Home Health & Hospice Week

Help your nursing home partners lighten their SCSA burden.

Give your skilled nursing facility partners a compliance boost when it comes to Significant Change in Status Assessments for hospice and palliative care. The Centers for Medicare & Medicaid Services updated its RAI Manual last fall, adding a SCSA timepoint to its requirements (see story, p. 173).

Avoid unnecessary assessments: When it comes to figuring out when an SCSA is required, a common point of confusion is for palliative or “terminal” care versus hospice, points out RN Michelle Synakowksi, Director of ProCare and a consultant at Leading Age New York. If a facility’s resident is terminal or elects palliative care but doesn’t elect hospice, this doesn’t mean the facility needs to do an SCSA.

Instead, they would develop the care plan with goals for palliative care and all care plan approaches anticipating a decline. But they don’t automatically need to complete an SCSA.

Still, they need to determine whether the resident with a terminal condition has a change in that condition that is “an expected, well-defined part of the disease course and is consequently being addressed as part of the overall plan of care for the individual,” notes RN Scott Heichel, Director of Clinical Reimbursement at LeaderStat. “If a terminally ill resident experiences a new onset of symptoms or a condition that is not part of the expected course of deterioration and the criteria are met for an SCSA, an SCSA is required.”