Understanding the Latest LTC Regulatory and Survey Changes

Posted by LTCS on October 16, 2017

How to Write a Care PlanIn the latest updates published by CMS there is very little new. The big changes are the  Entrance Conference Form, Matrix for Providers, and guidelines on how long term care facilities should provide trauma-informed care.

The survey pathways simply list the surveyor guidance in a checklist form. Nothing in the pathways is outside already established federal regulations.

All LTCS manuals have been updated to include the new changes.

The CMS site, Reform of Requirements for Long-Term Care Facilities has links for the complete Surveyor Guidance with changes marked by red italic font, the new forms, and all of the survey pathway checklists.

LTCS Federal and State Regulations Guide for long term care, nursing homes, and skilled nursing facilities

MDS Item Changes for October 2017

Posted by LTCS on September 28, 2017

The CMS Draft Version 1.15.x proposes new items for the MDS 3.0. Opioid use will be addressed in section N. An antipsychotic medication review will ask for information on the last attempted gradual dose reduction, and if no reduction was attempted, whether the resident’s physician has documented that dose reduction is contraindicated.

Coding Section N Medications

Section P will change its item sets on restraints to include alarms, including electronic devices, bed and chair alarms, floor mat alarms, and motion sensor alarms.

Coding Section P Restraints and Alarms

Proposed Revisions to PPS and MDS

Posted by LTCS on September 22, 2017

Case mix methodology will be changed and the MDS form streamlined next year, according to proposed changes recently announced by CMS.

RUGs would be replaced with the Resident Classification System, RCS-1 which would adjust for therapies, nursing services, and non-therapy ancillaries for a more resident centered allocation of resources.

Therapies would be assessed by resident characteristics rather than therapy time.

All PPS assessments would be eliminated except for the 5 Day and Significant Change of Status MDS.

Baseline Care Plan Requirements Outlined by CMS

Posted by LTCS on July 31, 2017

Long term care facilities must develop and implement a baseline care plan for each resident within 48 hours of admission beginning November 28, 2017, according to recently updated surveyor guidelines published by CMS.

The guidelines state the 48 hour baseline care plan must include “the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care,” including, but not limited to: initial goals based on admission orders, physician orders, dietary orders, therapy services, social services, and PASARR recommendation, if applicable.

According to the regulations, facilities may develop a comprehensive care plan in place of the baseline care plan if the comprehensive care plan meets all of the requirements for the baseline care plan outlined in the surveyor guidelines.

In order to assure all of the requirements of the guidelines are met, LTCS Books recommends that the facility develops and implements a comprehensive care plan within 48 hours of admission.

MDS Comprehensive Assessment v1.15.1 for October 2017

Baseline Care Plan Regulations

CMS Updated Surveyor Guidelines for Long Term Care Faciities