AADNS News Feed

Sorting through all that is happening in LTC and then figuring out just what you need to know can be a daunting task. Luckily, we’re here to help. Our nursing experts scour through mountains of information to identify the breaking news and important updates and changes that you need to know today. Find the latest on important topics with links to resources, websites, and tools to keep you up-to date.

  • Dec. 12 SNF ODF Agenda and Call-in Information

    By CMS - December 11, 2019

    The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for:  

    Date:  Thursday, December 12, 2019

    Start Time:  2:00 PM – 3:00 PM Eastern Time (ET);

    Please dial-in at least 15 minutes before call start time.

    Conference Leaders: Todd Smith & Jill Darling

    **This Agenda is Subject to Change**

    I.  Opening Remarks

    Chair – Todd Smith (Center for Medicare)

    Moderator – Jill Darling (Office of Communications)

    II.   Announcements & Updates

    *PDPM Update

    *Fiscal Year 2020 SNF VBP Facility-Level Dataset and SNF VBP Aggregate Performance

    III. Open Q&A


    Next ODF: TBD

    Mailbox: SNF_LTCODF-L@cms.hhs.gov

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  • Staffing Solutions Article Series: How to Improve Your Orientation Program and Encourage Staff Retention and Learning

    By Alexis Roam, MSN, RN-BC, DNS-CT, QCP - December 04, 2019

    Is the onboarding experience and orientation program in need of improvement in your nursing home? If so, you’re not alone; and the challenge is not unique to the healthcare industry. Only 12% of employees who completed the Gallup survey in 2017 said their employer did a good job onboarding them. According to surveys conducted by Digitate in 2018, only one in five employees would recommend their new employer to a friend after onboarding, and those who had a negative onboarding experience are twice as likely to look for new opportunities in the near future. With the demand high for a compassionate and competent workforce, and the current staffing crisis in post-acute care, investing in revitalizing the onboarding experience and orientation program in the nursing home could pay big dividends. The first article in the staffing solution series discussed ways to improve the onboarding experience using principles of hospitality. This article will build upon the first and discuss ways to improve the orientation program and encourage retention.

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  • Resident to Resident Altercations

    By Alexis Roam, MSN, RN-BC, DNS-CT, QCP - December 04, 2019

    Meet Ms. Smith and Mrs. Johnson

    During the DNS’s daily rounds, he overhears two CNAs conversing about how two residents frequently argue. The DNS inquires and learns Ms. Smith and Mrs. Johnson, both residents living in the memory care neighborhood, had an argument over a purse the previous evening. Ms. Smith grabbed the purse out of Mrs. Johnson’s hand, hit her twice with the purse, and walked away. Later the same day, a CNA sees Ms. Smith holding Mrs. Johnson’s arm and warning her to stay away from her purse or she will hit her with it again. Mrs. Johnson shakes her head and asks Ms. Smith to help her find her dog. The CNA re-directs Ms. Smith’s attention and assists her to her room so she can watch her favorite TV show. Two days later, Mrs. Johnson’s husband reports a bruise on his wife’s arm and is demanding to know what happened to her. There is no documentation in the medical record or incident report on file for any of the resident to resident altercations observed by the CNAs, nor the bruise. The following day, a state surveyor enters the facility to investigate a hotline complaint of abuse and requests the medical records for Ms. Smith and Mrs. Johnson.

    Ms. Smith and Mrs. Johnson probably remind readers of other residents currently or previously in their care. The scenario described is also likely familiar. However, the perception of and regulatory requirements related to resident to resident altercations have evolved, as has the expectation for each case to be investigated for potential abuse. F600 states “The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation as defined in this subpart.”

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  • Tuberculosis Screening, Testing, and Treatment of US Healthcare Personnel: Free CE (12/19)

    By CDC - December 04, 2019
    New FREE Continuing Education Activity from MMWR and Medscape

    CDC’s MMWR and Medscape are proud to introduce a new FREE continuing education (CE) activity. The goal of this activity is to describe updated National TB Controllers Association (NTCA) and Centers for Disease Control and Prevention (CDC) recommendations for screening, testing, and treating U.S. health care personnel (HCP) for tuberculosis (TB) to prevent transmission in healthcare settings.

    This activity is intended for public health/prevention officials, infectious disease physicians, hospital administrators, internists, pulmonologists, nurses and pharmacists and other physicians involved in prevention of TB transmission among and through HCPs.

    Upon completion of this activity, participants will:

    ·  Describe updated NTCA and CDC recommendations for baseline and postexposure TB screening and testing for HCPs

    ·  Determine updated NTCA and CDC recommendations for serial screening and testing for HCPs without latent TB infection

    ·  Identify updated NTCA and CDC recommendations for evaluation and treatment of HCPs with positive TB test results

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  • jRAVEN 1.7.2 Free MDS Submission Software Updated (12/19)

    By CMS - December 04, 2019

    jRAVEN (version 1.7.2) is now available for download which contains the following updates:  

    • A defect has been corrected that was causing the HIPPS score that is calculated in jRAVEN to not match the score calculated by the Submission System
    • Changes in support of the MDS Data Specifications Errata V3.00.3
    • The new MDS VUT, version 3.2.0, also updated in support of the Errata V3.00.3
    • All enhancements included with jRAVEN V1.7.0 & V1.7.1:
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  • CASPER Reporting User’s Guide for MDS Providers UPDATED (12/19)

    By QTSO - December 04, 2019
    Provides information and instructions pertaining to CASPER Reporting, including accessing Final Validation Reports.
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  • Nursing Home Infection Control Self-Assesssment Worksheet From CMS and CDC (12/19)

    By CMS - December 02, 2019

    This 2019 Nursing Home Infection Control Worksheet (ICWS) is a collaborative effort by CMS and CDC and meant to be used by facilities as a self-assessment tool. It comprises both regulatory requirements and best practices in infection prevention and control. A facility that uses this ICWS will identify gaps in practice and have a “roadmap” that can lead to an improved infection prevention and control program. The assessment reviews the following domains:

    • Infection Control program infrastructure and Infection Preventionist
    • Infection Preventionist relationship to Quality Assurance Committee
    • Infection surveillance and outbreak response.
    • Influenza and pneumococcal Immunization
    • Linen management
    • Infection prevention during transitions of care
    • Water Management Program
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  • CMS Memo: Phase 3 Survey Guidance Will Be Released in Calendar 2Q 2020

    By CMS - November 27, 2019

    The Centers for Medicare & Medicaid Services (CMS) is announcing updates and initiatives aligning with the CMS strategic initiative to Ensure Safety and Quality in Nursing Homes. These updates and initiatives include:


    • Phase 3 Interpretive Guidance: CMS will be releasing updated Interpretive Guidance and training for the Requirements for Participation for Long-Term Care (LTC) Facilities. However, this guidance will not be released by the November 28, 2019 implementation date of the regulations. We will be releasing the guidance in the second quarter of calendar year 2020, along with information on training and implementing related changes to The Long Term Care Survey Process (LTCSP). While the regulations will be effective, our ability to survey for compliance with these requirements will be limited until the Interpretive Guidance is released.

    • Medicare and Medicaid Programs; Revision of Requirements for Long-Term Care Facilities: Arbitration Agreements: On July 18, 2019, the Department of Health and Human Services (HHS) published a final rule establishing requirements related to the use of binding arbitration agreements. This final rule amends the requirements that Long-Term Care (LTC) facilities must meet to participate with Medicare and Medicaid. 

    • Actions to Improve Infection Prevention and Control in LTC Facilities: CMS has created a nursing home antibiotic stewardship program training; updated the Nursing Home Infection Control Worksheet as a self-assessment tool for facilities; and is reminding facilities of available infection control resources.

    • Release of Toolkit 3, “Guide to Improving Nursing Home Employee Satisfaction”: CMS has created a toolkit that helps facilities improve employee satisfaction.

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  • CMS Online Training: How to Develop an Antibiotic Stewardship Program (11/19)

    By CMS - November 27, 2019
    Class Description: To provide technical assistance to nursing home providers on the implementation of an Antibiotic Stewardship Program. Training goals include to support compliance with the requirements for an antibiotic stewardship program (ASP) and to improve appropriate antibiotic usage. Completion of the training does not automatically deem a provider compliant. This training supports compliance, but providers must still meet all components of the antibiotic stewardship requirements.
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  • CMPRP Toolkit: Guide to Improving Nursing Home Employee Satisfaction (11/19)

    By CMS - November 27, 2019

    There are many resources out there to help nursing facilities improve quality, but it can be overwhelming to identify which are most relevant to your facility’s specific needs and to stay up-to-date on the latest guidance. This employee satisfaction guide helps nursing homes determine the most appropriate and helpful resources to address challenges.

    Once your facility completes the employee satisfaction survey, you will be ready to address the identified improvement opportunities. The employee satisfaction guide is a repository of evidence-based approaches, solutions and interventions to address challenging areas discovered through the survey.

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  • Infection Surveillance: How to Beef Up Your Program

    By Caralyn Davis, Staff Writer - November 27, 2019

    A key problem in many nursing homes is inadequate infection surveillance. The written standards, policies, and procedures for an infection prevention and control program (IPCP) must include “a system of surveillance designed to identify possible communicable diseases or infections before they can spread to other persons in the facility,” according to §483.80(a)(2)(i) of the Code of Federal Regulations.

    "The Centers for Medicare & Medicaid Services (CMS) wants providers to have a more formalized surveillance program, says Deb Patterson Burdsall, PhD, RN-BC, CIC, FAPIC. “You have to understand the epidemiological concepts of incidence and prevalence rates; how to calculate infection rates; and how to feed that information back in a feedback loop to the frontline providers—the people who can actually do something about what is going on with infection data.”

    With the support of the director of nursing services, the infection preventionist can implement the key steps to develop an effective infection surveillance program. Read this article to find out those steps!
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  • Writing a Plan of Correction: Keys to Success

    By Caralyn Davis, Staff Writer - November 26, 2019
    Receiving the statement of deficiencies (form CMS-2567) from the state survey team and seeing citations finally laid out in black and white can be a shock for any director of nursing services (DNS), says Janet Feldkamp, RN, BSN, LNHA, CHC, JD, a partner at Benesch, Friedlander, Coplan & Aronoff in Columbus, OH. The following steps can help DNSs mitigate the shock and reduce the negative impacts from survey
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  • LTCSP Survey Resources: Surveyor Tools (11/19)

    By CMS - November 25, 2019
    This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP).
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  • LTCSP Procedure Guide - Updated (11/19)

    By CMS - November 25, 2019

    The LTCSP Procedure Guide provides instruction on the procedural and software steps necessary for completing the Long-term Care Survey Process. Surveyors use the Procedure Guide for all standard surveys of SNFs and NFs, whether freestanding, distinct parts, or dually participating. The LTCSP steps are organized into seven parts: 1) offsite preparation; 2) facility entrance; 3) initial pool process; 4) sample selection; 5) investigation; 6) ongoing and other survey activities; and 7) potential citations. Below is a broad overview of the key onsite parts of the LTCSP (parts 3 – 7).

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  • Top Ten Citations Part Two – Deep Dive into F812 and F656

    By Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA - November 13, 2019

    Last month, we provided members with a list of the top ten federal deficiencies since January of 2019. As a reminder, the top ten deficiencies are:

    1. F880 - Infection prevention and control

    2. F689 - Free of accidents, hazards/supervision/devices

    3. F812 - Food procurement/storage

    4. F656 - Develop/implement comprehensive care plan

    5. F684 - Quality of care

    6. F761 - Label/storage of drugs and biologicals

    7. F657 - Care plan timing and revision

    8. F758 - Free from unnecessary psychotropic med/prn use

    9. F677 - ADL care for dependent residents

    10. F550 - Resident rights

    (The citations above in red reflect the potential to cause substandard quality of care when a facility is cited at a scope and severity of F, H, I, J, K, or L level)


    This month, we will take a deeper dive into the number three and four top citations and explore common reasons that facilities are struggling to meet these regulations.

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