Important Links
CMS Interpretive Guidelines and Survey Procedures: Located in the Appendices to the State Operations Manual (SOM). See Appendix PP for Interpretive Guidelines for Long-Term Care Facilities.
CMS Survey and Certification Letters: CMS Survey and Certification Letters contain information related to survey and certification guidance for providers and suppliers to its Regional Offices and the State Survey Agencies. The letters are organized by Federal fiscal years. The first letter released for fiscal year 2009 would be labeled “S&C 09-01.” (June 09)
Review the important Certification Letters
CMS State Survey Agency Directory
State Health Department Websites
State Hospital Regulations
US Census Bureau Health and Nutrition Statistical Abstracts
Health Facts by State (from Kaiser Permanente)
National Center for Assisted Living (NCAL) Assisted Living State Regulatory Review 2009
This report offers a state-by-state summary of assisted living regulations covering 21 categories; provides contact information for state agencies that oversee assisted living activities; and includes each agency’s Web site address. (May 09)
Chronic Kidney Disease
Do you need to know how to prepare potatoes for a low potassium diet? Chef Kyle Shadix, MS, RD shares evidence based research and his advice. (May 09)
Read the article from Today’s Dietitian here.
COOL Takes Effect
Shoppers will have more information about where their food comes from under a new policy starting today. Labels on most fresh meats, along with some fruits, vegetables and other foods, will now list where the food originated. In the case of meats, some labels will list where the animal was born, raised and slaughtered. (April 09)
Read more about COOL
Watch a brief video about COOL
Friendly Spices Halt AGEs
Researchers at the University of Georgia recently examined extracts from 24 common herbs and spices. What they found in varying amounts were antioxidant-rich compounds known as "phenols." Phenols halt the action of unfriendly "AGEs" — compounds that cause damage to the body. (April 09)
Increase your knowledge about herbs and spices
F309 Quality of Care: Changes to Interpretive Guidelines
Each resident must receive and the facility must provide the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care. View the changes to Interpretive Guidance and get training slides from CMS.
Top 25 Tags Cited
Get the citation frequency report for including number of citations, the percentage of providers cited and percentage of surveys cited. Get the Top 25 tags cited.
CMS On-Line Training Site
The CMS Survey & Certification Online Course Delivery System can be found at http://surveyortraining.cms.hhs.gov. This training portal provides access to important tools and resources available through the Survey and Certification Group and LMS Connect.
·Surveyor Tools - Online courseware (BHFS, POD, ALSC, etc.)
·Satellite Broadcasts - Upcoming live satellite broadcast schedule.
·Archived Webcasts - Archived Video-on-Demand.
·Provider Tools - Online courseware for providers (MDS and OASIS).
·Trainer Tools - Resources for trainers.
·Help - Online help and answers to frequently asked questions.
Dietary professionals may be interested in these trainings in particular:
·How to Enhance the Quality of Dining Assistance in Nursing Homes
Air Date: 3/16/2007 Duration: 1 hour 30 minutes.
·From Institutional to Individualized Care Parts I, II and III - Integrating Individualized Care and Quality Improvement. All three parts can be found under the main page.
Five Star Quality Rating System
On December 18, 2008 the Centers for Medicare & Medicaid Services (CMS) will unveil the Five Star Quality Rating System on Nursing Home Compare. Nursing homes will receive an Overall Rating that is based on facility performance on three types of performance measures: Health Inspections, Staffing, and Quality Measures. Nursing Home Compare will also display the star ratings for each of the three performance measures alongside the Overall Rating. Nursing homes with five stars are considered to have much above average quality and nursing homes with one star are considered to have quality much below average. Go to Medicare's website for the 5 Star Rating System.
Revised Surveyor Guidance
Revised surveyor guidance for surveying Nutrition and Sanitary Conditions requirements in long-term care facilities became effective on September 1, 2008. A final copy of this new guidance will be available here (go to Appendix PP of the State Operations Manual) and ultimately incorporated into Appendix PP of the State Operations Manual. Corresponding Automated Survey Process Environment (ASPEN) changes are in place. Get a copy of this guidance and training slides. Read an article on this topic from Today's Dietitian.
MDS 3.0 versus MDS 2.0 Comparison Crosswalk
CMS released the draft MDS 3.0 versus MDS 2.0 Comparison Crosswalk. According to CMS and as stated in the crosswalk, "This draft crosswalk provides information to assist in the transition to the MDS 3.0. This crosswalk is a draft and does not contain the final list of MDS 3.0 items. Ongoing research and analysis could result in items being deleted or revised or in the addition of new items. The final list of MDS 3.0 items will be available by March, 2009. This crosswalk introduces the new MDS 3.0 item numbering scheme, identifies the differences between potential 3.0 items and 2.0 items, as well as identifying applications that utilized the specific MDS 2.0 items. To assist in the review of the crosswalk, columns are identified below along with a brief description of each column and the draft MDS 3.0 dropped items list."
View the entire cross walk.
Trends in NH Deficiencies and Complaints
This memorandum report describes the nature and extent of nursing home deficiencies and complaints in 2007 and identifies trends from 2005 to 2007. This study is part of the Office of Inspector General's (OIG) continuing commitment to addressing the quality of care in nursing homes. In the past 3 years, over 91% of nursing homes surveyed were cited for deficiencies and a greater percentage of for-profit nursing homes were cited than not-for-profit and government nursing homes. The most common deficiency categories cited were quality of care, resident assessment, and quality of life. Additionally, 17 percent of nursing homes surveyed in 2007 were cited for actual harm or immediate jeopardy deficiencies, and 3.6 percent were cited for substandard quality-of-care deficiencies-a slight increase since 2005. Get the facts on deficiencies and complaints.
MDS 2.0 Manuals and Forms Revisions
* October 2008 revisions to the MDS 2.0 RAI User's Manual are available under, Downloads, "RAI Manual
October Update 2008".
* MPAF Forms: The MPAF forms have been relocated and are available below under, "Downloads, MDS All
Forms".
* Appendix B: This is the source to retrieve updated versions of the State RAI Coordinators & Automation
Coordinators lists. Go to the CMS website to download these important documents. Get more information
on the new MDS 3.0.
Questions on Section K
K5c - Mechanically Altered Diet
Question: Currently the definition for "Therapeutic Diet" in the RAI Manual version 2.0, does not include mechanically altered diets. However, in the newly revised F325 tag, (eff: 9-1-08), the definition of mechanically altered diets is now included in the definition of the therapeutic diet. I have been telling the providers that until the new MDS version is out, to continue completing the MDS as it is written, following the 2.0 instructions. HOWEVER, I have heard that some providers had contacted CMS directly, and were told to start coding the MDS now, with the new definition.
Answer: The RAI User's Manual, currently the 2.0 version, has always been the source for coding the MDS, and this has not changed. You are correct in telling the providers that they need to continue to code item K5c according to the current RAI manual. This concept is also true with the revised F314 (eff: 11-12-04) which clearly expects facilities to provide care and services that are based in the current standards of practice but the MDS requires coding based on old standards that are reflected in the manual.