Set (MDS) will transition to the PHQ-2 to 9©. The PHQ-2 to 9© introduces a skip pattern logic to guide the completion of the depression screener.

The resident mood interview begins with two gateway questions that address the cardinal symptoms of depression: a persistent depressed mood and an inability to experience pleasure. By honing in on these symptoms, this tool can quickly identify those who may be at risk for depression. Based on the responses to the first two questions, the interview will either end or continue through the remaining seven questions. The embedded skip pattern is designed to reduce the length of the interview assessment for residents who fail to report the cardinal symptoms of depression. Although the interview coding may conclude with the first two questions, asking the remaining questions provides insight to the resident’s thoughts, feelings, and ideas can provide insight and impact care planning.

Beyond the initial screening, the information gathered from the PHQ-2 to 9© interview plays a crucial role in guiding supportive treatment planning and resource utilization, including:

  • Nursing component classification in the Patient Driven Payment Model (PDPM).
  • Addressing the physical, mental, emotional, social, and spiritual factors contributing to the resident’s ability to participate in meaningful activities.
  • Implementing leisure or identified interests within therapy sessions.
  • Facilitating participation in activities of interest outside of therapy.
  • Improving the resident’s health literacy to promote overall wellness.
  • Initiating referrals for additional evaluation of possible depression or other mood disorders.

Early identification of residents at risk for depression will allow for healthcare providers to intervene more effectively and efficiently. This proactive approach can lead to timely interventions and better outcomes for patients struggling with depression.

Resources

Be on the lookout for tomorrow’s blog: Care Area Triggers & Care Area Assessments

IN CASE YOU MISSED IT:

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MDS Changes Countdown – Day 6

COUNTDOWN DAY 6: Section GG – Functional Abilities

Gone are the days of the “rule of 3” and ADL self-performance versus support provided. In less than 2 weeks, Section G will be retired on all federal assessments, and Section GG will be the center of the MDS self-care and mobility universe. Elements of Section G will be transitioning to Section GG as outlined in the provided crosswalk.

Section GG is used in healthcare settings to assess functional abilities and care needs of residents. The data collected through this assessment serves as the foundation for creating individualized care plans designed to address each resident’s unique needs and goals. Accurate scoring of Section GG will become crucial in Care Area Assessments and Care Area Triggers (CATs), fundamentally shaping each resident’s individualized plan of care. Of the twenty Care Areas, seventeen use Section GG as CATs or indicators, thereby charting a new course in the determination of care needs. Additionally, Section GG will have a greater impact on 5-Star ratings, SNF quality reporting program (QRP), and SNF value-based purchasing (VBP) initiatives.

As healthcare facilities gear up for this monumental change, it is imperative that staff members proactively address additional training requirements. This includes a change in existing facility processes, a thorough review of coding language, aligning with the parameters of Section GG, and review of GG assessment periods. It is critical to foster a culture of strong interdisciplinary team (IDT) collaboration. By sharing expertise and insights from all departments within the facility, a seamless and successful transition to the era of Section GG can be assured.

Be on the lookout for Monday’s blog: Section D – Mood.

In Case You Missed It

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MDC Changes Countdown – Day 7

COUNTDOWN DAY 7: Additions, Modifications, and Clarifications

The upcoming revisions to the minimum data set (MDS) scheduled for October 1st bring significant changes. These revisions encompass 29 new and modified data elements, updates to 13 care area triggers, and modifications to 17 care area assessment worksheets. Notably, this update introduces gender neutral language and fully integrates the IMPACT Act of 2014 Standardized Patient Assessment Data Elements (SPADEs).

Below are just a few of the additions, modifications, and clarifications to review:

  • Medication List to Subsequent Provider/Resident (A2121-A2124) – New Data Elements
  • Pain Interference with Therapy Activities (J0520) – New Data Element
  • Nutritional Approaches (K0520) – Modification
  • Skin Conditions (M0300A-G) – Modification
  • High-Risk Drug Classes: Use and Indication (N0415) – Modification
  • Special Treatments, Procedures, and Programs (O0100) – Modification

The latest clarification is in relation to quality measures. CMS has released the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual V16.0 stating that one of the biggest changes involves the transition from Section G: Functional Status to Section GG: Functional Abilities and Goals.

These changes have broad implications for long-term care facilities. Proper training of staff is essential for a smooth implementation process. Staying updated is crucial for maintaining high-quality patient care and compliance with regulatory standards. Download the MDS 3.0 v1.18.11 RAI manual to guide successful implementation of all the new additions, modifications, and clarifications.

Be on the lookout for tomorrow’s blog: Section GG – Functional Abilities.

IN CASE YOU MISSED IT:

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MDS Changes Countdown – Day 8

COUNTDOWN DAY 8: Social Determinants of Health

When it comes to assessing and improving healthcare outcomes, it is not just about medical conditions and treatment. Understanding the social determinants of health (SDOH), that encompass various factors affecting people’s lives and impacting their well-being is crucial. These include socioeconomic status, education, neighborhood and physical environment, employment, and social support networks. The SDOH play a significant role in shaping an individual’s overall health as well as access to healthcare. 

To address the impact of the SDOH, the Centers for Medicare & Medicaid Services (CMS) has identified seven critical data elements for cross-setting standardization in assessment: 

  1. Race
  2. Ethnicity
  3. Preferred language
  4. Interpreter services 
  5. Health literacy
  6. Transportation
  7. Social isolation

Collecting data on these social determinants of health is about more than just checking boxes. It is an opportunity to gain insight into residents’ lives, beliefs, and values. The responses obtained during resident interviews paint a more comprehensive picture of potential barriers each resident may face upon discharge. By acknowledging and addressing these barriers, healthcare providers can better set residents up for success and in turn, reduce hospital readmissions and foster sustainable outcomes. 

Be on the lookout for tomorrow’s blog: Additions, Modifications, and Clarifications.

IN CASE YOU MISSED IT:

 

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MDS Changes Countdown – Day 9

COUNTDOWN DAY 9: Resident Interviews

In long-term care, the voice of the resident is invaluable. As the Minimum Data Set (MDS) evolves, it places increasing emphasis on resident input, particularly through interview-based questions. In the MDS 3.0 v.1.18.11, there are a total of twenty-one resident interview questionnaires (e.g., mood, preferences, pain). 

To provide the best possible care, accurate information is paramount. While medical assessments and charts are essential, self-report from the resident remains the single most reliable indicator of their well-being. Residents possess a wealth of knowledge about their own lives, preferences, and needs. Interviewing residents provides an opportunity to tap into this knowledge. By doing so, we gain insight into what they consider to be the most important facets of their lives. This knowledge forms the foundation for person-centered care and prioritizes individual preferences and choices. 

To ensure open communication in a supportive care environment, consider the following tips for a successful resident interview.

  • Introduce yourself to the resident.
  • Be sure the resident can hear what you are saying.
  • Ask whether the resident would like an interpreter.
  • Find a quiet, private area where you are not likely to be interrupted or overheard.
  • Ask the questions as they appear in the questionnaire.
  • Repeat the response options as needed.
  • Use cue cards as appropriate.
  • Move on to another question if the resident is unable to answer.
  • Break up the interview if the resident becomes tired.
  • Record the resident’s response, not what you believe they should have said.
  • If the resident becomes deeply sorrowful or agitated, sympathetically respond to their feelings.

In the ever-evolving landscape of long-term care, the resident interview has gained increasing importance. By placing residents at the center of decision-making and fostering a supportive care environment, we can truly honor their preferences and choices.

Be on the lookout for tomorrow’s blog: Social Determinants of Health. 

In case you missed yesterday’s blog, click to review: Know Your Resources.

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MDS Changes Countdown – Day 10

October 1 is 10 business days away, and with that date brings the long-awaited revisions to the minimum data set (MDS). Understanding these changes and their broad implications is crucial. Equally important is the efficient training of your staff for seamless implementation. Over the next 2 weeks, Reliant Rehabilitation will be sharing daily blog posts covering essential MDS updates, points to consider, and educational opportunities for staff including:
10. Know Your Resources
9. Resident Interviews
8. Social Determinants of Health
7. Additions, Modifications, and Clarifications
6. Section GG – Functional Abilities
5. Section D – Mood
4. Care Area Triggers & Care Area Assessments
3. Impact to State Case Mix
2. Quality Measure Impact
1. Interdisciplinary Collaboration

COUNTDOWN DAY 10: Know Your Resources
Foundational to any new learning is affirming that information is from a primary source of reference. For the MDS and RAI revisions, the primary source is CMS.
Each blog is developed by Reliant Rehabilitation’s team of RAC-Certified clinicians and contains easy to digest summaries of the MDS Updates.
Provided here is a compilation of CMS Websites, Training, and Manuals to download and bookmark as we embark on this blog series.

MDS 3.0 RAI Manual v1.18.11

MDS Item Sets v.1.18.11v5

CMS SNF 2023 Guidance Training Program

Monitor your email for updated information from Reliant including Real Time Memos, Reliant Reveal, and webinar trainings. To register for Reliant’s webinar on Effective Case Mix Management this Thursday, click HERE.

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Clinicians Who Inspire – Shelby Drolshagen – September 2023

Shelby Drolshagen, PTA/DOR at Logan County Senior Living makes putting the “FUN” in function a priority. She believes that if therapy is enjoyable, patients don’t notice how hard they are working. She is constantly thinking of ways to bring creative, exciting treatment approaches to her therapy sessions both individually and in group settings. Some of her favorite activities include wheelchair races, obstacle courses, corn hole, and activities related to Reliant’s A Year of Wellness topics. Shelby recently led a group session where patients made signage/labels for the facility; patient feedback was how much they enjoyed this purposeful activity and are eager to do a similar group activity again.

 

Shelby has obtained Champion Level I on Reliant’s Clinical Advancement Ladder and is working towards completing the educational courses required to achieve a Champion Level II designation in Dementia Care. Recently, she completed the course “Understanding Dementia in the Geriatric Population” where she learned about the importance of considering food options and addressing poor intake as residents with dementia may experience a change in taste as well as food preferences.

 

As DOR, Shelby strives to inspire her team to be their best and loves to bounce ideas off each of her peers to innovate new treatment ideas and activities. Another part of her role is to be a sounding board and create solutions when needed. Shelby believes that communication is key in team interactions and brings a non-biased opinion to help mediate concerns. Her favorite role is working with the residents at Logan County Senior Living and watching them thrive.

 

Shelby, thank you for demonstrating how much Care Matters and for being a clinician who inspires daily. Your unwavering dedication to your team and your patients inspires us all.

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Clinicians Who Inspire – John Smith – August 2023

This month, our Clinician Who Inspires is John Smith, Champion Level I Therapist, DOR and SLP at Diversicare of Tupelo. John enjoys cultivating a supportive atmosphere for the therapy team to excel in enhancing patient outcomes and attaining a rewarding professional journey. One of the biggest tips John shared is the importance of therapists finding their niche. He believes therapists excel in their careers and make a big impact on improving patients’ lives and functional outcomes when following their clinical interests and striving to enhance their knowledge and skills. John reports he isn’t the only one encouraging his team to embrace lifelong learning. Each member of the Tupelo team encourages and pushes each other to achieve their personal goals as well as goals for the whole team. As an example, John and the Tupelo team have begun climbing Reliant’s Clinical Advancement Ladder – a majority already achieving Champion Level I Therapist.

John also shared that attending July’s Lunch and Learn, Interdisciplinary Fall Prevention Across the Continuum of Care, was very beneficial for the therapy team and residents in their facility. He shares that by recognizing the importance of speech therapy in fall prevention and safety awareness, the team is able to address fall prevention more holistically resulting in reduced falls and an improved quality of life for their residents. John now works hand in hand with the physical and occupational therapy teams utilizing interdisciplinary groups and co-treatment. John enjoys creating real life situations for those patients who are at-risk for falls to problem solve through. verified site i thought about this contain https://www.pixelupdates.com/google-pixel-8-und-pixel-8-pro-android-telefone-fokus-auf-ki-und-fotografie/ https://www.iphoneviews.de/beste-orte-um-ihre-website-in-eine-anwendung-fuer-android-und-iphone-4-zu-verwandeln web site flavourraver payments Cali Vape: Discover the Disposable Vape from the Trusted Brand

The team also enjoys coordinating other interdisciplinary groups, including obstacle courses with challenges to maneuver wheelchairs and walkers around, addressing multiple functional areas at once. John revealed a major benefit to interdisciplinary groups has been the real-time communication between disciplines, sharing insights, and collaborating on care to ensure the group session is holistic with all areas are being addressed.

Thank you, John and the Tupelo Team, for demonstrating your dedication to providing the best care possible!

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Clinicians Who Inspire – Krista LaFollette – July 2023

This month, our Clinician Who Inspires is Krista LaFollette, Champion Level I Therapist, DOR and COTA at Southern Hills Specialty Care. Krista shared her belief that authentic engagement with others is key to success as a team member in the skilled nursing facility. Whether that consists of a friendly hello to a resident, small talk with nursing staff, or sharing a smile with someone in the kitchen, Krista believes that being personable and recognizing others facilitates an open dialogue that will lead to positive outcomes.

Krista reflected on some of the lessons she has learned over her years as a therapist and DOR, including the importance of being willing to learn and ask questions. She shared that though she is confident in her skills as a clinician, she recognizes that having an open mind to the varying needs of each resident, across a wide range of diagnoses, is crucial in providing patient-specific, best in practice care. “We can’t know every diagnosis, or how it will affect each patient, but we can always continue to learn as we go.”

One of the things that Krista has learned from her residents is that creative treatment interventions can not only be effective, but also fun. Krista and her team make an effort to incorporate holiday preparation and celebration into their therapy sessions to keep spirits high while simultaneously working on functional goal targets. Holiday door decorating with wrapping paper, cut out letters, or creating paper chains to countdown the special day, are just a couple of examples.

Krista’s care for others, both teammates and residents, was evident in her shared insights. Thank you for your care, Krista—it is an inspiration to us all!   

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Clinicians Who Inspire – Colby Millen – June 2023

This month’s Clinician Who Inspires is Colby Millen, DOR and PTA at Forest Haven Nursing Home. Colby spoke quite a bit about taking a comprehensive approach to patient care. He and the therapy team use innovative thinking to foster successful patient outcomes.   Colby elaborated about a particular patient who had trouble stopping while ambulating, walking directly into walls in front of him.  This is where creative thinking was utilized. A remote-controlled car was placed at the end of the hallway. The patient was told that if he stopped before the car, not running into it, then it would be his turn with the remote.  The continuation of this person-centered approach worked, and the patient’s family was stunned by the success.

In addition, Colby credits interdisciplinary collaboration as a major asset to patient care planning. An example of this is the Fall Team at his facility. During root cause analysis discussions regarding a resident who was falling frequently, Colby remembers reaching out to the clinical team for any additional guidance. One of the suggestions was to “go back to the basics.” Colby and the team implemented the patient’s favorite music and prior occupation into skilled therapy sessions. They were amazed that “going back to the basics” proved to be the intervention that was successful. Interdisciplinary collaboration also shines in group therapy at Forest Haven Nursing Home.

Colby spoke about the good relationship between the therapy team and nursing at his facility. He said therapy and nursing share in-depth discussions about any patient changes and difficulties. He stressed the importance of bringing concerns immediately to nursing so they can act quickly and vice versa with nursing communicating with therapy.

Finally, Colby spoke about attending this month’s Lunch and Learn webinar. The presenter said something that really resonated with Colby, “What you do for me, you take from me.” Colby used the example of a patient who can transfer out of bed on their own but needs a little more time. If care staff helps this patient instead of allowing the patient to do this on their own, potentially, the resident could eventually lose that skill and ability. Colby, your thoroughness, critical thinking, and care for not just your patients, but also the therapy team and nursing staff, is an inspiration to us all! Thank you for being a Clinician Who Inspires!

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Clinicians Who Inspire – Sylvia Calhoun-Daniel – May 2023

Our Clinician Who Inspires this month is Sylvia Calhoun-Daniel, Champion Level I Therapist, Speech-Language Pathologist and Director of Rehab at New Iberia Manor North. Sylvia believes that balance is the key to being a successful clinician and rehab director.  She finds her work to be incredibly rewarding and attributes her ability to strike a balance with her job duties to the exceptional team she works with.

Sylvia reflected on lessons learned over the past 3 years, including how therapy and nursing worked together to ensure resident wellness remained top priority. She witnessed physical therapy walking patients to have their weights taken, morning therapy groups focusing on oral hygiene, and other examples of interprofessional collaboration while targeting therapy goals. She states, “Covid taught us that we really need each other” and credits teamwork to having such a close-knit staff.

One of Sylvia’s favorite treatment interventions is the SLP Lunch Date she holds with her patients when they are mastering swallowing techniques or have had a diet upgrade. These celebratory lunches are held in the gym, where she invites the resident’s loved ones to join them for a meal. This is not only an opportunity to provide therapeutic trials but also a purposeful time for Sylvia to provide caregiver education and safe swallowing strategy training. She goes above and beyond to make the lunch extra special, whether it’s with a slushy from Sonic that one resident was craving or a specially requested pasta dish from a daughter.Discover the unique vaping experience with iGet Moon, a product that combines sleek design with advanced technology. Catering to diverse consumer groups, from casual users to vaping enthusiasts, iget moons offer a range of flavors and nicotine levels. Their compact size and ease of use make them perfect for on-the-go lifestyles, while the rich vapor production ensures satisfaction for all types of vapers. Experience the difference with iGet Moons today.

Sylvia’s message to other clinicians is simple: find balance and value each other. Thank you, Sylvia, for helping keep morale high and fostering an excellent team dynamic. Your unwavering dedication is an inspiration
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Clinicians Who Inspire – Rhiannon Haynes, COTA/DOR – April 2023

This month we had the privilege of speaking with Rhiannon Haynes, COTA and DOR, Champion Level I, at Envive Healthcare of Hartford City, to share some insight and inspiration from clinicians in the field. As we discussed treatment interventions and interdisciplinary communication, it was evident that Rhiannon brings “good vibes only” everywhere she goes.

Rhiannon encourages therapists to have no fear in thinking outside the box, trying new things, and reaching out to colleagues when it comes to providing the best treatment for residents. She shared the importance of humor, positivity, and patient-centered goals to motivate residents to not only participate, but also enjoy their therapy sessions. Recently, the therapists at Hartford City have incorporated the use of ‘Alexa’ in their therapy gym. Whether it be to play music during exercise, practice communication skills with Q&A, or to catch up on the week’s weather forecast, it has proven to bring something extra to therapy. Rhiannon also shared that holiday groups to create crafts and door decorations help brighten the halls of their community.

The staff at Rhiannon’s facility share the common goal of being there for one another so that ultimately, they can be their best for their residents. She spoke of the interdisciplinary team as a “family unit” that values each person’s role in overall cohesion and communication. “We all talk to one another with openness and common respect. We treat each other how we want to be treated, and that makes it easy for good vibes.”

Rhiannon- thank you for sharing your good vibes with your residents, your “family unit”, and your therapy peers! You are an inspiration, and your care matters!

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Clinicians Who Inspire – Richa Kohli, PT – March 2023

Richa Kohli, PT has worked in several different settings and with various patient populations. For the last 7 years, Richa has worked solely with geriatrics which is unequivocally her favorite. When it comes to providing physical therapy (PT) to geriatrics, Richa states it’s all about “being patient.” Richa, who also has a Master’s Degree in Clinical Psychology, says that when she intently listens to her patients they reciprocate and are more prone to listen to what she has to tell them in relation to PT. Richa also spoke of how important it is to make treatment personal and to take into consideration what the patient wants to do. Embracing what your patient needs or wants helps to avoid treatment becoming mundane.

Richa talked greatly about the fun group activities that her team is a part of. They partner twice a week with activities for group and find that this interdisciplinary approach allows for better coordination and participation.  

As the sole PT in her facility, Richa doesn’t miss a chance to encourage her peer therapists to broaden their knowledge base. Richa enjoys taking courses on Reliant U and reviewing journal articles to grow her skill set and equip herself with knowledge to provide evidence-based treatment.

Richa, thank you for all you do for your residents and fellow therapists. Thank you for reminding us to always listen empathetically and continue to learn and grow daily to positively impact our patients’ lives. You are an inspiration and your care matters!

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Quarterly Confidential Feedback Reports for FY 2024 SNF VBP Program Available

The March 2023 Quarterly Confidential Feedback Reports for the FY 2024 SNF VBP Program are now available to download via the Quality Improvement and Evaluation System (QIES)/Certification and Survey Provider Enhanced Reports (CASPER) reporting system. These reports contain interim stay-level data for the SNF 30-Day All-Cause Readmission Measure (SNFRM) for 10/1/2021 – 6/30/2022 (Quarter 1 – Quarter 3 of FY 2022, the FY 2024 SNF VBP Program performance period). The interim data contained in these reports are not final and are subject to change; thus, they are not eligible for the SNF VBP Program’s Review and Correction process.

CLICK HERE to review the FAQs.

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CMS Nursing Home Stakeholder Call on 2/22/23

On February 22, 2023, CMS held a Nursing Home Stakeholder Call as part of a series of calls prior to the end of the PHE on May 11, 2023. Topics discussed included the following:

  • End of the Qualifying Stay and Benefit Waiver – The qualifying hospital (3-day) stay and benefit period (100-day refresh without the 60-day wellness) waivers will end on 5/11/23. Clarifying examples provided indicated waiver application may be applied for qualifying patient whose stay begins on or before 5/11/2023. Stakeholders were reminded that CMS is unable to extend these waivers beyond the PHE, any permanent solution would have to be implemented by congress through legislation.
  • Billing of vaccines under Part B – Billing of vaccines and monoclonal antibodies during a Part A stay under the guise of consolidated billing and excluded under the bundle and billed under Part B will be in effect until June 30, 2023.
  • Vaccination requirements and reporting – Staff vaccinations (primary series only) will continue to be required until 11/5/24 and reporting of vaccinations under NHSN must be completed until 12/21/24.
  • COVID-19 testing requirements – End when the PHE expires; however, nursing homes are still going to be expected to test per CDC standards for infection control and prevention.
  • Staffing study – Data is still being collected and analyzed on the staffing study. CMS is currently reviewing the data to determine what policies will be implemented.  CMS reiterated stakeholders will have ample time to provide feedback on any proposed changes.
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Preparing for the End of the PHE Fact Sheets

As we prepare for the end of the Public Health Emergency (PHE) on May 11, 2023, CMS and HHS have released fact sheets to aid in a smooth transition.

The PHE Fact Sheet includes information on

  • COVID-19 vaccines, testing and treatments.
  • Telehealth services.
  • Nurse Aide Training for Nursing Homes.

The LTC Fact Sheet highlights

  • The end of the 3-day prior hospitalization and 60-day wellness period waivers at the end of the PHE.
  • Payment for COVID-19 vaccines and monoclonal antibodies.

The COVID-19 PHE Transition Roadmap outlines flexibilities and processes that will and will not be affected by the end of the PHE.

CMS has agreed to provide additional resources as the end of the PHE nears. Reliant Rehabilitation will continue to keep you updated as new information is released.

 

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Clinicians Who Inspire – February 2023 – Dana Marsh

Through the Clinicians Who Inspire series, we continue to share motivation, creativity, and inspiration from clinicians in the field. This month we spoke with Dana Marsh, Champion Level I Therapist, Speech-Language Pathologist and Director of Rehab at Spring Valley Care Center. Dana states, “You’re never going to regret being kind.” Her favorite part of working in long-term care is being able to utilize her speech pathology skillset to improve outcomes with the added bonus of incorporating small acts of kindness that make a huge difference in patients’ lives.

Dana holds regular morning groups (pictured here) where patients are guided through skilled prompting, modeling, and use of compensatory strategies to share current events, games, snacks, and coffee while targeting their speech and language goals.

For clinicians looking to further their knowledge with education courses, Dana recommends Clinical Effects and Considerations of Stroke Based on the Affected Region of the Brain, a Reliant University course she completed that describes common clinical manifestations of stroke based on the affected region of the brain, and discusses the implications on treatment strategies and consideration.

Dana values student internships at her facility from local universities. She enjoys the mentorship opportunities it presents and has even gained additional team members from these placements. Her biggest piece of advice to her clinical colleagues is to work together with all the various departments in the facility. She feels that working together with all departments ensure that everyone feels valued and unified in the overall goal to ensure that patients are receiving the best care. Thank you, Dana, for sharing your passion and creativity with your patients, interdisciplinary team, and therapy peers!

 

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