Long-Term Care Survey Alert

Ready for a new F tag for deficiencies in posting nursing staffing information? The Centers for Medicare & Medicaid Services has developed F356 in lieu of F492 to cite facilities for noncompliance with posting requirements. The new tag goes into effect as of the June ASPEN release.

Tag F492 remains in effect "for other issues involving compliance with federal, state and local laws," states a CMS survey and certification memo. However, CMS is rescinding "previous directions" in S&C 03-11 for using F492 to cite deficiencies in posting nursing staffing information.

New guidance instructs surveyors doing annual surveys to "verify correction of current noncompliance" as they would on a revisit. The surveyors will use a variety of methods to determine whether a nursing facility corrected the past problem and has prevented it from recurring.

DAVE 2 is setting its sights on MDS accuracy rather than payment issues, unlike its predecessor, DAVE. That's a key message from a presentation at a recent CMS-sponsored SNF Open Door Forum. DAVE 2 teams have been conducting on-site MDS reviews of a number of nursing facilities in several states (AZ, CA, IN, MA, NJ, NY, OH, VA, TN).  Nurse reviewers (usually two per team) doing on-site visits will review approximately 12 MDS records completed within 30 days prior to their on-site visit, according to a DAVE2 fact sheet. The reviewers will also conduct their own MDS assessments of residents to compare to the facility-performed assessments. You can access the fact sheet at www.cms.hhs.gov/NursingHomeQualityInits/Downloads/MDS20DAVE2FactSheet.pdf.  

Vitamin D may reduce the risk of falls and fractures in older adults, according to a study reported by researchers at the University of California at San Diego School of Medicine at the American Geriatrics Society annual meeting. The researchers found that elders with lower vitamin D blood levels did more poorly on various physical performance tests, such as standing up from a seated position, than did study participants with higher vitamin levels. This suggests that "vitamin D supplementation may have an additional benefit beyond falls and fracture reduction by its direct effect on muscle functions,"said the researchers, Thuy-Tien L. Dam, MD, and Elizabeth L. Barrett-Connor, MD, in a press statement posted at www.americangeriatrics.org/news/2006new_studies.shtml.