Did you know that the updated Quality Measures will be reported via the 5 Star Quality Rating System on Nursing Home Compare beginning April 1st, 2012? Is your facility ready?
There are now two specific pressure ulcer Quality Measures:
- Percent of residents with pressure ulcers that are new or worsened-Short Stay
- Percent of high-risk residents with pressure ulcers-Long Stay
If your facility could use a refresher on the new measures, WoundRounds is here to help. Recently we asked David Rokes, RN and COO of Post Acute Consulting to share his insights and knowledge on the topic of Wound Care and Reimbursement. David has over 19 years’ experience in driving reimbursement results while maintaining the utmost compliance. In his discussion, David supplies us critical information on Quality Measures and other reimbursement topics such as:
- How to correctly identify and document the staging of a wound or pressure ulcer
- Using the Braden and Norton Scales during an assessment of a wounds
- How to comply to Code Section M correctly and accurately
- The Impacts of Rug-III and Rug-IV on your wound care treatment
- Proper expense management
If your facility is struggling to understand wound care reimbursement requirements and is looking for the latest regulations and documentation requirements, please view the free presentation entitled Clinical Reimbursement and Wound Care.
Why Resource Utilization Groups Matter
It’s no secret that wound care is costly and labor intensive, and facilities need to ensure they’re getting appropriate payment for services rendered. This means mastering the clinical indicators for RUG-IV, as well as RUG-III if you are still using this for Medicaid Case Mix in your state. This can result in a loss of over $100/day for a Part A resident if it is coded incorrectly.
WoundRounds recently asked me to share insights and knowledge on the topic of Wound Care and Reimbursement. I’ve spent over 19 years driving reimbursement results while maintaining the utmost compliance. In this free webinar, I share critical information impacting reimbursement such as:
- How to correctly identify and document the staging of a wound or pressure ulcer
- Using the Braden and Norton Scales during an assessment of a wounds
- How to comply to Code Section M correctly and accurately
- The Impacts of Rug-III and Rug-IV on your wound care treatment
- Proper expense management
If your facility is struggling to understand wound care reimbursement requirements and is looking for the latest regulations and documentation requirements, please view the free presentation entitled Clinical Reimbursement and Wound Care.
David Rokes, RN and COO of Post Acute Consulting
drokes@postacute.com
Lack of documentation and poor documentation top our list of legal mistakes made by LTC facilities. We’ve found that 35-40% of the LTC wound-related lawsuits are extremely difficult to defend because of gaps in documentation. This doesn’t mean the facility or the staffs are at fault, it simply means the proper documentation wasn’t made in order to defend the long term care facility.
In our law practice, we focus on the defense of long term care, assisted living and independent living facilities. After handling over 2,000 cases, we have arrived at the conclusion that long term care wound cases present issues that often times change the burden of proof from what would normally be the case if the exact same facts occurred in a hospital setting. Although defending long term care wound cases can utilize the same medical/clinical arguments available in similar cases involving hospitals, the fact that a wound develops in a long term care facility now puts the onus on the facility to show that everything was done and the resident’s clinical condition made the wound “unavoidable”. Absent proper documentation showing a wound is unavoidable is a very difficult proposition.
If you would like to learn more about best practices in reducing legal risks, view our free, on-demand webinar entitled: “Avoiding Costly Legal Pitfalls in Wound Care.” In this webinar, I co-present with Anne Scheurich, CWOCN and Director of Clinical Services at Telemedicine Solutions, on a variety of topics around legal issues and wound care including documentation and trending tips, developments in wound photography, and case studies that illustrate what to do and more importantly, what not to do in wound care.
Tim McVey
Lawyer with McVey & Parsky LLC
dtm@mcveyparsky-law.com
312 551 8764
As seen in Long-Term Living Magazine...
Ask wound care nurses in the LTC setting how they do their jobs and they’ll likely respond, “It’s all about getting more done with less.” Financial pressures, along with MDS 3.0 and other compliance and regulatory initiatives, are intensifying scrutiny of wound care practices.
In the following article, wound care nurses from three facilities share how the use of an electronic point-of-care documentation system is transforming their jobs and enabling them to achieve better outcomes.
Click Here to continue reading.
As seen on "McKnight's Long Term Care News"......
Wound photography is a subject that divides many wound care professionals. On one hand, photography is a valuable tool to show trends in patient healing, and on the other hand, it can be polarizing in a courtroom. My experience as a clinician is positive with wound photography, especially in a courtroom setting.
My first experience facing the legal aspects of wound photography occurred early in my wound care career as a home health nurse. In that case, our patient had been discharged from the hospital because her 90 days were up with Medicare. She had multiple co-morbidities, including lupus, and suffered from 4 Stage IV pressure ulcers that were acquired during her hospital stay.
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At the recent Florida Health Care Association (FHCA) and the American Health Care Association (AHCA) conferences, WoundRounds asked attendees, “What would you do with an extra day a week?” Nurses, administrators, consultants, owner/operators, and wound care experts gave the question some serious thought. The number one response we received was “provide more bedside care,” which is a great example of the fact that we are all in business to help improve people’s lives.
In today’s challenging environment, nurses are being asked and expected to do more with less. Facilities are struggling to provide better patient care and manage rising costs, all while complying with increasing demands from regulators. Automated solutions can help them shift their focus from paperwork to patient care.
At a recent implementation of WoundRounds, a new customer was able to quickly eliminate three forms and two reports from their manual process of wound management and risk management. “You gave me back my Saturdays,” she told our team. “I can now spend time with my family on the weekends knowing full well that the care I provided to my patients and the documentation required are both complete.”
What would you do with an extra day a week? Feel free to Email Cory or visit us at booth 844 at the LeadingAge Conference at the Washington Convention Center, October 17-19. We are anxious to hear your answer!
As seen on "McKnight's Long Term Care News"......
Recently a colleague sent me a link to “Preventing Pressure Ulcers in Hospitals, A Tool Kit for Improving Quality of Care,” from the Agency for Healthcare Research and Quality. It's the latest “how-to” manual designed to help wound care providers improve pressure ulcer prevention. It didn't contain anything really new. It would seem not much has changed in the 16 years since the original AHCPR Pressure Ulcer Guidelines were published. But as I read it three things struck me:
1. Almost one-third of the manual is devoted to the challenge of change management, not clinical management of wounds.
2. It provides of plethora of “tools” (i.e. paper forms) to help nurses monitor performance and track wound outcomes manually.
3. There is no mention of the use of technology as a tool to enable nurses to achieve better outcomes in less time.
Chapter headings and sub-headings in the AHRQ Tool Kit reveal the daunting challenge providers face when taking on quality improvement: “Are we ready for this change?” “Do organizational members understand why change is needed?” “Is there a sense of urgency?” “How will we manage change?” “What if we're not ready?”
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Anne Scheurich, RN, BS, CWOCN is the Director of Clinical Services at Telemedicine Solutions/WoundRounds.