Author: Reliant Communications

Posted on

Clinicians Who Inspire – Jermie Jackson – December 2024

This month’s Clinician Who Inspires is Jermie Jackson, PTA and Champion Level II Therapist, at Diversicare of Tupelo. During the interview, Jermie discussed the importance of adaptability during treatment sessions. Jermie explained that no matter how much planning goes into a session, there is always the possibility of a situation that will require the therapist’s flexibility. With an open mind, Jermie has found the ability to be flexible while always maintaining focus on the patient’s goals. Another key to Jermie’s approach to care is incorporating aspects of the patient’s home environment into his treatments as much as possible. Jermie explained that home simulations help keep patients focused on their goals and allows them to understand their strengths and weaknesses.

Jermie and the team at Diversicare of Tupelo pride themselves on challenging each other daily. Jermie was excited to speak about the entire full-time team climbing Reliant’s Clinical Advancement Ladder, as well as their collaborative relationship. Therapists often discuss treatment suggestions with each other to optimize each patient’s therapy session. With the holidays in full swing, therapists plan their treatments to not only challenge their patients but also bring the season’s festive spirit to the therapy gym.

Thank you, Jermie and the team at Diversicare of Tupelo, for consistently raising the bar with flexibility, patient-centered care, and a collaborative approach that allows your patients to achieve their highest potential. You are an inspiration to us all!

Posted on

Clinicians Who Inspire – Amy Hill, SLP/DOR – November 2024

November’s Clinician Who Inspires is Amy Hill, SLP/DOR and Champion Level I Therapist at Portland Health and Rehabilitation Center. In our interview, Amy shared a valuable perspective on resident communication, innovative strategies to ensure interdisciplinary communication, and creative treatment approaches that motivate her residents.

With the unique ability to speak three languages, experience working for a translation company, and current livelihood as a speech language therapist, Amy demonstrates a vibrant passion for communication. She spoke on the importance of a resident’s ability to communicate their needs, regardless of their native tongue or medical history. In her practice Amy has seen great benefit from the use of communication boards using pictures, visual aids and tools for use of resources, as well as continual education with all staff and caregivers on individualized speech strategies for each resident.  

Along with resident communication, Amy esteems interdisciplinary communication of the utmost importance as well. In her building, Amy has implemented various communication strategies to allow therapy staff to provide valuable information related to resident appointments, planned groups, notable changes in function, and discharge plans. Through the use of communication binders and white boards, the therapy staff has found a way to remain connected, even when they are working at different times of the day.

One of Amy’s greatest learning experiences working in a skilled nursing facility has been to adapt her approach according to what is most meaningful and functional for each resident. She stated that “without patient buy in, you’re not going to get anywhere”. Amy always takes time during her initial encounter to interview the resident to learn about their interests, motivators, and what areas of function are most important to them, to in turn, develop goals and treatment approaches tailored to the individual. Some examples include treatment that focuses on turn taking and math to allow a resident to perform better at their weekly poker match or practicing finances with a short-term resident to allow them to pay their bills when they return home.

Amy, thank you for your enthusiasm, care, and passion in all that you do. Your efforts are an inspiration to us all!

Posted on

Clinicians Who Inspire – Beth Sines – October 2024

This October, we feature Beth Sines, OTA/Director of Rehab and Champion Level II Therapist at South Shore Nursing and Rehabilitation, as Reliant’s Clinician Who Inspires! In speaking with Beth, her passion for her profession, residents, and teammates was radiant.

Beth has been an OTA for 17 years and is currently studying to achieve a master’s degree in occupational therapy. Through her studies she has reignited a vision for therapy interventions that are individualized and purposeful to each resident, without sacrificing fun. Beth uses Tik Tok, Pinterest, and Reliant group emails to spark ideas for individual and group activities that might be a little unexpected for residents who are used to ‘run of the mill’ therapy exercises. Take, for example, an activity that incorporates residents shooting Nerf guns at therapists wearing deer antlers (for the hunters of the group), or at helium balloons with pictures of ghosts on them for a ‘Ghostbusters’ twist. Another example Beth shared was providing the opportunity to prepare silverware sets as a functional task that would also allow residents to give back to their community. Beth continues to see increased enthusiasm in residents as her team garners creativity and meaning into their therapy interventions.

In our interview, Beth also discussed the importance of interdisciplinary relationships. Beth expressed gratitude for the support she and her therapy team receive from their facility partners. She highlighted the importance of being adaptable in her interactions, mediating challenges with open communication, and being open to constructive feedback as a few key ways to interdisciplinary success.

Beth, thank you for your passion for quality care. Your efforts are an inspiration to us all!

Posted on

Clinicians Who Inspire – Jonathan Perkins – September 2024

This month’s Clinician Who Inspires is Jonathan Perkins, PTA/DOR, Champion Level II Therapist at Canton Oaks. Jonathan shared many thoughts on the role that having a positive attitude plays on both team members and each patient’s success. He believes that his playful and joyous demeanor sets the tone for having great workdays and therapy sessions. Even if he is having a bad day, he does what he can to turn things around and be a positive, light-hearted motivator for all.

Jonathan shared that on every Thursday, his therapy team leads “Fun with Therapy” for the facility. They walk throughout the facility encouraging residents to come out of their room to get them moving, stretching, and communicating. The activity motto is to “keep moving” and the therapy team also uses it as an opportunity to talk with residents and keep open communication about any changes that they may be experiencing.

Another unique activity that Jonathan helps to coordinate is working with the Activities Director to facilitate a daily activity for residents in therapy.  The Activities Director comes into the therapy gym each day to initiate activities and/or discussions that are beneficial to each patient’s goal achievement.

Jonathan also discussed the importance of continuous education and sharing newfound knowledge with others. He has taken a plethora of courses centered around fall prevention and shares learned tips through daily communication with both the therapy team and facility staff.  He encourages everyone to continually learn new things and share!

Jonathan, you are an inspiration to all of us! We appreciate your dedication to your patients, your team, and your entire facility’s success. Thank you for being a Clinician Who Inspires!

Posted on

Clinicians Who Inspire – Julie Kidd – August 2024

This month’s Clinician Who Inspires is Julie Kidd, DOR and SLP at Faith Community Nursing and Rehabilitation. In conversation, Julie spoke of the importance of keeping patients involved both in the facility and out in the community. Since Faith Community Nursing and Rehabilitation is embedded within the city, a favorite activity for patients is signing out and walking/propelling to the nearby Dollar Store with therapy. Of course, Julie and the therapy team at Faith make this a functional activity by planning in the days prior – making a list of items needed, planning anticipated rest breaks needed with walking, and problem solving the best time of day for this adventure, in lieu of the Texas heat. Using an interdisciplinary approach, PT works with the patients on navigating around obstacles like potholes on the journey while ST works on memory tasks, such as remembering the items from the list, and safety awareness. A main goal that Julie hopes to accomplish this year is setting up the opportunity for patients to read books to the children in the nearby school. This would be another great way for them to connect with the community.

Julie proudly shared other fun and interactive activities that her team coordinates. They host a wheelchair “car wash” day.  Using a multidisciplinary approach, the patients get to plan and then participate in washing their wheelchairs to make them sparkly clean. Patients also routinely water plants outside of the facility. Therapists make the activity functional for speech sessions by working on memory, sequencing, and problem solving throughout the watering task.

As a speech therapist, Julie spoke in detail about the importance of rounding during meals. She explained that it’s important to interact with the patients during mealtime to promote socialization, but also to allow for a closer eye on patients with dysphagia to ensure carryover of tasks from therapy to their real-life environment. 

Julie, your out of the box approach to treatment and patient care challenges us all to stretch our imagination and put the “fun” back in function. You truly are a Clinician Who Inspires!

Posted on

Clinicians Who Inspire – Andrew Gerben – July 2024

This month’s Clinician Who Inspires is Andrew Gerben, COTA/DOR, and Champion Level I Therapist at The Woodlands. Andrew shared that taking an interdisciplinary, “all hands-on deck”, approach to patient care has been a huge factor in his team’s success. He emphasized that getting along and working well with team members allows the utmost focus to be on the patient. They see great value in co-treatments and multi-disciplinary group activities, which are common practice in their gym.

Andrew discussed unique group ideas and said that his team utilizes Reliant’s monthly activity idea emails and A Year of Wellness themes for inspiration. Some of the groups gain such positive feedback from the residents that they are made into yearly traditions, such as the blooming spring gardening.

Andrew’s “team” mentality goes far beyond his therapy team. He also takes pride in his role of being a facility liaison and bridging communication and education between therapy and nursing. He hosts monthly in-services for all staff to review proper transfer techniques and make sure that everyone feels confident. He enthusiastically shared that everyone knows if there is a question, he will find the answer!

Andrew discussed the importance of continuous learning. His entire team is now part of Reliant’s Clinical Ladder, and each therapist is focusing on a different track. He said that this allows for them to share knowledge and be more well-rounded as a team.

Andrew, you are an inspiration to all of us! We appreciate your dedication to not only your patients but your facility’s success as a whole. Thank you for being a Clinician Who Inspires!

Posted on

Clinicians Who Inspire – Stephanie Garza – June 2024

This month’s Clinician Who Inspires is Stephanie Garza, Champion Level II Therapist, PTA, and Director of Rehabilitation at Lone Star Ranch Rehabilitation and Healthcare Center. Stephanie discussed the importance of therapy for our residents and therapists’ responsibility to provide tools that will allow them to be as functional as possible.

In conversation, Stephanie spoke about the residents’ love for group therapy, sharing that the excitement is palpable on their journey to the gym to participate in a fun group sessions. Stephanie and her team are constantly thinking of creative ways to perform therapy, citing a deer hunt interdisciplinary group as one of her favorites. During this activity, they brought blow up deer and Nerf guns to the facility and gathered the residents outside for a “deer hunt”.  PT worked with the residents on standing balance, OT focused on fine motor skills and hand eye coordination, while ST worked on following Nerf gun instructions. These interactive experiences during group therapy allowed residents to enjoy themselves while working on functional progress.

Professional growth is of utmost importance to Stephanie; not just for herself, but the growth of her team as well. Stephanie explained that most of the therapy staff at Lone Star are also clinical instructors. With the new addition of the Clinical Instructor path on Reliant’s Clinical Advancement Ladder, Stephanie has encouraged her team to continue to climb the ladder. She added that it’s important to share education with the team because “the more knowledge you have, the more effective you are.”

Stephanie, you are an inspiration to all of us. Thank you for being a Clinician Who Inspires!

Posted on

Clinicians Who Inspire – Tricia Peña – May 2024

Join us in celebrating this month’s Clinician Who Inspires: Tricia Peña, SLP and Champion Level I Therapist from Westgate Hills Rehabilitation and Healthcare Center! As the month of May welcomes bright skies, colorful blooms, and National Speech-Language-Hearing Month, it seems only fitting to shine a light on Tricia’s positivity and fresh take on speech therapy in skilled nursing homes. 

Tricia didn’t initially see herself working with geriatrics, but as she became aware of the perseverance and wisdom this population embodies, she saw it as a privilege. Tricia recognizes that some of her residents feel as though they are nearing their final stages of life. She believes that her attitude, as well as yours and mine, have the capacity to bring joy to these moments that may be precious to our residents.

Practically speaking, Tricia shared three factors to success as an SLP in the skilled nursing setting. First: teamwork. Tricia painted the picture of an SLP siloed in their efforts with a resident and contrasted this image to one of an SLP working in collaboration with PT, OT, social work, nursing, and the physician. In her comparison of these two scenarios, it was evident that not only the SLP’s training and techniques, but those of all disciplines, were more effective when carried over by all members of the interdisciplinary team. Next, Tricia discussed the importance of implementing her interventions within an authentic, functional context. She shared that she tries to provide her treatments outside of the resident’s room and incorporate real-life scenarios, to increase meaning and relatability to the task. Finally, Tricia touched on the value of continued learning throughout her career as an SLP. Tricia has taken advantage of some of the courses available on Reliant University, as well as the opportunity to participate in the Clinical Ladder program. Specifically, she highlighted the course “Disorders and Medications That Impact Swallowing,” describing it as eye-opening and beneficial to her everyday practice.

As Tricia shared her experiences, her light and her love for speech language therapy shined bright. Thank you, Tricia, for your inspiration, and Happy National Speech-Language-Hearing Month!

Posted on

Clinicians Who Inspire – Diane Heiderman – April 2024

Join us in celebrating April’s Clinician Who Inspires — Diane Heiderman! As an aspiring Champion Level II Therapist, COTA and Director of Rehab at Collingswood Nursing and Rehab, Diane shared that she contributes much of her success to being proactive versus reactive. She explained that being proactive with communication regarding any changes noted to a resident can help the entire care team intervene early, which in turn is a win for the patient. She loves nothing better than celebrating those wins with her patients!

Diane spoke of the importance of working together as a care team. She said it is important to always be teachable and moldable because many times we wear many different hats in a day. Working together to make the whole patient story come together is what she feels maximizes the patient’s quality of life and leads to successful discharge.

For fun team building, Diane and her team celebrate wacky holidays! Recently they celebrated National Cereal Day. Each team member brought a different box of cereal, and they had many laughs throughout the day trying the different cereals.

Diane loves her profession and says that helping people is what drives her endless commitment. Thank you, Diane, for sharing your passion and inspiring other clinicians to continue the important work we do every day! Happy Occupational Therapy month!

Posted on

Clinicians Who Inspire – Rochelle Healy – March 2024

This month’s Clinician Who Inspires is Rochelle Healy, SLP and Champion Level II Therapist at St. Sophia Health and Rehabilitation Center.

Rochelle reminisced on how she wanted to become an SLP for as long as she could remember.  With her love of all things language, her fascination with the brain and its many functions, and her love of helping others it seemed that speech language pathology was the perfect fit. 

To this day, her passion for speech and language persists. As a way of paying it forward and building the future of SLP, Rochelle mentors students and facilitates their growth. She enjoys giving students as many opportunities as possible to build their knowledge base and provide them with practical application scenarios to build on their classroom studies. She stated, “I actually learn just as much from them as they do me, their fresh take on things is invaluable.”

When she’s not educating students and learning from her peers, she is implementing “Fun Fridays” with her patients.  On each Friday they have fun groups which entail patient-led ideas to address focused goals.  From modified “catch phrase” to learning new card games, Rochell ensures a FUN time is had by all. Rochelle shared that her primary motivation as a therapist is getting to watch her patients succeed.  She said that the biggest factor in success with her patients is allowing them autonomy to lead their sessions, letting them use their voice to decide how the treatment session will flow.

Thank you, Rochelle, for sharing your passion and inspiring other clinicians to continue the important work we do every day!

Posted on

Clinicians Who Inspire – Blake Allen, PTA – February 2024

When Blake Allen, PTA from St. Simeon’s in OK, experienced a neurological event that resulted in loss of function on her right side, her entire world changed in a moment. Through this life-changing experience and her journey through rehabilitation, she attained an unanticipated capacity to serve others through example and inspiration.

In conversation, Blake shared how her empathy equips her to relate to her patients’ fear, frustration, or weariness when a medical event like a fall or onset of a new condition alter how they function in daily life. She uses her personal experience as a relatable example of the power of therapy, and how dedication to treatment sessions “really works”, even if it is a slow race to the new normal.

Through Blake’s story, clinicians are inspired to embrace the power of empathy with each patient we encounter. Though we may not have the same experience as Blake or our patients, we are equipped with the ability to imagine what our patients may be thinking or feeling. We have the opportunity for conversations to seek understanding and guidance in developing patient-centered goals and encouragement. Each interaction impacts those in our care. As Blake puts it, “we are the friendly face that the patient gets to see every day.”

Thank you, Blake, for sharing your incredible resiliency, recovery, and the important reminder that our care matters. You serve as an inspiration to us all!

Posted on

Clinicians Who Inspire – Catherine Shafer – January 2024

This month’s Clinician Who Inspires is Catherine Shafer, Champion Level I Therapist, COTA and Therapy Coordinator at Thunder Care and Rehab.

Catherine shares her primary motivation as a therapist is the joy her patients bring her. She recalled a recent day where she walked into her patient’s room to find him excitedly awaiting her arrival for their therapy session, stating that he was ready to get better. Beyond the enthusiasm and progress of her patients, Catherine also recalled the many stories, learning experiences, and wisdom that her patients have bestowed upon her during her time as a therapist. Catherine smiled as she stated, “sometimes I wonder whose therapy session it really was.”

When she’s not learning from the nuggets of wisdom she receives from her patients, she’s engaging with her peers, searching Reliant University, and logging into the Lunch and Learn trainings to grow clinically and foster her purpose. She encourages all therapists to do the same to refresh knowledge and remind us why we do what we do every day.

Catherine looks forward to the spring season with opportunities for fun gardening activities with her patients, continued relationship building with her interdisciplinary team, and more invaluable nuggets of elderly wisdom. Catherine, thank you for sharing your passion in what you do. Your dedication to Care Matters inspires us all!

Posted on

Clinicians Who Inspire – Alex Johnson – December 2023

In this month’s Clinicians Who Inspire series, we interviewed Alex Johnson, PTA, Director of Rehabilitation, and Champion Level I Therapist at Jolley Acres Healthcare. Alex believes in keeping the interdisciplinary team and patients excited in order to achieve the best outcomes. He and the team at Jolley Acres often use PC gaming platforms to help keep patients engaged while working on difficult tasks. With the gaming platform, Alex explained that it provides challenging and dynamic activities such as weight shifting, single limb support, bending, and rotating. A favorite, Elf on the Slope, allows patients to work on dynamic sitting or standing balance while navigating “Buddy the Elf” through ski slopes on an action-packed adventure. Alex emphasized the importance of the intensity of each treatment session, explaining that it’s the therapist’s role to ensure the patient is getting “the most value” from each treatment session. 

Alex spoke of using the abundance of resources provided by Reliant. He encouraged other therapists to use programs such as Reliant’s Clinical Advancement Ladder to grow their expertise as a therapist in the field. Alex also promoted the use of group therapy sessions ranging from full body workouts to address global strengthening needs to carnival games in which the patients encourage each other to complete activities such as ball toss and bowling. Thank you, Alex, for being a Clinician Who Inspires!

Posted on

Clinicians Who Inspire – Jennifer Saldaña – November 2023

This month’s Clinician Who Inspires is Jennifer Saldaña, Therapy Coordinator, and rising Champion Level I SLP. Jennifer believes providing personalized care and being a constant learner helps her to thrive as a clinician.

When providing treatment, Jennifer focuses on what motivates the patient. She gave an example of a patient who was an avid gardener. Jennifer made sure to keep a plant in her office so the patient could speak to the plants as they targeted speech and language goals together.

She has also provided training and encouraged housekeeping staff to browse through residents’ memory books with them and to engage in conversations with the patient while they are tidying their rooms. Along with improving socialization opportunities and carryover, she finds that staff enjoy these interactions and appreciate learning effective, individualized methods to communicate with residents.

For residents who enjoy group therapy, Jennifer works with other disciplines to collaborate and provide multifaceted activities. Recently, she worked with OT. They utilized balance balls for an exciting cardio-drumming exercise where she implemented verbal recall tasks and music-based conversation starters. Her favorite holiday season group activity is sending out cards to loved ones. Residents have even opted to send cards to staff members who have retired and are no longer working at the facility. This exchange has proven heart-warming to both the senders and recipients.

Jennifer values learning and recommends Aging Process: What is Happening to the Body and What Does it Mean?located in Reliant University. She appreciated the comprehensive examination of the normal aging process and has applied this knowledge to improve patient health literacy with healthy aging education. She also encourages clinicians to discuss different perspectives and to always continue to learn from each other.

Thank you, Jennifer, for sharing your personal contributions and innovative ideas and also for your dedication to providing patient-specific, meaningful care.

Posted on

Clinicians Who Inspire – Nicole Burrough – October 2023

This month’s Clinician Who Inspires is Nicole Burrough, Champion Level II Therapist, DOR and COTA at Yazoo City Rehabilitation and Healthcare Center. In conversation, Nicole shared her biggest takeaway in her time as a therapist and DOR is that teamwork is the key to success. She discussed her belief that effective communication, a “willingness to help attitude”, and being receptive to others’ input contributes to positive relationships with the other professionals on her team. This, ultimately, fosters a great team that is able to produce great outcomes.

With this communication and receptivity, Nicole’s team frequently implements group therapy sessions that incorporate training of multiple skills at one time. They are currently planning a pumpkin painting group that will address balance, gross and fine motor coordination, and sequencing all at once! Nicole shared that these groups are important in providing encouragement and motivation to the residents at their facility.

Finally, Nicole discussed the importance of educating other healthcare professionals on the benefit of therapists in SNFs. This education not only demonstrates the value of each therapy discipline, but also provides increased opportunities to ensure each resident meets their maximal level of functional independence.

Nicole, thank you for sharing your team player attitude! Your dedication to Care Matters inspires us all!

Posted on

MDS Changes Countdown – Day 1

COUNTDOWN DAY 1: Interdisciplinary Collaboration

When it comes to MDS assessments, teamwork makes the dream work. The MDS is a critical component of comprehensive resident care in long-term care facilities. Completing these assessments effectively requires an interdisciplinary team (IDT) approach. Interdisciplinary collaboration in MDS streamlines the assessment process and has the power to elevate the quality of care delivered to residents.

IDT meetings are the cornerstone of effective interdisciplinary collaboration, and the frequency of these meetings should be carefully considered. Regular meetings provide a platform for team members to share insights, discuss resident cases, and align on care plans.

Effective communication is at the heart of interdisciplinary collaboration. To create meaningful plans of care, it is crucial to communicate with various IDT members. This includes residents themselves, other disciplines who have recently interacted with the resident, direct staff from all shifts, and the resident’s physician. Each of these sources can provide valuable insights into the resident’s condition, preferences, and progress. By involving multiple disciplines, care plans can be tailored to align with the resident’s unique preferences and goals. This ensures that residents not only receive medically necessary care, but also maintain their dignity and quality of life.

Achieving success in MDS assessments is a collective effort. By fostering interdisciplinary collaboration, long-term care facilities can navigate the evolving landscape of MDS assessments while continuing to deliver high-quality, resident-centered care. Collaboration truly is the key to unlocking success in resident assessments and care planning. 

Reliant’s Interdisciplinary Team Meeting Clinical Resource

IN CASE YOU MISSED IT

 

Posted on

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

Posted on

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

Posted on

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:

Posted on

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:

Proudly powered by WordPress