Menu

Category Archives: Skilled Nursing

Blog

Infection Prevention and Control System Check with Susan LaGrange

Pathway Health’s Susan LaGrange presents the Infection Prevention and Control System Check Webinar. Infection Control continues to be one of the top deficiencies in the country. Whether you are an Infection Preventionist, Administrator, DON or Nurse Manager, this one-hour, fast-paced presentation will walk you through key strategies to check your system for quality and compliance.

Attendees will gain insight into the following:

  • How to identify three key steps for daily oversight of the Infection Prevention and Control Program
  • Describe strategies to engage staff for compliance
  • Develop an audit system that involves employees from all levels of the organization for success!

Tune in March 13 at 1 p.m. CT/ 2 p.m. ET for this FREE educational webinar.

Attendance is limited to the first 500 registrants, so register early here!

 

Blog

The Heart of Health Care: The Many Roles of Nursing Leaders in Post-Acute Care

In today’s vastly changing health care environment, the role of nursing leadership is one thing that remains consistent. It is and always will be the heart of health care.

My role as an operational leader was to set the strategic direction of the organization while working side-by-side with my nursing leader. I found organizational success unattainable without the contributions of my nursing leader and her team.

Nursing leaders focus on setting standards, setting policy, dealing with compliance, and overseeing quality measures and clinical outcomes. They spearhead innovation and transformation within their teams and the organization as a whole.

As I reflect on my career, and the dynamic nurse leaders that I have had the opportunity to work with, I note the following are the cornerstones of successful nursing leaders:

Oversight

Nursing leaders provide direction for their department while holding staff accountable. Nursing leaders oversee many responsibilities, including:

  • resident care delivery
  • customer and staff satisfaction
  • clinical processes
  • compliance
  • financial outcomes

Knowledge

Nursing leaders continually expand their knowledge and understanding of industry changes. Their main goal is caring for our residents. Staying on top of the changes that affect the organization can challenge nursing leaders. It is important that nursing leaders continue accessing education, tools and outside resources. Education provides a level of support for their organizations’ priorities, as well as expected outcomes.

Translating the information and knowledge into organizational best practice is another responsibility. Aligning industry changes with facility and department goals helps to relieve some of the pressure felt by nursing leaders. Implementing best practices allow nursing leaders to focus on targeted, high-level priorities and clinical processes for successful outcomes.

Align Talent and Clinical Success

Nursing leaders continue to work with their team at all levels. They identify the knowledge, skills and abilities of their team. Then, they align those talents with the clinical priorities of their organization. This allows for ongoing mentorship and development of future nursing leaders. Successful nursing leaders help build upon their success by surrounding themselves with an amazing team. Team building is essential to leading a diverse group of people with distinct personalities and skills. Fostering an environment of collaboration and professional growth is a key strategy for successful nursing leaders.

Motivate and Innovate

Given all the changes faced by nursing leaders, they possess a unique ability to motivate staff, especially in times of challenge. They know when to talk and when to listen. They are often confident and optimistic while inspiring enthusiasm in those around them. Today’s nursing leaders also spark and support innovation, knowing change is necessary to succeed in the new health care environment.

 

Being a leader is an amazing journey. It continues to provide opportunities for innovation, as well as personal and professional growth. Working next to dynamic nursing leaders in post-acute care is an honor and a privilege. Thank you for being at the center of our organizations, and for being the heart of health care.

 

Happy Valentine’s Day!

 

Lisa Thomson

Chief Strategy and Marketing Officer

 

Contact Pathway Health for more information on how we can expand the education and expertise of your long term care staff.

Blog

Wisconsin Director of Nursing Council Symposium 2019

Pathway Health representatives will attend the 25th Symposium at the Grand Geneva Resort for the annual WI Director of Nursing Council in Lake Geneva, WI. The event’s theme is Get Your Game On, a call-to-action for attendees and presenters alike as they congregate for the latest insights in nursing. Pathway Health leaders will be involved in discussions focused on:

  • CMS/Survey Preparedness,
  • Phase 3 Readiness,
  • Patient-Driven Payment Models and more!

Visit our industry specialists at booth #219 from February 25-27 and stay apprised of our progress on social media. Don’t wait for the Symposium! We have online educational programs available now.

Blog

Register now! Fireside Training Courses in February

Pathway Health offers multiple opportunities to bolster your professional education in the new year. Register now for guaranteed access to one of our Fireside Training classes.

 

By striving to improve yourself and your colleagues, your facility grows the quality of its care and the effectiveness of its staff. Explore the multiple options for furthering your education with Pathway Health on our Education page for more insight, expertise, and knowledge.

Blog

What Do You Really Need to Do Now to Prepare for PDPM?

When the Medicare payment model changes for nursing homes on October 1, 2019, the drivers of reimbursement will be dramatically changed. Under the current payment model, the amount of therapy provided to the resident in a seven-day period is the major determinant of the amount of daily payment the nursing home will receive from Medicare. Additionally, the resident’s level of dependence in activities of daily living (ADL) impacts the final payment category and amount. The higher the level of ADL dependence, the higher the payment rate. The nursing assistant staff documents the supporting charting of each resident’s ADL dependence level.

The new payment model, Patient-Driven Payment Model (PDPM), uses the resident’s clinical conditions as the main determinant of payment. The resident’s ADL dependence score is derived from an area of the Minimum Data Set (MDS) that is assessed and documented by the professional staff. There is no impact on the payment rate from the amount of therapy services provided. Payment is higher in the Physical Therapy (PT) and Occupational Therapy (OT) components of PDPM for residents who require some ADL help but are not totally dependent. These residents are more likely to be able to participate in and benefit from therapy services.

The PDPM system is comprised of six components:

  1. Non-Case-Mix Base Rate
  2. Physical Therapy
  3. Occupational Therapy
  4. Speech therapy
  5. Skilled Nursing
  6. Non-therapy Ancillary

Each component is scored separately and has federally established rates for each Case-Mix category in the component. The Case-Mix rates for each component are summed to establish the overall daily payment rate for the resident’s skilled stay under Medicare Part A.

There will be no transition period to PDPM. On September 30, 2019, Medicare payment will be from the RUG-IV classification system. On October 1, 2019, Medicare payment will be determined by a new MDS that established the PDPM payment rate. Because there will be no transition, nursing facilities need to perfect their systems that impact PDPM now.

The triad of systems, or M-I-P, that support PDPM are highlighted below:

  • MDS coding accuracy, especially in Section GG, functional performance and Section I, diagnoses
  • ICD-10 diagnosis coding accuracy and management
  • Pre-bill claim check review

MDS Coding – 

Section GG of the MDS was added in October 2017. Confusion remains about the best process for obtaining an accurate assessment of the resident’s USUAL performance in the first three days and last three days of their Medicare stay. The most effective approach is to have the nursing and therapy staff collaborate on coding Section GG. If the resident only performs the activity in therapy, that is the resident’s usual performance. If the resident performs the activity multiple times per day with nursing staff and only once with therapy, the resident’s performance with nursing staff best represents their usual performance.

ICD-10 Diagnosis Coding – 

Section I of the MDS is dependent upon accurate ICD-10 diagnosis coding and management so that the MDS and the Medicare claim contain the same information in the same order. There are few resources for staff education for ICD-10 coding for nursing homes. Most nursing facilities do not have a professionally certified medical coder on staff. Ensure that the staff responsible for coding understands the Official Coding Guidelines as published by the CMS and NCHS.

Download here.

 

Most clinical software used in nursing homes automatically enters the diagnosis codes onto the bill. There must be processes in place to ensure that the admitting and primary diagnoses are entered in the correct location on the bill and the coded conditions entered on the bill provide the clinical “story” that supports the amount being billed.

Pre-bill Claim Review – 

Pre-bill Claim Review involves an interdisciplinary team process that starts with the draft bill or claim and validates the information on the bill as well as the supporting documentation in the resident’s medical record. When this process is conducted effectively, the facility submits a “clean claim” that is a much lower risk for audit or medical review, thus is paid quickly and accurately.

PDPM Solutions to Start Preparing Now

Pathway Health PDPM experts can assess your facility’s M-I-P systems and provide a detailed action plan for enhancing or improving these processes. Our PDPM consulting services and tools can support your busy leaders and staff to effect a smooth transition to the PDPM system. Pathway Health also offers expert PDPM training – classroom, onsite and web-based. Contact us to learn more.

 PDPM Solutions


New! Complimentary PDPM Resource

Non-Therapy Ancillary Condition/Extensive Services Tool – PDPM – DOWNLOADABLE

The Non-Therapy Ancillary (NTA) component of PDPM presents an opportunity to capture reimbursement for resident comorbidities and special treatments. This one-page tool is a quick reference to those items that qualify in the NTA component of PDPM. Download now>

 

Author:
Karolee Alexander,
Director of Reimbursement and Clinical Consulting,
Pathway Health

Blog

Announcing New INTERACT Training Option

Provide INTERACT Certified Champion training, anytime, anywhere!
Now available through The Learning Pathway, this on-demand course provides an in-depth description of the INTERACT™ QIP strategies, care processes, tools, and other resources to improve care of changes in condition and prevent hospital transfers when safe and feasible; and shares key lessons learned on successful Program implementation and sustaining the Program over time.
INTRODUCTORY SAVINGS OFFER:
$499* until 11/30/18
(Regularly $629)
*Discount only available for online learning through The Learning Pathway.
10 CE credits have been applied for and are pending approval.

The Learning Pathway, powered by Pathway Health, provides a clear path to excellence in learning for your team 24/7.

Blog

Hot Topic – NEW LONG TERM CARE SURVEY PROCESS

NEW LONG TERM CARE SURVEY PROCESS

Now Available for Long Term Care Facilities

Entrance Conference, Facility Matrix and Numerous LTC Pathways

The Centers for Medicare and Medicaid Services just posted the following tools on their Survey and Certification Guidance to Laws and Regulations page for the new survey process, effective November 28, 2017:

Blog

Announcing Exclusive INTERACT® License Agreement

Pathway Health announces they have entered into an exclusive licensing agreement with Florida Atlantic University (FAU) to provide INTERACT® training, education, management, consulting services, including INTERACT™ 4.0 for Skilled Nursing Facilities, INTERACT™ 1.0 for Assisted Living and INTERACT™ 1.0 for Home Health. Under the terms of the agreement Pathway Health will also be sub-licensing the copyrighted INTERACT™ 4.0 and INTERACT™ 1.0 systems to entities such as Electronic Health Record providers and other technologies that want to incorporate INTERACT into their product offerings.

“Our nearly 20 years as a proven resource to the health care field, coupled with our insight, expertise and knowledge in the post-acute care continuum were the reasons that FAU selected Pathway Health as the exclusive company with the right to license and provide training, education and expertise to providers implementing INTERACT,” said Pathway Health Chief Executive Officer Peter B. Schuna.

INTERACT® (Interventions to Reduce Acute Care Transfers) is a quality improvement program that focuses on the management of acute change in patient condition. It includes clinical and educational tools, strategies to implement them, and related educational resources.

“Even though the INTERACT quality improvement program is publicly available, effective implementation and ongoing training are key to substantially reduce unnecessary interventions, as well as complications and costs associated with these interventions,” said FAU Vice President for Research Daniel C. Flynn, Ph.D.

Through this agreement, Pathway Health will continue to leverage their expansive network of consultants and strategic partners to help reduce hospital readmission rates and improve overall efficiencies.

“Pathway Health’s expert consultants will collaboratively assist hospitals, skilled nursing and assisted living facilities, home care companies and accountable care organizations improve the quality of care by providing key insights and training to support providers’ value-based care initiatives,” commented INTERACT creator Joseph G. Ouslander, M.D.

To learn more about how to effectively implement INTERACT or becoming a strategic partner, contact Peter Schuna at 877-777-5463.

Blog

Announcing Exclusive INTERACT® License Agreement

Pathway Health announces they have entered into an exclusive licensing agreement with Florida Atlantic University (FAU) to provide INTERACT® training, education, management, consulting services, including INTERACT™ 4.0 for Skilled Nursing Facilities, INTERACT™ 1.0 for Assisted Living and INTERACT™ 1.0 for Home Health. Under the terms of the agreement Pathway Health will also be sub-licensing the copyrighted INTERACT™ 4.0 and INTERACT™ 1.0 systems to entities such as Electronic Health Record providers and other technologies that want to incorporate INTERACT into their product offerings.

“Our nearly 20 years as a proven resource to the health care field, coupled with our insight, expertise and knowledge in the post-acute care continuum were the reasons that FAU selected Pathway Health as the exclusive company with the right to license and provide training, education and expertise to providers implementing INTERACT,” said Pathway Health Chief Executive Officer Peter B. Schuna.

INTERACT® (Interventions to Reduce Acute Care Transfers) is a quality improvement program that focuses on the management of acute change in patient condition. It includes clinical and educational tools, strategies to implement them, and related educational resources.

“Even though the INTERACT quality improvement program is publicly available, effective implementation and ongoing training are key to substantially reduce unnecessary interventions, as well as complications and costs associated with these interventions,” said FAU Vice President for Research Daniel C. Flynn, Ph.D.

Through this agreement, Pathway Health will continue to leverage their expansive network of consultants and strategic partners to help reduce hospital readmission rates and improve overall efficiencies.

“Pathway Health’s expert consultants will collaboratively assist hospitals, skilled nursing and assisted living facilities, home care companies and accountable care organizations improve the quality of care by providing key insights and training to support providers’ value-based care initiatives,” commented INTERACT creator Joseph G. Ouslander, M.D.

To learn more about how to effectively implement INTERACT or becoming a strategic partner, contact Peter Schuna at 877-777-5463.

Blog

MDS Coordinators are at the Heart of Health Care

Screen Shot 2016-02-16 at 1.49.34 PM

Minimum Data Set (MDS) professionals play an integral role in completing assessments and monitoring the entire interdisciplinary process to meet state and federal requirements.

Unfortunately, there are not enough trained MDS Coordinators to meet the growing demand across the U.S.  There is currently a national shortage of MDS Coordinators, and this shortage is only going to escalate in the next five years.

infographic-yellow-2-1024x751

Taking the time to develop and train your staff is a challenge. The Grow Your Own MDS Coordinator Program can be customized to fit the needs of your organization. For your convenience, our trainers are prepared to come to you!

w1-PHS-091113-Landing-Page-Header1

This program is designed for:

  • Nurses with little to no MDS knowledge
  • Nurses who are new to LTC
  • Administrators looking to develop a lead MDS professional
  • Ensure a trained MDS “back-up” to support your current lead professional

The Pathway Health Grow Your Own MDS Coordinator Program is unparalleled in the industry and places your new MDS Coordinator on the right track from the beginning.

THE PATHWAY HEALTH DIFFERENCE

This program goes beyond basic MDS training offered by others, and provides:

  • Advanced coding training and scheduling
  • Reimbursement optimization
  • Regulatory impact of MDS/RAI process and overview from pre-admission to billing
  • Medicare guidelines
  • ADL Training – detailed training on ADL tracking, coding and impact to organization
  • Assessments – supporting assessments, requirements and documentation to support MDS
  • Quality Measures – what are they, impact to facility, analysis, how to utilize effectively

START PLANTING THE SEEDS OF MDS SUCCESS

Are you cultivating MDS professionals with the insight, expertise and knowledge they need to meet the growing reimbursement and regulatory challenges? The team at Pathway Health is ready to assist

  • Intensive Classroom Training
  • Customized Training at Your Location

 

View more and contact us>