In today’s rapidly evolving healthcare landscape, skilled nursing facilities (SNFs) constantly seek innovative strategies to enhance resident care, streamline operations, and stay ahead of regulatory requirements. One significant step forward for SNFs is the decision to change software systems. While implementing new software can be daunting, it presents an opportunity to revolutionize how SNFs manage their daily operations. This blog post will highlight the considerations and best practices involved in transitioning from one software system to another and how your facility can navigate this change successfully. So, fasten your seatbelts as we embark on the journey of SNFs in changing software systems.

Needs Assessment & Vendor Selection
Start by identifying the specific needs and requirements of your SNF. Pinpoint the areas where the software can bring the most value, such as resident management, billing and financial, scheduling, clinical documentation, or reporting.

The title for this article asks two questions: can the elderly survive in a youth-oriented America? And does a healthy age exist in a growing older society?

America, a young and vibrant nation! Not necessarily so! We are young in years, 247 to be exact, but old with a prevailing and burgeoning aging population. We are, unquestionably, growing old. This can be validated by the following factors. One in particular is a major decline in the birth rate. This is, in part, attributed to (1) a delay in young couples getting married, (2) the high cost of living, (3) living in smaller dwellings, and (4) caring for an aging parent with complex medical issues. And let’s not forget an increase in a longer life expectancy, the rise of the baby boomer generation (1946-1964) and a vast growing elderly population, 65 and older.

On November 6, 2023, the Office of Inspector General (OIG) released an updated General Compliance Program Guidance (GCPG) manual, the first significant update in 15 years. The updates made provide clearer guidance on what an effective compliance program is, and how healthcare organizations can implement them.  The following seven elements make up an effective compliance program. 

1. Written policies and procedures
2. Compliance leadership and oversight
3. Training and education
4. Effective lines of communication with the Compliance Officer and disclosure program
5. Enforcing standards with consequences and incentives
6. Risk assessment, auditing, and monitoring
7. Responding to detected offenses and developing corrective action initiatives

Written Policies and Procedures
Policies and procedures outline how your organization and employees are expected to behave. In healthcare, policies and procedures are essential for several reasons. They ensure that patient information is handled correctly and secured, help to create a safe work environment for employees while protecting patients, and ensure ethical billing practices by preventing fraud, waste, and abuse.

According to current research, 1) “the elderly tend to overconsume empty calories, 2) remain undernourished and 3) can cause a biological imbalance with a selection of foods.” Nutritional patterns that are held by the elderly don’t always reflect healthy dietary practices regarding the choice of foods. Nutritional awareness involves 1) a proven learning process concerning the numerous varieties of appropriate foods that are readily available, and 2) can bolster the body’s response and ultimately, an improvement in nutrition.

Economic considerations and a lack of mobility can, unfortunately, place the older person in what dietitians call “a serious nutritional jeopardy.” Eating habits that evolve from early childhood tend to encourage specified dietary choices. Although these diets are primarily favored by the elderly, they don’t necessarily provide healthy meals. Store bought foods that are prepared as a “fast food” are often purchased for convenience instead of health. Fast foods may satisfy the palate but will also contain excessive salt, high saturated fats and refined sugars. In addition, caloric consumption also needs to be decreased while the need for healthy nutrients should not!

January 1st kicked off a new year; and for skilled nursing facilities and Medicare Advantage beneficiaries, this new year offers big opportunities to get the access to care needed. Powerful changes included in the Medicare Advantage (MA) Contract Year (CY) 2024 Final Rule went into effect on 1/1/2024.

Biggest Changes Beginning 1/1/24

With a shifted focus, facilities have begun to navigate the new normalcy of the Healthcare Staffing industry—a focus filled with a heightened sense of responsibility for priorities such as financial sustainability and clinician quality amidst an unbalanced, ever-evolving market.

In our dedication to being approachable leaders, many of us have adopted an open-door policy. However, is it always beneficial? Our role as administrators demands a blend of addressing urgent needs and strategic foresight, which can be disrupted by a constant stream of interruptions, negatively affecting our focus and decision-making capabilities.

Research suggests it takes over 20 minutes to fully regain concentration after a distraction. It’s a tough dilemma in our field, where every decision impacts lives. How can we balance this?

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Earlier this year, CMS announced the start of the Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review program. This is in response to a 15.1% increase in improper payments for 2022 services, as projected by the Comprehensive Error Rate Testing (CERT) program—likely driven by the change in payment model from Resource Utilization Group (RUG) IV to the PDPM (Patient-Driven Payment Model) in October 2019.

As a result, CMS has directed all Medicare Administrative Contractors (MACs) to conduct a pre-payment review of five SNF claims for all providers nationwide, with few exceptions. Unless your SNF is already under medical review or is considered a low-volume provider (fewer than five Part A claims per calendar year), you will be subject to the Targeted Probe and Educate (TPE) program and may have already received notification from your MAC.

Healthcare organizations have an obligation to patients to protect their sensitive information, which is why HIPAA compliance is vital. Organizations that are HIPAA compliant not only protect their patients but also their business’ reputation. Two recent Office of Civil Rights (OCR) settlements highlight the importance of compliance.

In one case, a medical center came under fire for disclosing patient information to a news reporter. The other case involved poorly implemented security measures, ultimately leading to a ransomware attack that exposed sensitive patient information.

Are your employees putting your business at risk with AI?

At Model, we assist numerous clients with their Cybersecurity Compliance Frameworks and Policies. Model utilizes a leading vCISO Compliance tool that recently introduced a Generative AI Cybersecurity Control. I thought you might be interested in seeing the list of questions it raises:

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To be frank, the implementation of the Minimum Data Set (MDS) 3.0 version 1.18.11 assessment did not go as smoothly as most had hoped. Even the most prepared providers could not have anticipated stumbling through continuous electronic medical record (EMR) glitches, overlapping with twenty-one (21) errors in the MDS RAI Manual version 1.18.11 identified by the Centers for Medicare and Medicaid Services (CMS), and issues submitting MDS assessments into Internet Quality Improvement & Evaluation System (iQIES).

How Did Errors Impact Providers?
EMR errors were not specific to any one vendor, CMS said all EMR vendors experienced problems. To illustrate the magnitude and complexity of errors providers encountered; one-month post-implementation of the MDS 3.0 version 1.18.11, one of the most prominent EMR software’s in the US continues to investigate unresolved errors, releasing a multi-page document detailing the status of resolutions. So, what’s going on? Across multiple software vendors, providers reported significant complications:

An 89-year-old woman told her daughter, “Please don’t hide the truth from me. At my age, I can cope with just about anything. It’s the uncertainty that I can’t understand.”

Crisis and stressful situations occur throughout life but are thought to be more devastating in the later years when one may begin experiencing a slowing and/or decline in mental reserve. Therefore, whenever a crisis is coupled with cumulative stress, it tends to stretch the limits of one’s coping capacity. What can emerge is helplessness, lack of self-control and eventually, dependence on others.

The continuity theory proposed by the researcher Havighurst, is focused on “the relationship between life’s satisfaction and activity as an expression of enduring personality traits.”

According to the research, “Personality is considered an important factor in determining a relationship between the many roles we play in life and life-satisfaction.” Neugarten & Associates present three ideas on personality that are fundamental to the belief about the aged individual. They are:

This line of work is never normal. Being a leader in senior living and healthcare is grief-inducing, emotional, and uncertain every day. Burnout and breakdown cannot be how your hard work in this field ends. You deserve better, and you certainly cannot afford to crack!

Something has got to give.

I would like you to participate in a brief mental exercise.

Close your eyes and visualize the images you see when you say the following words: “old man, elderly gentleman, old woman, elderly lady.” 

For too many years “senile” just meant old without being pejorative. Even “geriatric” was originally a value-free term rather than part of the lexicon of contempt toward old people. Yet today, the language used to describe the changing age makeup of the elderly population is short of an apocalypse.

Older people are likely to be seen as a burden and a drain on resources. Their only contribution, it seems, is to make worse the “dependency ratio,” a term that enshrines dubious assumptions about who will be financially dependent on whom.

We know that having the right tools is essential to your success. That’s why as a member of the ACHCA, you have access to discounted contract pricing on various items from ODP Business Solutions™.

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