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Long Term Care Survey Alert - 2010; Volume 12, Number 12
Risk Management:
Don't Let Bed Bugs Catch You Asleep at the Wheel
Prevent, detect, safely eradicate these resilient pests. Bed bug infestations can wreak h...
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Document Management:
Ditch These Potential Pitfalls to Electronic Records and MDSs
If you don't have policies for these 2 critical practices, now's the time to write them. E...
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Medication Safety:
Meds With Sedative Effects Can Add Up to Falls, Respiratory Failure
Is the resident taking an antiepileptic for behavioral issues? Read on. Taking a look at ...
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Education:
4 Ways to Get a Bigger Bang for the Buck From Professional Conferences
Check out these preparation and notetaking tips. Attending a conference is a great opport...
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Professional Management Tip:
Ready to Ask the Administrator for More Nurses? Consider These Key Factors
Sometimes the staffing numbers aren't the real issue, says expert. Your facility suddenly...
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Personal Finance:
Attention, Conference-Goers: Take Advantage of Tax Write-offs
Attending a meeting to boost a career move may be deductible. If your employer reimburses...
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Survey & Drug News
CMS is cutting facilities some slack in citing F287 deficiencies. F287 requires facilitie...
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Long Term Care Survey Alert - 2010; Volume 12, Number 11
Enforcement:
Update Your Narcotic Pain Medication Policy With This Key Change
Nurses can call in some controlled med prescriptions, if they do this first. When nursing...
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Survey Trends:
Beware: CMS Increasing the Number of Special Focus Facilities, Escalating Oversight
The agency's tougher stance on SFFs may portend a rougher survey road ahead for all facili...
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Survey Management:
5 Ways to Avoid or Get Off the Special Focus Facility List
Don't throw up your hands if you end up an SFF candidate. CMS is widening and toughening ...
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Staff Training:
How Would Your Facility Handle These 3 Common Resident-to- Resident Conflicts?
Tips help you defuse altercations and soothe residents at odds with each other. You hear ...
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Survey Update:
CMS Officials Provide the Scoop on 4 MDS-Related Changes
Make sure you're using the revised CMS-802 form. The MDS 3.0 is shaking up the survey and...
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Clinical & Survey News to Use
Make sure to double check fentanyl patches. Actavis Inc. in October announced a voluntary...
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Reader Question:
Is CMS F441 Glucometer Example Revision a Get Out of IJ Free Card?
Legal experts provide the good and bad news. Question: You noted in the last issue of Lon...
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Long Term Care Survey Alert - 2010; Volume 12, Number 10
Survey Management:
Stay on the Right Track During the MDS 3.0 QI/QM Blackout
Prepare for surveyors to take a much closer look during the initial tour. The MDS 3.0 may...
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Infection Control:
Using a Glucometer on More Than One Resident? CMS Clarifies What You Need to Do
One option provides a way out of this tricky infection control issue. Test yourself: Does...
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Appendix PP IJ Example for F441 to Omit Failure to Clean Glucometers Between Patients
Reusing fingerstick devices still constitutes IJ, according to the new example. In a rece...
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Risk Management:
Tips Help You Identify Quality Concerns During QI/QM 'Blackout'
Make sure your MDS coding is on the mark. Surveyors conducting traditional surveys aren't...
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Staffing Management Tips:
Give Staff 2 Vital Resources to Provide Optimal Care: Knowledge and Time
Skimping on this essential activity up front can cost the facility down the road. Ensurin...
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Quality Reporting Trends:
Prepare for Changes to Nursing Home Compare
More detailed staffing info may help provide the 'rest of the story' for some facilities....
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Compliance & Clinical News
Looking for help in providing residents the pain medication they require without running ...
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Reader Question:
Get the Upper Hand During the QIS Exit Conference
Question: How does the exit conference for the Quality Indicator Survey typically work? W...
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Long Term Care Survey Alert - 2010; Volume 12, Number 9
Wound Assessment:
Don't Let Pressure Ulcer Impostors Rob You of Solid Clinical and Survey Outcomes
If these wound types aren't on your 'rule out' list, you can't rule out F314 and F309 tag...
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Risk Management:
Is Your Facility Vulnerable to Mega-Million Dollar Lawsuits Alleging Staffing Shortfalls?
If you use this method to communicate about staffing concerns, watch out. Skilled Healthc...
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Survey Management:
Eliminate F353 Tag Risk for Staffing Issues
Find out what got one facility in hot water in a civil case. Repeated F tags for staffing...
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MDS Corner:
Is It a Bruise or Suspected Deep Tissue Injury?
Performing this assessment can help differentiate between the two. Mistaking what's reall...
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Hazard Prevention:
4 Critical Strategies Can Boost Siderail Safety
If you aren't making this measurement even without siderails in place, residents could be...
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Tool:
Check Out the 7 Entrapment Zones
FDA specifies these measurements for 4 of the zones. The seven areas in the bed system wh...
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Survey & MDS News
Ready for surveys without QI/QM reports? Starting Oct. 1 when the MDS 3.0 goes live, CMS ...
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Test Yourself:
Are these Statements about Hospice on or off the Mark?
Does your facility and the hospice need a single care plan for a nursing home resident on...
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Reader Question:
What Regs, Oversight Should a Facility Provide for Volunteers?
Question: Our facility has increased its size and census over the past year and we are co...
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Long Term Care Survey Alert - 2010; Volume 12, Number 8
Quality of Care:
Inject These 3 Key Approaches Into Your Medication Review
Find out how these common drugs can trigger the prescribing cascade. Sidestepping unneces...
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Disaster Planning:
Fine-tune Your Disaster Plan With This Real-World Case Scenario
Drilling down to the details can help you weather a flood or other catastrophe. A disaste...
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Risk Management:
Don't Let Disasters Sink Your Data-Driven Operations
2 broad-stroke efforts protect your electronic and paper medical records. As nursing home...
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Quality of Life:
Develop a Systematic Plan for Meeting Residents' Basic Human Need for Touch
Get staff with this program for staff to use touch in their various professional capaciti...
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Care Tip:
Integrate Tactile Stimulation and Touch in Activities
An activity expert shares some inside tips for meeting this basic need. Activities provid...
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Tool:
These Indicators Can Help Tell You How a Resident Is Responding to Therapeutic Touch
Here's how you'll know that your touch is welcome, says skilled touch expert. Positive In...
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MDS 3.0 Corner:
Test Your MDS 3.0 Coding Know How
Try your hand at these questions. 1. When do you do the mood assessment in Section D? A. ...
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Clinical News to Use
Are your SNF's rehab therapists obtaining strength measurements on elderly patients? Rese...
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READER QUESTION:
Can a Meddling Family Member Spell HIPAA Trouble?
The answer depends on who's telling the person what. Question: How should our facility ha...
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Long Term Care Survey Alert - 2010; Volume 12, Number 7
Risk Management:
Preempt the Perils of Online Social Media Forums
Prohibit staff from making this No. 1 privacy mistake. Online social forums provide a gre...
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Patient Safety:
Make Summer Outings a Breeze With These 6 Safety Strategies
Be on the lookout for this subtle change that can signal dehydration. For many long-term ...
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Survey 202:
Tap the Survey Interpretive Guidelines to Stamp Out F Tags
You won't have a leg to stand on if you get IJ for this. If you're looking for an ace up ...
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Watch Out for These Immediate Jeopardy Scenarios
An INR of 9 or greater even without bleeding can spell IJ if you don't do this. If you're...
Read more
Tool:
Tune In to These Signs of Heat Stroke in the Elderly
This condition warrants a 911 call for an ambulance. The warning signs of heat stroke, wh...
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Clinical Tips:
Integrate Liberal Doses of Nonpharmacological Remedies in Your Pain Management Toolkit
Think inside the box for making the most of what you have to combat pain. If notions of n...
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MDS Corner:
CMS Adds Another MDS 3.0 Training Session, Posts Revised RAI Manual
Don't miss this key change to UTI coding. CMS is providing another opportunity for in-per...
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Survey Management Tip:
Jettison F Tags at the Exit Conference or Before
Hint: The activities documentation may be the ticket for preventing a citation. You know ...
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MDS & Clinical News to Use
CMS addresses how to manage MDS 3.0 discharge assessments. The MDS 3.0 requires facilitie...
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Long Term Care Survey Alert - 2010; Volume 12, Number 6
Survey Management:
Don't Go Out on a Limb: Use This 4-Point Decision Tree for Effective IDR and Appeals
Redefining your idea of a win may pave the way for one. The idea of challenging F tags an...
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Clinical Care:
Shore Up Your Clinical Systems for Assessing, Responding to Acute MI
Watch for this common initial sign of a perfusion change. The clock is always ticking whe...
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Clinical Tip:
Beware: Pulse Oximetry Can Provide a Misleading Snapshot of O2 Status
An ED nurse expert explains why. Using pulse oximetry to assess a person's oxygenation is...
Read more
Care Management :
Turn to SBAR for Handoffs to the Emergency Department
Summing up what's going on can expedite care. You may send a resident with signs of ...
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MDS 3.0 Corner:
Comb Through the MDS 3.0 for These 'Rest of the Story' Details for Surveyors
Examples range from fall severity to diabetic ulcers to continence status, and more. If y...
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Management 202:
Stop the Revolving Door: Target These 3 Common Management Mistakes
This automatic assumption can put a talented caregiver on an unhappy path. Managerial tac...
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Survey & Clinical News to Use
Patients with metastatic prostate cancer now have a new treatment option. The Food & ...
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Reader Questions:
A Resident Requests Acupuncture -- Now What?
Question: A post-operative SNF patient and her family want her to have her regular acupun...
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Reader Questions:
Should the SNF do a Sig Change MDS Assessment in This Case?
Question: If we have done the 5-day PPS assessment on a resident who goes back to the hos...
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Long Term Care Survey Alert - 2010; Volume 12, Number 5
Medication Management:
Caring for Patients With Parkinson's Sx? This Review Could Provide a Critical Clue
Your astute assessment could cure the person's symptoms. If you automatically think Parki...
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Regulatory Compliance:
How to Navigate DEA's Tougher Stance on Controlled Meds in Nursing Homes
Know what you're up against and 2 ways to work around it. Has tougher Drug Enforcement Ad...
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Legislative Trends:
Be Aware of These 2 Healthcare Reform Legislation Measures
Wannabe whistleblowers may soon be trolling your survey records for a qui tam case. The h...
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Legislative Trends:
SNF Patients' Excruciating Pain Grabs Senate Subcommittee Attention
Nursing home provider puts a face on delays caused by DEA restrictions on controlled meds...
Read more
Caregiver Safety:
5 Tips Help You Steer Clear of Sharps Injuries
Don't stick with this No. 1 bad habit known to cause injuries. Prevention is the best rem...
Read more
Ocupational Safety:
Know Your Options for Managing Needlestick Injuries
You should consider HIV prophylaxis in this scenario. Picture this: You're administering ...
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MDS 3.0 Corner:
Get Up to Speed on the Latest MDS 3.0 and RUG-IV Developments
Check out a helpful CMS-posted Q&A on MDS 3.0. If you feel like MDS 3.0 and RUG-IV im...
Read more
Stress Management Tip:
Tune Out Work-Related 'To Do' Lists and Ruminations With This Simple Strategy
This works well for some busy nurses, says expert. You have a zillion things to do at wor...
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Survey & Clinical News to Use
AAHSA-compiled stats help you read between the lines for Medicare initiatives. For one, t...
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Long Term Care Survey Alert - 2010; Volume 12, Number 4
RESIDENT SAFETY:
Don't Let Renovations or Repairs Impair Your Safety Track Record
Cover the bases with this 4 strategy plan. Maintaining and updating your building can pay...
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RISK MANAGEMENT:
Dot the I's, Cross the T's When Managing Residents' Non-Compliance with Skin Care
IJ case highlights the hazards of mishandling this common problem. A resident at high ris...
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QUALITY IMPROVEMENT:
Ditch These 5 Modifiable Risks Before They Undermine Your Facility's Liability Profile
If you think you're stuck with fiscal constraints, check out this key advice. You don't w...
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MANAGEMENT:
Reduce Caregiver Stress With 3 Key Strategies
This approach to death and dying creates a positive, supportive environment. For long-ter...
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STRESS MANAGEMENT:
Take This Balanced Approach to Maintaining Your Wellbeing
Are you focusing on these four aspects of yourself? With the MDS 3.0 and RUGs-IV on the n...
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What Do You Think? Does Staying on Top of DAB and ALJ Rulings Pay Off as a Survey Management Strategy?
Doing this instead may provide a bigger bang for your effort. Questions: How advantageous...
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MDS 3.0 CORNER:
Be Prepared to Do Discharge MDS Assessments When the MDS 3.0 Goes Live
Find out what CMS may be able to tell based on this assessment. Unless CMS makes a change...
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CLINICAL NEWS TO USE
If you're looking for a baseline standard-of-care exercise program for your post-breast c...
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Long Term Care Survey Alert - 2010; Volume 12, Number 3
WOUND CARE:
Close Your Wound Care Protocol Vulnerabilities With 5 Strategies
One clue will help you avoid an initial big mistake. In the wound care arena, your skin u...
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SURVEY MANAGEMENT:
Beware: These 2 Syndromes Will Derail Your Best Survey Management Plans
If you aren't holding these meetings, you're missing a key opportunity. When survey day d...
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SURVEY MANAGEMENT:
Are Your Glucometers Putting Your Facility at Risk?
Immediate jeopardy case provides a heads up for all facilities. If your facility isn't cl...
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Clinical Tip:
A Simple Strategy Can Head Off Falls and Related Injuries
All you need is this inexpensive device. A caregiver may not always have the time to chec...
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STAFF HEALTH PROMOTION:
Boost Your Own Health With This Practical Know-How
To stay on top of your game at work, avoid this No. 1 dietary mistake. To care for others...
Read more
TOOL:
Check Out This Sample Wound Care Protocol
Stage III Pressure Ulcer/Full Thickness Skin Loss into Sub-Q Treatment: Wound Preparation...
Read more
Staff Health :
Caregivers: Shed Excess Pounds for Good With This Simple Plan
Try these 2 simple strategies in lieu of counting calories. Between the stress of making ...
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CLINICAL RESEARCH NEWS TO USE
Got vitamin D? The vitamin captured the spotlight as a fall prevention remedy in a review...
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Long Term Care Survey Alert - 2010; Volume 12, Number 2
SURVEY MANAGEMENT:
5 Things You Never Want to Happen During the Survey -- and How to Make Sure They Don't
Simple tips stop smokers from setting off fire alarms and staff from going rogue. Anyone ...
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QUALITY OF CARE:
A 3-Prong Plan Can Expedite Care for Emergent Conditions
Before you phone the doctor about a patient, make sure to do this. Ensuring residents rec...
Read more
Survey Management Tip:
Nervous When Surveyors Watch You Do Med Pass?
Try these quick tricks to avoid getting tripped up. You're getting ready to pour the morn...
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RISK MANAGEMENT:
Beware Aberrant Prescribing Patterns Linked to a Provider's Financial Interest in a Product
The OIG 2010 work plan includes looking at this kind of drug use. Imagine reading a newsp...
Read more
QUALITY OF CARE:
Create Crystal Clear Phone and Preauthorized Orders With These Tips
A standing order can help or hurt depending on whether you have these controls in place. ...
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TOOL:
This Data Collection Form Can Help Nurses Present a Clear Picture to Physicians
...
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MDS 3.0 UPDATE:
Get Up to Speed With the MDS 3.0: Here's What You Need to Know Now
The manual sheds light on coding, but prepare for a QI/QM blackout. The MDS 3.0 appears t...
Read more
READER QUESTION:
Do ALJ or DAB Rulings Indicate Whether IJ Citations Should Involve Actual Harm?
Question: I'm a new administrator for a nursing home and am surprised that we can get an ...
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Long Term Care Survey Alert - 2010; Volume 12, Number 1
ASSESSMENT:
Predictive Pain Model Flags Residents at Risk for Having Unrelieved Pain
If a resident coded without pain has these conditions, take a closer look. To identify re...
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SURVEY MANAGEMENT:
Follow These 'Lessons Learned' for Staying Off CMS' Special Focus Facility List
Find out how a once troubled facility moved ahead of the QI curve. Learning that your fac...
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Look for Pain's Indirect Effects to Identify People Who Need Better Assessment or Rx
Pain can cause increasing cognitive impairment. Pain can be pervasive and show up in a nu...
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SURVEY MANAGEMENT:
Got Electronic Health Records? Follow These Strategies for Meeting Surveyors' Needs and Keeping F Tags at Bay
Refusing to do this task can put your facility on the road to decertification. If your fa...
Read more
PHARMACY:
To Dispose of Controlled Meds,Your Facility Needs a Well Thought Out Plan
Environmental concerns up the ante for managing this common task. A patient dies or goes ...
Read more
TOOL:
Computerized Reports Flag Residents Whose MDSs Show They May Have Undetected Pain (Also see the next page)
...
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Care Tip:
Reiki Can Be an Effective Pain Management and Spiritual Aid
Is your facility incorporating this modality in its toolkit? Opioids remain the gold stan...
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SURVEY & CLINICAL NEWS TO USE
CMS has corrected an error in survey guidance for F441 specifying the strength of a disin...
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