MDS Alert

Plus: NPUAP criticizes ‘hand check method’ for bottoming out.

You could soon be faced with conducting a new facility assessment to review your facility’s capabilities and your resident population.

On July 16, the proposed rule “Medicare and Medicaid Programs: Reform of Requirements for Long-Term Care Facilities” appeared in the Federal Register. A central element of the proposed regulation requires nursing facilities to conduct a facility assessment.

The assessment would include an analysis of the facility population, which “would take into account resident needs based on acuity, diagnosis and the individualized, comprehensive care plan,” according to a July 21 analysis by the CMS Compliance Group Inc. (CMSCG). To help facilities determine the resources they need to care for residents on a daily basis and during emergency situations, the facility assessment would include the following information:

• Resident statistics, including number of residents, facility capacity, overall acuity of resident population, etc.;

• Required staff competencies to provide the necessary level of care;

• Personnel, including employees, contracted staff and volunteers, and their education/training and resident care competencies;

• The physical environment, equipment and services required to provide the necessary level of care;

• The facility resources, including buildings, transportation and equipment;

• The services provided, including physical therapy, pharmacy and any types of rehabilitation;

• Factors that could potentially affect the care provided, including ethnic, cultural and religious factors;

• Contracts/third-party agreements for services/equipment used during daily operations and emergency operations; and

• Health information technology, including Electronic Medical Records (EMRs) and capabilities for sharing electronic information.

The facility assessment would require annual updates and will provide the foundation for several regulatory areas, including staffing, reducing unnecessary use of antipsychotic medications, preventing healthcare associated infections (HAIs), and providing food and nutrition, according to CMSCG.

The proposed rule contains many other regulatory changes, all of which aim to revise the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs.

Link: The proposed rule is available at  www.federalregister.gov/articles/2015/07/16/2015-17207/medicare-and-medicaid-programs-reform-of-requirements-for-long-term-care-facilities.

In Other News …

Consider New Pressure Ulcer Guidance On ‘Bottoming Out’

Are you using the “hand check method” to monitor bottoming out? If so, the National Pressure Ulcer Advisory Panel (NPUAP) says this isn’t a good idea.

In a new Position Statement entitled, “Hand Check Method: Is it an Effective Method to Monitor for Bottoming Out?,” NPUAP recommends limiting the use of the hand check to static air overlay mattresses. “This method of determining bottoming out is inappropriate for replacement mattresses and integrated bed systems (bed frame and support surface),” NPUAP says.

To read the Position Statement, go to www.npuap.org/wp-content/uploads/2012/01/Hand-Check-Position-Statement-June-2015.pdf.

Take Advantage Of These PEPPER Resources

New statistics are now available regarding the Program for Evaluating Payment Patterns Electronic Report (PEPPER).

Skilled nursing facility (SNF) PEPPER summarizing statistics for fiscal years 2012 through 2014 are now available through the PEPPER Resources Portal, according to a July 1 announcement by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL). “To date, 51 percent of all SNFs have retrieved this important data.”

To access the PEPPER Resources Portal, go to https://securefile.tmf.org/Default.aspx?ReturnUrl=/. For more information on accessing your PEPPER, go to the Distribution page at http://pepperresources.org/PEPPER/Distribution-Schedule-Get-Your-PEPPER. You can also access PEPPER training sessions at http://pepperresources.org/Training-Resources/Skilled-Nursing-Facilities and download the updated SNF PEPPER User’s Guide at http://pepperresources.org/Portals/0/Documents/PEPPER/SNF/SNFPEPPERUsersGuide_Edition3.pdf.