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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More Ways to Save:
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Skilled nursing facility (SNF) budgets have been stretched thin for years, with most providers cutting any unnecessary items from their expenses. However, some administrators are still seeing their revenue decreasing.

Many point to the two-year PDPM parity adjustment recalibration, continued effects of COVID-19, and inflation as the cause of decreasing SNF revenue. However, have you considered how managed care receivables, SNF Quality Reporting Program (QRP) outcomes, and ranking in the SNF Value Based Purchasing (VBP) program may be impacting your bottom line? These often-overlooked factors may reveal opportunities to increase income.

The National Governor’s Association characterizes a homeless person as “one who is unable to secure permanent and stable housing without assistance.” The term “homeless” includes many categories such as the de-institutionalized, the chronically mentally ill, skid row alcoholics, street people, etc.

According to the researchers Damrosch and Strasser, “Many shelters focus on assisting the situationally distressed new poor.”

The industry is buzzing… after pandemic-related delays, CMS finally released the draft Minimum Data Set (MDS) 3.0 version 1.18.11 for implementation on October 1, 2023, with the final version expected to be published before the new year. It’s been widely regarded as the largest change to the MDS in over a decade. With less than one year to prepare, a slew of changes that impact everything from interdisciplinary communication to assessments, and risk to both Medicare and Medicaid revenue, where should you start?

Let’s look at cause and effect. What are the most significant changes in the MDS 3.0 version 1.18.11 and what impact to skilled nursing facility (SNF) operations should administrators expect?

Researchers are aware of the detrimental effects of a practice called scapegoating. Many of us, during our life, have often played several roles that periodically we cast upon others. The aged parent, like it or not, often “inherits” one of these roles and becomes an unwitting scapegoat.

The researcher Archer suggests, “The focus of negative energy, arising out of scapegoating flows from a younger generation in the form of unfulfilled dreams, whereas the elder is the receiver or carrier of these multiple disappointments and worn traditions.” He further states, “The elderly individual tends to personify all of the facets of life that the young are conditioned to avoid i.e. death, illness, depression and uselessness.” It then becomes relatively easy for a young person to transfer their negativity and project it onto the aged parent in the form of an unwanted feeling, although the parent may in fact have already internalized the social rejection that is felt.

In August of 2022, a Japanese woman by the name of Kane Tanaka died at the amazing age of 119, just two weeks shy of the biblical 120. When questioned at her 116th birthday what was her best diet for staying healthy and living a long life, her answer was simple, “I appreciate anything I eat.” When Mrs. Tanaka died she became the world’s oldest recorded person. She, in fact, lived seven years longer than the oldest American veteran of World War II.

The current average life span for a Japanese woman today is 87.7 years and 81.6 for a man. And the statistics continue growing! Government data reports that at present, Japan has the greatest number of centenarians (100 years plus) than any other country. As of August 2021 there were 86,000 individuals in Japan who have turned 100 in a country with a population of 125 million.

In Part I of the question of whether the grass is really greener on the other side, we asked whether the grass is really greener with in house therapy. In Part II we want to look at whether the grass is greener with a contract therapy company.

Our company recently completed an RFP project for contract therapy services for a client.

The phrase “is the grass really greener on the other side” is generally used to imply that things are not necessarily better on the other side. However, there are times when the “other side” may be better. The challenge is determining when the other side might be better, or are things on your side best for you.

In the world of skilled nursing this concept has been on the minds of many operators when looking at moving from a contract therapy relationship to an in house model. The shift to the Patient Driven Payment Model (PDPM) meant that therapy minutes would no longer be a primary driver of Medicare A reimbursement. The belief was this would lead to fewer minutes being delivered which in turn meant that it might be more cost effective to have an in house therapy program.

According to the researcher Hogstel, “Anxiety is a diffuse feeling of panic, dread and lack of control that can be insufferable in its acute stages.” He further states, “Little is known about anxiety and its numerous manifestations even when it has not reached negative clinical proportions. It is a multi-response to helplessness, isolation, alienation and emotional insecurity. Evidence of anxiety in the elderly is often not as apparent as in younger clients.”

According to the research, “Anxiety is the motor that keeps people moving toward mastery of new and threatening situations.” The researchers Jarvik & Russell claim, “Anxiety runs with a soft, pleasurable purr that is not always perceptible. However, when it’s an extreme or prolonged personal stress, it is likely to initiate episodes of anxiety that is experienced as a noticeable jittering hum in the gastric area.”

We’ve all been there–you’re walking through the mall and see something you just can’t live without, only to get home just hours later and immediately experience buyers remorse. But what if we told you there’s a scientific reasoning for why this occurs.

Summertime in California means we’re headed outside to enjoy the fresh air and warmer temperatures that the season offers. Even still, you’ll want to make sure you’re well prepared before you head out on a hike to avoid a potentially dangerous situation. Take a look at some of the following tips to keep you safe from the California heat and wilderness this summer.

Stay Hydrated