Long-Term Care

Long-Term Care Articles by Topic: MDS

What's new at MDSCentral

  • MDS 3.0 Update, Issue 16, September 6, 2010

    If you haven't visited MDSCentral recently, here's what you've missed.

How are you supposed to complete the discharge assessment when a resident suddenly leaves the facility?

  • MDS 3.0 Update, Issue 16, September 6, 2010

    Regulatory Specialist Diane Brown answers a reader's question about completing the discharge...

CMS covers SNF PPS assessments during third RUG-IV call

  • MDS 3.0 Update, Issue 16, September 6, 2010

    CMS held the third and final call in their RUG-IV National Provider Call series on Wednesday...

Billing Alert for Long-Term Care, September 2010

  • Billing Alert for Long-Term Care, Issue 9, September 1, 2010

    Inside: Keep your claims error-free with a simple check HCPCS update and the HCFA 1500 Preparing...

A closer look at the MDS 3.0: Section O

  • Billing Alert for Long-Term Care, Issue 9, September 1, 2010

    If you feel like you’re scrambling to stay on top of the new MDS 3.0 assessment tool so you...

Updates from the Las Vegas MDS 3.0 Train-the-Trainer conference

  • MDS 3.0 Update, Issue 15, August 23, 2010

    The CMS MDS 3.0 Train-the-Trainer conference in Las Vegas came to a close August 13, leaving...

What’s new at MDSCentral

  • MDS 3.0 Update, Issue 15, August 23, 2010

    If you haven't visited MDSCentral recently, here's what you've missed.

Updates from CMS' MDS 3.0 Train-the-Trainer Conference

  • Contemporary Long-Term Care Weekly, Issue 32, August 12, 2010

    Much is being discussed in Las Vegas at the MDS 3.0 Train-the-Trainer Conference. CMS has provided...

Completing the SOT OMRA under the MDS 3.0

  • MDS 3.0 Update, Issue 14, August 9, 2010

    To prevent inappropriate RUG classification due to therapy projection, CMS decided to omit Section...

Do therapy aide minutes count on the MDS 3.0?

  • MDS 3.0 Update, Issue 14, August 9, 2010

    Q: Are the minutes a therapy aide spends on set-up time recorded on the MDS and used in...

The MDS 3.0

  • CNA Training Advisor: Lesson Plans for Busy Staff Trainers, Issue 8, August 1, 2010

    CNA Training Advisor provides newsletter-style inservices containing valuable information and a...

Navigate new and improved therapy assessments

  • PPS Alert for Long-Term Care, Issue 8, August 1, 2010

    The October implementation of the MDS 3.0 will be here before we know it, and educating staff...

How should deep tissue injuries be coded on the MDS 2.0?

  • MDS 3.0 Update, Issue 13, July 26, 2010

    Our guest blogger answers a reader's question about coding deep tissue injuries.

MDSCentral provides an overview of RAI changes

  • MDS 3.0 Update, Issue 13, July 26, 2010

    As of July 15 2010, CMS has released all updated sections of the RAI User’s Manual for the...

ADL updates: Get the details on Section G of the MDS 3.0

  • PPS Alert for Long-Term Care, Issue 7, July 1, 2010

    The activities of daily living (ADL) are a critical component of resident care. They gauge the...

Tip of the week: Things to remember when conducting MDS 3.0 interviews

  • Contemporary Long-Term Care Weekly, Issue 25, June 24, 2010

    The MDS 3.0 will implement new guidelines for conducting interviews that will help capture the...

Section P: Is dextrose in an IV considered a medication?

  • MDS 3.0 Update, Issue 11, June 14, 2010

      Editor’s note: The following answer was provided by Jennifer A. Butt, RN, RAC-CT...

Clarify and cover what's critical with clinical

  • Billing Alert for Long-Term Care, Issue 6, June 1, 2010

    Every day in SNFs across the country, information enters and exits, moving through the various...

Billing Alert for Long-Term Care, June 2010

  • Billing Alert for Long-Term Care, Issue 6, June 1, 2010

    Billing Alert for Long-Term Care provides valuable information about billing regulations...

SCSAs: Tips for correct completion

  • PPS Alert for Long-Term Care, Issue 6, June 1, 2010

    Determining when a Significant Change in Status Assessment (SCSA) is necessary and completing the...

How should I code Zinc and other supplements on the MDS?

  • MDS 3.0 Update, Issue 10, May 31, 2010

    Q: How should Zinc, and other supplements from health food stores, be coded on the MDS? We have a...

How do I bill for concurrent therapy?

  • MDS 3.0 Update, Issue 9, May 17, 2010

    Q: If I am providing concurrent therapy to two resident for one hour, can I bill both for one hour...

CMS to hold another MDS 3.0 training conference

  • MDS 3.0 Update, Issue 9, May 17, 2010

    The Centers for Medicare & Medicaid Services (CMS) recently announced via their Web site that...

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2010

    We answer readers’ questions about conducting resident interviews under the MDS 3.0.

Don't be left in the dark during the QI/QM blackout

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2010

    After the MDS 3.0 is implemented October 1, providers and surveyors will not have access to the...

PPS Alert for Long-Term Care, May 2010

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2010

    The May 2010 issue of PPS Alert for Long-Term Care provides long-term care professionals with tips...

CMS’ Train-the-Trainer information update

  • MDS 3.0 Update, Issue 8, April 19, 2010

    During the MDS 3.0 Train-the-Trainer conference in Baltimore last week, CMS officials provided an...

CMS makes changes to MDS 3.0

  • Contemporary Long-Term Care Weekly, Issue 15, April 15, 2010

    CMS posted new versions of the MDS 3.0 item subsets on its Web site April 9, along with a document...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 7, April 5, 2010

    Q: What will measure quality indicators on the MDS 3.0? To read Regulatory Specialist Diane...

Say hello to 3.0: The new MDS' effect on billers

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2010

    The October 1 implementation of the MDS 3.0 will mean big changes for SNF and MDS coordinators will...

PPS Alert for Long-Term Care, April 2010

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2010

    The April 2010 issue of PPS Alert for Long-Term Care provides long-term care professionals with...

Defining Pressure Ulcers Under the MDS 3.0

  • MDS 3.0 Update, Issue 6, March 22, 2010

    The definitions included in the RAI User’s Manual, Version 3.0, for the four different stages...

Fall prevention for high risk residents

  • LTC Nursing Assistant Trainer, Issue 5, March 11, 2010

    Residents are at high risk of falls during their first week of admission because they are new to...

Free special report: Get your MDS 3.0 training on track

  • MDS 3.0 Update, Issue 5, March 8, 2010

    Navigating the multitude of changes between the MDS 2.0 and MDS 3.0 and determining how to best...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 5, March 8, 2010

    Q: Under MDS 3.0, if a patient is transferred/discharged to the hospital at 11pm, can we count the...

Say hello to 3.0: The new MDS' effect on billers

  • Billing Alert for Long-Term Care, Issue 3, March 1, 2010

    The implementation of MDS 3.0 on October 1 means big changes for SNFs. The latest PPS assessment...

Billing Alert for Long-Term Care, March 2010

  • Billing Alert for Long-Term Care, Issue 3, March 1, 2010

    Billing Alert for Long-Term Care provides valuable information about billing regulations...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 4, February 22, 2010

    Q: When coding pain under Section J on the MDS 2.0, do you code intensity before or after...

Implement policies and procedures for a successful restorative nursing program

  • PPS Alert for Long-Term Care, Issue 2, February 1, 2010

    Although meeting the requirements and MDS coding criteria is a good start to developing a...

Individualizing resident activities: Take a team approach

  • PPS Alert for Long-Term Care, Issue 2, February 1, 2010

    Although the current Interpretive Guidelines for F248, Activities, have been in place since June...

PPS Alert for Long-Term Care, February 2010

  • PPS Alert for Long-Term Care, Issue 2, February 1, 2010

    The February 2010 issue of PPS Alert for Long-Term Care provides long-term care professionals with...

Tip of the week: Understanding MDS basics for residents skilled under Part A

  • Contemporary Long-Term Care Weekly, Issue 3, January 21, 2010

    The Minimum Data Set (MDS) drives all billing, including consolidated billing. It is a federal...

Tip of the week: Understanding MDS basics for non-skilled residents

  • Contemporary Long-Term Care Weekly, Issue 2, January 14, 2010

    The Minimum Data Set (MDS) drives all billing, including consolidated billing. It is a federal...

Navigate restorative nursing regulations and coding criteria

  • PPS Alert for Long-Term Care, Issue 1, January 1, 2010

    Restorative nursing is a critical component to successfully individualizing long-term care...

PPS Alert for Long-Term Care, January 2010

  • PPS Alert for Long-Term Care, Issue 1, January 1, 2010

    The January 2010 issue of PPS Alert for Long-Term Care provides long-term care professionals with...

CMS announces MDS 3.0 training opportunities

  • MDS 3.0 Update, Issue 31, December 14, 2009

    During the December 8 SNF Open Door Forum, the Centers for Medicare & Medicaid Services (CMS...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 31, December 14, 2009

    Q: Do the ICD-9 codes listed on the MDS require a specific order?

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 12, December 1, 2009

    Columnist Diane Brown discusses medical record numbers, concurrent therapy, and coding internal...

Improve accuracy when coding activities of daily living

  • PPS Alert for Long-Term Care, Issue 12, December 1, 2009

    Coding activities of daily living (ADL) in Section G of the MDS 2.0 is an ongoing problem for many...

PPS Alert for Long-Term Care, December 2009

  • PPS Alert for Long-Term Care, Issue 12, December 1, 2009

    The December 2009 issue of PPS Alert for Long-Term Care provides long-term care professionals with...

Billing Alert for Long-Term Care, December 2009

  • Briefings on Long-Term Care, Issue 12, December 1, 2009

    Billing Alert for Long-Term Care provides valuable information about billing regulations...

Billing Alert for Long-Term Care, December 2009

  • Billing Alert for Long-Term Care, Issue 12, December 1, 2009

    Billing Alert for Long-Term Care provides valuable information about billing regulations...

CMS posts sections of the RAI User’s Manual

  • MDS 3.0 Update, Issue 31, November 30, 2009

      The Centers for Medicare & Medicaid Services (CMS) released chapters 1, 3, and 5 of...

CMS releases final MDS 3.0 item set

  • Contemporary Long-Term Care Weekly, Issue 43, November 1, 2009

    The Centers for Medicare & Medicaid Services (CMS) released the much anticipated final MDS 3.0...

Capturing preadmission IV medications

  • PPS Alert for Long-Term Care, Issue 11, November 1, 2009

    Help your facility get the documentation needed to code IV medications provided during a...

Avoid confusion when coding cognitive patterns

  • PPS Alert for Long-Term Care, Issue 11, November 1, 2009

    Coding section B of the MDS 2.0, which deals with a resident’s cognitive patterns, does not...

Save valuable time with strategies to improve nurse documentation

  • PPS Alert for Long-Term Care, Issue 11, November 1, 2009

    MDS coordinators can save valuable time by tackling one of the most demanding aspects of the...

PPS Alert for Long-Term Care, November 2009

  • PPS Alert for Long-Term Care, Issue 11, November 1, 2009

    The November 2009 issue of PPS Alert for Long-Term Care provides long-term care professionals with...

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2009

    Columnist Diane Brown discusses restorative nursing, completing section AA of the MDS 2.0, and more.

Steps to successful care planning

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2009

    Facilities that develop and use the individual resident care plans daily seldom have problems with...

Say goodbye to section T of the MDS

  • MDS 3.0 Update, Issue 24, August 24, 2009

    The FY 2010 SNF final rule, which CMS released July 28, includes components that will change some...

Recovery audit contractors: Ready or not, here they come

  • PPS Alert for Long-Term Care, Issue 8, August 1, 2009

    There is no hiding from the Recovery Audit Contractor (RAC) program, which CMS is in the process of...

Prepare for the MDS 3.0 by improving customer satisfaction

  • PPS Alert for Long-Term Care, Issue 8, August 1, 2009

    Customer satisfaction is becoming increasingly important in long-term care and will play a major...

PPS Alert for Long-Term Care, August 2009

  • PPS Alert for Long-Term Care, Issue 8, August 1, 2009

    The August 2009 issue of PPS Alert for Long-Term Care brings long-term care professionals...

CATs versus RAPs

  • MDS 3.0 Update, Issue 22, July 27, 2009

    The latest MDS 3.0 draft introduced the long-term care industry to Care Area Triggers (CAT), which...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 22, July 27, 2009

    Q: If a resident with dentures is able to tolerate a regular diet, how should I code Section K of...

Upcoming ADL changes

  • MDS 3.0 Update, Issue 21, July 13, 2009

    It can be difficult to keep track of all the changes facilities will face with the implementation...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 21, July 13, 2009

    Q: A resident in our facility is covered by a Managed Medicaid plan and also has Medicare Part C...

CMS releases new MDS 3.0 draft item set

  • PPS Alert for Long-Term Care, Issue 7, July 1, 2009

    CMS released an updated MDS 3.0 draft item set May 7, and the new version includes significant...

PPS Alert for Long-Term Care, July 2009

  • PPS Alert for Long-Term Care, Issue 7, July 1, 2009

    The July 2009 issue of PPS Alert for Long-Term Care brings long-term care professionals information...

Expedited reviews: Are you ready for the QIO's call?

  • Billing Alert for Long-Term Care, Issue 7, July 1, 2009

    Providers can prepare for an expedited review by communicating internally and with residents and by...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 19, June 15, 2009

    Q: I'm the RNAC at a small hospital-based transitional care unit, and most of our residents are...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 18, June 1, 2009

    What should we do when a resident cannot complete an interview?

MDS 3.0 a focus of the Open Door Forum

  • MDS 3.0 Update, Issue 18, June 1, 2009

    CMS officials reviewed the changes included in the latest MDS 3.0 Draft Item Set and addressed...

PPS Alert for Long-Term Care June 2009

  • PPS Alert for Long-Term Care, Issue 6, June 1, 2009

    The June 2009 issue of PPS Alert for Long-Term Care brings long-term care professionals information...

LTC certification could shorten providers' software searches

  • PPS Alert for Long-Term Care, Issue 6, June 1, 2009

    In April, the Certification Commission for Healthcare Information Technology (CCHIT) announced that...

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 6, June 1, 2009

    Columnist Rena R. Shephard, MHA, RN, RAC-MT, C-NE, answers your questions

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 16, May 4, 2009

    Q: I would like our social service staff to begin using the mood interview questions from Section D...

Preparing for October 2010: What your SNF can do to get ready for the MDS 3.0 now

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2009

    When CMS recently announced the MDS 3.0 implementation would be delayed until October 2010, many in...

F309 puts pressure on pain management

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2009

    To comply with F309, nursing facilities must reexamine how they assess and manage pain in...

PPS Alert for Long-Term Care, May 2009

  • PPS Alert for Long-Term Care, Issue 5, May 1, 2009

    The May 2009 issue of PPS Alert for Long-Term Care brings long-term care professionals information...

LTC associations requested MDS 3.0 implementation delay

  • Contemporary Long-Term Care Weekly, Issue 17, April 30, 2009

    In early January, several long-term care industry associations wrote a letter to President...

Updated MDS 3.0 timeline available

  • MDS 3.0 Update, Issue 15, April 20, 2009

    CMS posted an updated MDS 3.0 timeline on its Web site Thursday, revised to reflect the October...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 15, April 20, 2009

    Q: Now that the MDS 3.0 has been has been delayed, should my facility put all prep work on hold?

Updated MDS 3.0 timeline appears briefly on CMS Web site

  • Contemporary Long-Term Care Weekly, Issue 14, April 9, 2009

    CMS posted an updated MDS 3.0 timeline on its Web site Tuesday, but apparently removed the timeline...

Assessment reference dates under MDS 3.0

  • MDS 3.0 Update, Issue 14, April 6, 2009

    By allowing interviews to be conducted the day after the ARD, the MDS 3.0 draft contradicts the...

Tip of the week: Know when to notify physicians about abnormal labs

  • Contemporary Long-Term Care Weekly, Issue 13, April 2, 2009

    In some situations, the facility continues to have the responsibility for identifying potential...

The triple-check system: A proactive approach to Medicare compliance

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2009

    A solid triple-check system designed to internally audit claims prior to submission may decrease...

Maximize your Medicare reimbursement

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2009

    Do you think racking up therapy minutes is the only way to get a good Medicare reimbursement? If...

Identify ADL decline before your next survey

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2009

    Identifying activities of daily living (ADL) decline early is the key to helping residents maintain...

Build an MDS team for a more accurate, efficient MDS process

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2009

    Using team-gathered information to complete an MDS improves accuracy.

Alert for Long-Term Care, April 2009

  • PPS Alert for Long-Term Care, Issue 4, April 1, 2009

    The April 2009 issue of PPS Alert for Long-Term Care brings long-term care professionals...

CMS delays MDS 3.0 implementation

  • MDS 3.0 Update, Issue 12, March 9, 2009

    On Thursday, March 5, the Centers for Medicare & Medicaid Services (CMS) announced that the...

MDS 3.0 tip: Be aware of changes to coding fractures

  • MDS 3.0 Update, Issue 12, March 9, 2009

    The most recent MDS 3.0 draft asks under Section J, Health Conditions, whether residents had any...

Revised ABN for Part B services

  • Contemporary Long-Term Care Weekly, Issue 9, March 5, 2009

    SNFs must use the revised advanced beneficiary notice (ABN) form for items or services expected to...

MDS 3.0 Tip: Section I, Active Disease Diagnosis, contains new time element and diagnoses

  • MDS 3.0 Update, Issue 11, February 23, 2009

    Under the most recent MDS 3.0 draft, Section I, Active Disease Diagnosis, contains some significant...

CMS to revise MDS 3.0 timeline

  • MDS 3.0 Update, Issue 10, February 9, 2009

    CMS is revising its MDS 3.0 timeline, but agency officials say CMS is still aiming for an October...

MDS 3.0 Tip: Scheduling resident interviews

  • MDS 3.0 Update, Issue 9, January 26, 2009

    Several resident interviews must be completed within a three-day window based on the Assessment...

Choosing a new software vendor for MDS 3.0

  • MDS 3.0 Update, Issue 9, January 26, 2009

    Searching for a new automation vendor is a complex process, but here are a few guidelines to keep...

MDS 3.0 Tip: Familiarize yourself with Item C1100, Procedural Memory

  • MDS 3.0 Update, Issue 8, January 12, 2009

    The MDS 3.0 staff assessment for mental status includes a new item, C1100, Procedural Memory...

Preparing staff for MDS 3.0 interviews

  • MDS 3.0 Update, Issue 8, January 12, 2009

    Are training materials available to help long-term care facilities prepare staff members to conduct...

PPSA Q&A

  • PPS Alert for Long-Term Care, Issue 1, January 1, 2009

    Rena R. Shephard answers questions about putting rehab on hold, discharge tracking, and restraints.

Negative pressure wound therapy: The pros and cons

  • PPS Alert for Long-Term Care, Issue 1, January 1, 2009

    With negative pressure wound therapy becoming a more common form of wound care treatment, many...

MDS 3.0 Tip: Start practicing interviews now

  • MDS 3.0 Update, Issue 7, December 29, 2008

    Help your staff members find their comfort zone for interviewing by having them practice on each...

MDS 3.0 Tip: Changing resisting care to rejection of care

  • MDS 3.0 Update, Issue 6, December 15, 2008

    On the draft MDS 3.0 item set, item E800, Rejection of care, will replace the MDS 2.0 item E4e...

MDS 3.0 draft changes look back periods

  • MDS 3.0 Update, Issue 5, December 1, 2008

    Q: I thought the look back period on the MDS 3.0 was going to be five days. Now, it looks like some...

Q&A with Regulatory Specialist Diane Brown

  • MDS 3.0 Update, Issue 5, December 1, 2008

    Q: I thought the look back period on the MDS 3.0 was going to be five days. Now, it looks like some...

CMS releases MDS 3.0 draft item set

  • PPS Alert for Long-Term Care, Issue 12, December 1, 2008

    Officials say new assessment will be implemented on schedule CMS released new MDS 3.0 information...

Improving care and process through technology

  • PPS Alert for Long-Term Care, Issue 12, December 1, 2008

    One organization’s successful software transition When United Methodist Homes began to roll...

Interviewing cognitively impaired residents under the MDS 3.0

  • MDS 3.0 Update, Issue 4, November 17, 2008

    Q: The majority of residents at my facility are cognitively impaired.  I’m not sure that...

Most staff members will need MDS 3.0 training

  • MDS 3.0 Update, Issue 3, November 3, 2008

    Q: Who on my staff do I really need to train on the MDS 3.0 changes?

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 11, November 1, 2008

    Rena R. Shephard answers questions about stamped physician signature, pressure ulcer staging...

MDS 3.0 Tip: Sharpen your staff’s interviewing skills

  • MDS 3.0 Update, Issue 2, October 20, 2008

    As resident voice and choice become a central part of long-term care, interviewing skills will be...

MDS 3.0 Tip: Identify your training needs

  • MDS 3.0 Update, Issue 1, October 6, 2008

    The details of the MDS 3.0 are still unknown, but it’s safe to say your staff members will...

Working with software vendors to transition to MDS 3.0

  • MDS 3.0 Update, Issue 1, October 6, 2008

    Q: Our facility will need to update our software when we transition to the MDS 3.0. What questions...

Keys to keeping PPS assessments on schedule

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2008

    On the surface, keeping Medicare-required MDS assessments on track appears to be one of the easier...

Learn the difference: Late vs. missed assessments

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2008

    The skilled nursing facility (SNF) PPS and consolidated billing final rule for fiscal year 2009...

Counting therapy minutes: Use a triple-check review to ensure accuracy

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2008

    Even facilities that routinely review their therapy minutes and days prior to MDS submission can...

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 10, October 1, 2008

    Q. I forgot to set the assessment reference date (ARD) for the 60-day Medicare-required MDS...

PPS Q&A

  • PPS Alert for Long-Term Care, Issue 9, September 1, 2008

    Rena R. Shephard answers questions about billing Medicare Part A, coding IV fluids, and more.

Coding therapy on the MDS: Make sure minutes are coded accurately to avoid denials

  • PPS Alert for Long-Term Care, Issue 9, September 1, 2008

    The most recent report from the Comprehensive Error Rate Testing (CERT) program points to a slight...

Working the RAPs successfully: A guide to the process

  • PPS Alert for Long-Term Care, Issue 9, September 1, 2008

    Working the resident assessment protocols (RAP) is a multistep process that requires the...

RAP documentation: Achieve compliance

  • PPS Alert for Long-Term Care, Issue 9, September 1, 2008

    Tips to help MDS coordinators ensure adequate RAP documentation at their facilities.