Increasing Reimbursement in Long Term Care

There are many ways the MDS coordinator can increase the reimbursement level of the facility. While quality of care is the top priority, working to get the top level of payment that is justifiably due for services is of the utmost importance. Increased funds produce more resources for care.

http://ltcsbooks.com/increasing-reimbursement-in-long-term-care 

Staffing Data Submission

Long term care facilities will be required to electronically submit staffing information based on payroll to CMS beginning July 1, 2016. CMS will use the data to monitor staffing levels and employee turnover and tenure, which can impact the quality of care delivered. 

Facility staffing information will be posted on the CMS Nursing Home Compare website used in the Nursing Home Five Star Quality Rating System. 

CMS Staffing Data Submission Source Documents and Training Materials

Nursing Assistant Shortage Reaches Critical Level

As the demand for caregivers in long term care increases, fewer people are drawn to caregiver positions. The ratio of twenty residents to one CNA is now common, preventing any possibility of adequate care, job satisfaction, or staff retention.

“More than 1.3 million new paid caregivers will be needed to meet demand over the next decade,” according to a recent New York Times article.

The article also cites low wages and Medicare / Medicaid funding deficits as factors contributing to the problem. 

A Shortage of Caregivers, New York Times Article

Online Inservices

More and more long term care facilities and home health care agencies are turning to online inservices for comprehensive coverage of inservice topics and the convenience of online learning.

Online CNA inservices allow the learner to move at his or her own pace. Graphics and sound enhance the learning experience, making it more pleasurable to learn material.

Packages designed for facilities or agencies make online CNA inservices a bargain, and there are a variety of purchase options to suit every need.

Pedagogy, Inc., a national provider of online continuing education and training courses in the health care professions is very pleased to announce that LTCS Books, a nationally recognized provider of Nursing Care plans, Certified Nurse Aide training, Home Health Care education, and MDS 3.0 Coding has joined forces.

Speaking of the new partnership with LTCS Books, Capra Dalton, Pedagogy’s CEO states “This is really exciting for Pedagogy. LTCS Books has provided nursing care plan books and staff development to over a third of the long term care facilities in the nation. We are very happy to now offer LTCS’s expertise in an online format.

Facilities will now be able to offer online education through any device with an internet connection, any time of day or night, freeing staff from the costly and time consuming burden of providing staff training, orientation and inservice education in the traditional classroom setting. Pedagogy’s online Learning Management System will also allow complete education management in a paperless, convenient format.”

Online CNA Inservices

Nursing Assistant Lifting Injuries are Common

Nursing Assistants experience an average of 4.5 injuries per person per year, according to a report published by RTI International, and one main cause of injuries is lifting devices not being available. 

Lack of training is another cause of injury cited by the study, with more than one third of nursing assistants reporting that their initial training left them unprepared to work safely. 

Nursing assistants new to direct care or new to a facility (40% of all nursing assistants, due to high turnover) are at a much higher risk of injury, states the report. 

Working overtime, low wages, and feeling rushed at work are other factors associated with lifting injuries cited by the study. 

Work-Related Injuries Among Certified Nursing Assistants 

Safe Transfers and Lifts, Online Nursing Assistant Inservice 

Lifting Policy and Nursing Policy for Long Term Care

Long Term Care Inservice Regulations

Regulations governing mandatory long term care inservices come from a variety of agencies that regulate long term care practices, enforce compliance, and make recommendations on employee education.

CMS mandates that facilities must complete a performance review of every nursing assistant at least once every 12 months, and must provide regular inservice education based on the outcome of these reviews, and that the inservice training must:

Be no less than 12 hours per year

Address areas of weakness as determined in nurse aides’ performance reviews, and for nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.

OSHA, the CDC, and the NFPA also mandate certain long term care inservices. 

Generally, a long term care staff development department will provide an inservice at least once per year on each of the following topics: Abuse Prevention, Activities of Daily Living, Catheter Care and Urinary Tract Infections, Cognitive Impairment, Constipation, Dementia Management, Falls, Feeding Residents, Infectious Diseases, Nutrition and Hydration, Pain Care, Range of Motion, Resident Rights, Restraints, Sensory and Communication Impairments, Sexual Harassment and Professional Communication, Skin Care and Pressure Ulcer Prevention, Standard Precautions, Toileting Programs, Transfers and Lifts, Urinary Incontinence, Wandering and Elopement Risk, and Workplace Violence. 

LTC Inservice Regs

Online Inservices for CNAs and Nursing Assistants

Resident-to-Staff Aggression is a Common Problem

Resident verbal and physical aggression is most common during morning care, says a recent article in the Journal of General Internal Medicine.

The article concludes that since resident-to- staff aggression has such a negative impact on job performance and staff satisfaction, much more research is needed to develop interventions to decrease resident aggression. 

Aggression Directed at Nursing Home Staff by Residents

Behavior Care Plans 

Anger Care Plan

Online Nursing Assistant Behavior Inservice 

Coding Section E, Behavior