Bits & Bytes from Accu-Med A newsletter for users of Accu-Care for Windows Software CMS Launches 10 New Quality Measures Scores to be publicized for easy consumer access The pilot program of the Centers for Medicare & Medicaid Services (CMS) has a new consumer quality initiative for nursing facilities. CMS is currently wrapping up the pilot study in six states. Several long term care advocacy groups are pushing CMS to make changes to address concerns uncovered by the pilot project. National launch is set for November 2002. Tom Scully, administrator of CMS, envisions providing information about quality outcomes to consumers of all types. At the recent Baltimore conference sponsored by The American Health Quality Association (AHQA), he announced the commitment of $30 million dollars to a continuing ad campaign that will spread the word about the quality initiative and give consumers contact information for CMS. The 10 Quality Measures (QMs) are for use by consumers, news media and others who wish to evaluate the quality of nursing facilities. They are: * * * * * * * Late-loss ADL worsening Pressure ulcers Pressure ulcers (with FAP) Residents with pain Physical restraints used daily Infections Failure to improve or manage delirium in short-stay residents * Failure to improve or manage delirium in short-stay residents (with FAP) * Short-stay residents with pain * Short-stay residents with improvement in walking (with FAP) Accu-Med Services, Inc. An Omnicare Company Accu-Med... the right prescription for software! Fall 2002 The pilot is testing ways to help the public understand the quality measures, improve care through QIO/nursing home quality improvement projects, and find better ways to reach beneficiaries. These new measures will not be incorporated into the MDS survey process at this time; according to CMS. Come November, you’ll wish you had this Pro-Tracking’s comprehensive QM reports can help you improve these 10 critical measures, before they become part of the public record. If you score well on the indicators, you are in possession of a powerful tool. Positive score reports can be a strong base for press releases and marketing materials. In addition, you will want to check the QI scores of your competitors. Where are the strengths and weaknesses of competitors compared to yours? How can you use this information to competitive advantage? Get the competitive edge on the new CMS quality measures. Call Pro-Tracking at 800-445-3548 or visit our web site at www.pro-tracking.com. Pro-Tracking Performance Related Outcomes How To Reach Us Support 800-777-9144 Option 7 Sales and Administration 800-777-9141 Internet www.accu-med.com Admission/Discharge/Status Change Report Helps at Survey Time The “Admission/Discharge/Status Change” report can be helpful to your facility during survey. It gives you a quick and easy way to get a listing of all residents who have been admitted and discharged for a date range - which can be requested many times during a facility survey. To get the report, follow these steps: 1. Open the Admissions Module 2. Pull down the reports menu 3. Choose Daily Census 4. Choose Resident Status Change Select your date range under the “conditions” tab. You also have the ability to choose a sort order by stay date (default), medical record number, resident name, or location. One important note to remember: include all inactive residents to be sure to get all discharged residents who have been made inactive since their discharge. Keeping up with HIPAA In July, we sent you a packet of information detailing our plans to help you with HIPAA compliance. Fact sheets will be updated and sent to you periodically. If your facility plans to file for a one-year HIPAA transactions extension, you must do so before October 15, 2002! The CMS website reads “electronic filing is fast and easy” so here’s the address if you still need it: http://www.cms.gov/hipaa/hipaa2/ascaform.asp Same words, different order, different reports The “Diagnoses by Resident” report (reports/diagnosis reports/diagnoses by resident) lets you print all diagnoses for specific residents or for all residents. By using “Resident by Diagnosis” (reports/diagnosis reports/resident by diagnosis) you can identify which residents have a specific diagnosis code. QM Help New Report Tracks Daily, Frequent Pain Pro-Tracking has developed a new report consolidating MDS data as related to pain. To see how your facility checks out, log in to www.Pro-Tracking.com and look under “Reports” for “Pain Report.” Although pain is not currently a QI, it is one of the 10 Quality Measures that will be publicized by CMS starting in November, 2002. Verify your MDS data. If some data elements on the MDS are not completed correctly, the facility will appear worse on the quality indicators than it should. Another strategy is to improve performance in areas where genuine problems or shortcomings exist. For example, if a number of residents are experiencing frequent or severe pain, a targeted effort may be needed to help manage pain in facility residents. This quality measure does not examine use of pain medications or use of pain management strategies. Rather, it simply evaluates whether residents report or experience frequent or severe pain during the seven-day assessment period when the MDS is completed. This measure will identify residents who experience moderate pain at least daily (MDS items J2a=2 and J2b=2) or severe pain at any frequency (MDS item J2b=3). Accuracy of the MDS items is critical for this indicator, and these items are often incorrectly scored. The MDS instructions state that the nurse should score these items according to the resident’s actual pain experience during the seven-day period, regardless of diagnosis or treatment in progress. For example, the nurse might score a resident with lung cancer, who takes narcotics for pain, as elevated on pain frequency and intensity, even though the medications are controlling the pain well. If the nurse scores the MDS items using this philosophy, the facility will score very poorly on the pain measure. The next step is to ensure that the facility is accurately identifying and treating residents who experience pain. As a starting point, run the Pain Report and review those residents to ensure they are receiving adequate pain management. Use this report with the Facilities Pain Management program. The MDS nurse should notify the interdisciplinary team when a resident has unmanaged pain. If a resident with a PRN pain medicine order is taking the PRN medicine frequently, this is a trigger for the team to discuss changing to a routine status. Version 4.5 - Coming Soon! Keep your eyes on the mailbox for Accu-Care for Windows version 4.5. This contains not only an important regulatory update, but it has some great new features, too. HIPAA Privacy & Security Enhancements Release 4.5 provides new Audit Controls to create audit trails, which will enhance your HIPAA compliance plans. You decide how deep you want the audit trail to go. It can be as simple as tracking Accu-Care log-ins and log-outs or it can be deep enough to track who has viewed individual resident information and reports on this information. Flexible audit logs allow you to look at the audit trail by user or by resident, and to view or print by selected date range. Assessment Enhancements * NEW MPAF! The MPAF is ready for your facility’s use. Check your state’s regulation for when to use this shorter form. * NEW Minnesota RUGs III calculator * NEW Nebraska RUGs III calculator * NEW Washington RUGs III Weight Set has been implemented! * Enhanced MDS Verson 1.20 error checking Admission Face Sheet Enhancements With the all-new “Print Studio” feature, you can customize your face sheets on-screen and then print your face sheets exactly the way you set them up on the screen. This flexible tool lets you tailor your face sheets to meet your facility’s needs. Want to add information to your face sheet? Eliminate unwanted data? Create a short-form face sheet for assisted living or adult day care? Add your facility logo or a resident photo? You can do all this and more with the new “Print Studio” feature. Used in conjunction with the “Face Sheet Studio,” you can rearrange the appearance of the Admissions Module tabs to match your new custom face sheets. We’ve also modified the module to display the Code Status on the face sheet by default. Medical Records Enhancements The big news in medical records is a new Behavioral Monitoring feature for any medication. Use this feature to define a list of behavior monitoring statements for psychotropic, pain or sleeping medication orders and attach them to any medication order. You can print these statements on a flow sheet with custom titles or list them on your “behavior report.” Progress Note Module Enhancements The Progress Notes module now includes an option for “No Change” in status. We made the module more user-friendly: bold fonts are available for templates and the grey background has been replaced with white for better printing clarity. Squashing Bugs In addition to all the great new stuff, we’ve also done some house cleaning and fixed some “bugs”. All customerreported issues from the 4.0 release have been resolved in version 4.5. TIPS and TRICKS CMS 672 & 802 Reports Situation: When surveyors arrive at your facility, they require the facility’s most current data. Accu-Care for Windows allows you to edit the CMS (formerly HCFA) 672& 802 reports to reflect any changes in your residents’ conditions since their last MDS. Possible Problem: When you go into the reports, you will see the edit screen before printing. However, edits made to this screen will not be saved after you print and exit. Solution: Since these reports get their information from the ongoing assessment, update the ongoing assessment frequently with current information for the residents. Update the ongoing by opening assessments and highlighting a resident. Then click the “on-going” button. By doing this, current information will be reflected in the 672 & 802 when you are ready to print. Both reports can be found in “Assessments” under “Reports” and “CMS Reports.” Rapid Weight Entry utility saves time Using “Rapid Weight Entry” in the Medical Records Module to record your resident weights will save your facility valuable data entry time. Rapid Weight Entry allows you to enter the current weight for each resident without opening his or her individual account. This utility gives a listing of residents with a field to enter their current weights, dates and devices used. You can enter weights for one resident, multiple residents, or all residents. Sort and filter options are available by location or resident name. Find Rapid Weight Entry in the Medical Records Module under “Tools”. Your Opinion Counts! Q. What does a free shirt cost? A. Your opinion. Here’s How.. Accu-M ed Ser icare Com vices, Inc. pany An Omn 1. 2. 3. 4. 5. 6. Read Bits & Bytes Go to www.accu-med.com Click on “Bits & Bytes” Click on “Readership Survey” Tell us your Bits & Bytes likes and dislikes Cross your fingers! With any luck*, you’ll soon be sporting a very cool Accu-Med logo shirt. *Winners will be chosen quarterly. Our shirt-winning Summer readers were: Sadie Clark from La Hacienda in San Diego, Texas; and Heather Rowen from Devereux House in Marblehead, Massachusetts. Congratulations! W Can your pharmacy services provider have an influence on staffing, census, and regulatory issues? At Omnicare, the nation’s leading provider of pharmacy services, we’ve shown that we can. Please call Omnicare for more information at (800) 990-6664, Ext. 3435. 300 TechneCenter Drive Suite A Milford, OH 45150 An Omnicare Company Accu-Med Services, Inc.
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