Infection Prevention and Control Resources

With the latest updates to the State Operations Manual, it is more important than ever to promote resident safety and well-being through infection prevention and control. A robust and successful infection control program requires many thoughtfully designed and well-operating pieces—from antibiotic stewardship and physician engagement to immunization planning and tracking, reduced hospital readmissions, and comprehensive clinical surveillance. Explore the resources below to learn how you can bolster your infection control program.

Learn more about  AADNS's comprehensive Antibiotic Stewardship Program in Long-Term Care Virtual Workshop.

  • Five Star Preview Reports Available Now; Help Line Open Thru 6/29

    By QTSO - June 24, 2018

    The Five Star Preview Reports will be available on June 25. To access these reports, select the CASPER Reporting link located on the CMS QIES Systems for Providers page. Once in the CASPER Reporting system, select the 'Folders' button and access the Five Star Report in your 'st LTC facid' folder, where st is the 2-character postal code of the state in which your facility is located and facid is the state-assigned Facility ID of your facility.

    Nursing Home Compare will update with June's Five Star data on June 27, 2018.

    Important Note: The 5 Star Help line (800-839-9290) will be available June 25, 2018 through June 29, 2018

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  • Nursing Home Compare & PBJ Updates: Long-stay Resident Hospitalization Rate to Be Added to NHC / Five Star; Non-Nursing Staff for PBJ to Be Posted; Health Inspection Freeze to End (6/18)

    By CMS - June 22, 2018
    • In October 2018, the long-stay hospitalization measure will be posted on the Nursing Home Compare website as a long-stay quality measure. In the spring of 2019, this quality measure will be included in the Five Star Quality Rating System.  Additionally, in July 2018 we will update the other claims-based quality measures reported on the Nursing Home Compare website.
    • To increase transparency, CMS will begin posting the number of hours worked by other staff (i.e., non-nursing) in July 2018. Facilities are required to submit hours for all other staff as listed in Table 1 of the PBJ Policy Manual. We will also distinguish between hours submitted for direct employees and contract staff. 
    • In October 2019, CMS will resume posting the average number of citations per inspection for each state and nationally. CMS is monitoring outcomes of the new inspection process and plans to resume health inspection rating calculations (i.e., end the freeze) in the spring of 2019. CMS will communicate more details about this prior to its implementation.



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  • June 30 Deadline to Contest Inaccuracies in SNF QRP QM Provider Preview Reports (6/18)

    By CMS - June 22, 2018
    Skilled Nursing Facility Quality Reporting Program (SNF QRP) QM Provider Preview Reports have been updated and are now available. Providers have until June 30, 2018 to review their performance data prior to public display on the Nursing Home Compare site. Corrections to the underlying data will not be permitted during this time. However, providers can request a CMS review during the preview period if they believe their data scores displayed are inaccurate.
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  • CMS Memo Revises Policies Re: Immediate Jeopardy and Immediate Imposition of Federal Remedies (6/18)

    By CMS - June 22, 2018

    Memo # 18-18-NH

    Posting Date 2018-06-15

    Fiscal Year 2018

    Summary

    This memo replaces the following Survey & Certification (S&C) Memos: 16-31-NH released July 22, 2016 and revised on July 29, 2016, and S&C: 18-01-NH, released in draft on October 27, 2017. The October 2017 memo solicited comments on a proposed directive requiring, for certain situations, immediate imposition of federal remedies on Medicare and Medicaid participating skilled nursing facilities. After reviewing comments, CMS is issuing a final version of the directive. Substantive revisions to the prior Immediate Imposition of Federal Remedies guidance include:

    • When the current survey identifies Immediate Jeopardy (IJ) that does not result in serious injury, harm, impairment or death, the CMS Regional Offices may determine the most appropriate remedy; 
    • We clarified that Past Noncompliance deficiencies (as described in §7510.1 of this chapter) are not included in the criteria for Immediate Imposition of Remedies; and, 
    • For Special Focus Facilities (SFFs), S/S level “F” citations under tags F812, F813 or F814 are excluded from immediate imposition of remedies. 
    • Revisions to Chapter 7 of the State Operations Manual (SOM) (Attachment): The Centers for Medicare & Medicaid Services (CMS) has revised guidance in Chapter 7 of the SOM related to the Immediate Imposition of Federal Remedies as noted in this memo and its attachment. Other sections of Chapter 7 have been revised to ensure conformity and consistency with these revisions.        
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  • Proposed SNF Patient-Driven Payment Model (PDPM) for Medicare Part A: Technical Resources UPDATED (6/18)

    By CMS - June 20, 2018

    In May 2017, CMS released an Advanced Notice of Proposed Rulemaking (ANPRM) which outlined a new case-mix model, the Resident Classification System, Version I (RCS-I), that would be used to replace the existing RUG-IV case-mix model, used to classify residents in a covered Part A stay into payment groups under the SNF PPS. Since the ANPRM, we continued our stakeholder engagement efforts to address the concerns and questions raised by commenters with RCS-I. This resulted in significant changes to the RCS-I model, which have prompted us to rename the proposed model discussed in the FY 2019 SNF PPS Notice of Proposed Rulemaking (NPRM) the SNF Patient Driven Payment Model (PDPM). 

    June 2018 Update: A few typographical and usability issues were recently identified by certain stakeholders with SNF PDPM the classification logic (SNF PDPM Classification Walkthrough, Grouper Tool, and NTA Comorbidity Mapping).  In order to address these issues, CMS has posted revised versions of the three files below. Stakeholders should use these revised SNF PDPM files to inform their comments on the proposed rule.
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  • PDPM At-a-Glance Tool

    By AANAC - June 19, 2018
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  • 13 Best Practices to Prevent High-Scope Citations for F686 (Skin Integrity)

    By Jessica Kunkler, MA, Staff Writer - June 19, 2018

    Since the new Long-Term Care Survey Process (LTCSP) launched on November 28, 2017, 702 citations have been given for F686 (Skin Integrity). 22% of those tags are a G scope or above. Many of the citations are for:

    ·         Failure to provide care to treat and/or prevent worsening pressure ulcers

    ·         Failure to prevent facility-acquired pressure ulcers

    ·         Failure to develop and/or follow the care plan

    ·         Failure to ensure accurate assessment, obtain treatment orders, or communicate with other professional staff

    ·         Failure to prevent infection of wounds

    Widespread pressure ulcer issues are no surprise when facilities don’t have proper protocols in place for prevention, early identification, and treatment, according to Wendy DeCarvalho, MS, BSN, RN, DNS-CT, Director of Nursing for Scotia Village in North Carolina. As a DNS and clinical nurse consultant in long-term care facilities nationwide, DeCarvalho has worked to improve Quality Measures, including those for pressure ulcer rates. “If the staff doesn’t have protocols in place, pressure ulcers often go unchecked, untracked, and untreated,” she says. She recommends the following best practices.

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  • Fall Prevention: It’s Easy to Miss What You’re Not Looking For

    By Linda Shell, DNP, MA, RN, DNS-CT - June 19, 2018
    Does this sound familiar? Mary, an 87-year-old memory care resident and recurrent faller, has another fall in her room. A housekeeper spots her lying on the floor. Staff members rush to help. Alarm, floor mat, low bed? What will it be this time? The nurse completes an incident report and an intervention is care planned. The same scenario with Mary repeats itself over and over. She falls, a new intervention fails, her family grows concerned, staff members become frustrated, and the resident and facility are at risk.
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  • Q&A: Does anyone have a procedure for destruction of unused and/or discontinued narcotics?

    By AADNS Network - June 19, 2018
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  • Noninvasive Nonpharmacological Treatment for Chronic Pain: AHRQ Systematic Review (6/18)

    By AHRQ - June 18, 2018

    Purpose of Review

    To assess which noninvasive nonpharmacological treatments for common chronic pain conditions improve function and pain for at least 1 month after treatment.

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  • CMS 2016 SNF Medicare Utilization Data (6/18)

    By CMS - June 18, 2018
    • MDCR SNF 1. Medicare Skilled Nursing Facilities:Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement, Calendar Years 2011-2016
    • MDCR SNF 2. Medicare Skilled Nursing Facilities:Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status, Calendar Year 2016
    • MDCR SNF 3.Medicare Skilled Nursing Facilities:Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Area of Residence, Calendar Year 2016
    • MDCR SNF 4. Medicare Skilled Nursing Facilities:Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement and Covered Days of Care, Calendar Year 2016
    • MDCR SNF 5. Medicare Skilled Nursing Facilities:Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Facility and Bedsize, Calendar Year 2016
    • MDCR SNF 6. Medicare Skilled Nursing Facilities:Distribution of Medicare Covered Skilled Nursing Facility Days, by State of Provider and Major Resource Utilization Groups (RUG)-III, Calendar Year 2016



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  • IMPACT Act: CMS Launches Data Element Library Supporting Interoperability (6/18)

    By CMS - June 18, 2018

    New resource provides streamlined access to CMS assessment data elements mapped to health IT standards

    The Centers for Medicare & Medicaid Services (CMS) announced the agency’s first Data Element Library (DEL). The DEL is a new CMS database that supports the exchange of electronic health information. Using this free, centralized resource, the public for the first time can view the specific types of data that CMS requires post-acute care facilities (such as nursing homes and rehabilitation hospitals) to collect as part of the health assessment of their patients. These assessments include questions and response options (data elements) about patients, including demographics, medical problems and other types of health evaluations. Many of these data elements have been standardized, which means that they are exactly the same no matter which type of post-acute care facility is using them. Healthcare facilities integrate all of this patient information into their medical record systems, and this information is used for multiple purposes, such as payment by CMS, quality measurement and quality improvement. It is important to note that the DEL doesn’t contain any patient-identifiable data whatsoever.

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  • NIH HerbList App (6/18)

    By NIH - June 17, 2018
    App offers easy access to scientifically backed information on herbs and herbal products.
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  • Early August: Look for SNF VBP Annual Performance Scores and Phase 2 Program Review and Corrections (6/18)

    By CMS - June 15, 2018
    Phase Two of the Review and Corrections process will begin when annual performance score reports are made available in the Certification And Survey Provider Enhanced Reports (CASPER) system in early August 2018. Phase Two will allow SNFs 30-days to submit correction requests to their SNF VBP performance score and rank only for the FY 2019 Program year. Over the next several months, CMS aims to provide additional resources and training on the Review and Corrections process and how to submit proper Phase One and Phase Two requests.
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  • Register Now: July 31 - Aug. 1 SNF QRP Train the Trainer Event Agenda Available

    By CMS - June 11, 2018

    The Centers for Medicare & Medicaid Services (CMS) will be hosting a 2-day Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) in-person ‘Train the Trainer’ event for providers on July 31 and August 1, 2018, at the Four Seasons Hotel Baltimore, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations.

    The primary focus of this 'Train-the-Trainer’ event will be to provide those responsible for training staff at SNFs with information about SNF QRP changes and updates to the Minimum Data Set (MDS) 3.0 Version 1.16.0, effective October 1, 2018. Topics will include information on new and changed items, including changes associated with Section M (Pressure Ulcer/Injury), the introduction of Section N (the Drug Regimen Review Measure), Section O (including updates to guidance on Chemotherapy and Ventilator Guidance), and Section GG (Functional Mobility). Presenters will also discuss resources available on cms.gov, and support available through the SNF Help Desks. 

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