Long-Term Care

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• Tip of the week: Get to know the chronic care measure domains

  Increasingly, SNFs must rely on data and data analysis to objectively view the quality of care delivered to their residents. The data gathered and reported by the quality measure (QM) systems designed for long-term care are information-rich and provide guidance, direction, statistics, frequency, and monitoring of potential quality problems.

• Skilled Healthcare found liable for improper staffing, fight far from over

  Skilled Healthcare, a California-based support provider to long-term care facilities, was found liable July 6 for improperly staffing 22 facilities in the state. As a result, Skilled Healthcare was ordered to pay $677 million in restitution, the largest jury award in the U.S. this year, according to Bloomberg News.

• Tip of the week: Develop policies that address key OSHA compliance issues

  Although all workers are responsible for maintaining compliance with Occupational Safety and Health Administration (OSHA) standards, the administrator needs to also make sure maintenance personnel, along with the associated housekeeping and laundry departments, develop policies that will address key compliance issues. OSHA inspectors may direct their concern toward worker safety, but maintaining compliance with their standards crosses over and fortifies the safety of residents as well.

• CMS releases transition information during RUG-IV call

  During the RUG-IV National Provider Call on August 24, CMS provided listeners with important information regarding the transition from the MDS 2.0 and RUG-III to the MDS 3.0 and RUG-IV. To receive payment for covered days in September 2010, you must have a RUG-III group, and to receive payment for covered days in October 2010, you must have a RUG-IV group. RUG-III can be calculated from the MDS 2.0 and the MDS 3.0; however, RUG-IV can only be calculated from the MDS 3.0. This creates a problem for residents in a Medicare Part A stay whose RUG assignment from one SNF PPS assessment covers days in September and October of this year.

• Trainer’s tip: Bariatric care equipment needs

  Many long-term care facilities successfully care for residents with bariatric needs. Because specialized furnishing and equipment are needed, many facilities have designated rooms or wings equipped for bariatric care. Facilities cannot admit a resident needing bariatric care on the spur of the moment like they would with a normal geriatric resident. Planning is needed.

• Providing bariatric care

  Persons who are obese have highly specialized needs. Care that is routine for persons of normal size cannot be done the same for the bariatric population. This includes many ADLs, such as bathing, transfers, mobility, and transportation. Routine activities may be difficult. Things we take for granted, such as standing up, sitting down, and walking to the bathroom, can be strenuous or painful for obese residents. Certain aspects of care can be frustrating or humiliating.

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