Featuring HTS Healthcare Hero, Kristen Stedman

Meet Kristen Stedman, a 9-year HTS veteran and a PTA at Ketcham Memorial Center.

Kristen’s healthcare hero status was further solidified by Ketcham’s Administrator, Kathy Wittmer who stated, “We wouldn’t have been able to make it through navigating the PHE without the infection control nurse and Kristen.”

Kristen displayed her commitment to the residents during the PHE in many different capacities. For example, she showed up at Ketcham everyday – regardless if she had therapy patients on her schedule or not. Specifically, Kristen was involved in helping transition patients to ambulances, checking temperatures, and answering call lights to help prioritize patient needs.

Kristen stated the most challenging part of the PHE is knowing residents who became sick and some who even passed away. Oden, Indiana (where Ketcham is located) is a small town. “Since the community is so small, we are like family,” said Kristen. As like many facilities across the nation, Ketcham’s staff pivoted to meet the needs of residents. They adapted and they did so as often as necessary. The therapy team at Ketcham was praised for many reasons with the primary being their ability to change in order to navigate these new COVID-ridden waters.

Now that the initial shock and “pivot” is over, Kristen described some other COVID-related challenges. Restorative is now working in the therapy gym side by “distanced” side. This has required some shift in scheduling. The activities department is now requiring split groups. This also presents a call to action for better communication and organization when scheduling patients attending therapy sessions. All in all, everyone at Ketcham has worked together nicely. As Kristen put it, “For other facilities that are going through this now, it is most important to stick together (with the IDT). Everyone has to work together and you have to be there for each other.”

Thank you Kristen and Ketcham Memorial Center for sharing your Story from the Field!


Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

Blog by:  Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

Now that routine surveys are beginning to take place in most states, it is important that vigilant infection prevention and control practices do not take a backseat to other survey-ready quality assurance activities. Notably, HHS announced a $2.0 billion payment incentive program (VBP) with $500 million per month for four months Sept. -December 2020 paid based on SNF performance in managing the rate of COVID-19 infections each month and the COVID-19 mortality rate for the month as compared to other facilities with similar community infection rates. Details are forthcoming on the specific formula to be used for distribution of funds, but it is anticipated that a facility may be excluded from receiving a portion of these funds if performing significantly worse than peers on these measures.

Click here to continue reading this blog.

 

About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

By: Sheena Mattingly, Director of Clinical Outcomes

On August 26, 2020 CMS released a memo detailing COVID-19 testing requirements. In order for nursing homes to participate in Medicare and Medicaid, staff and residents need to adhere to new testing requirements. A revised survey tool for surveyors to assess nursing home compliance in this matter is also available.

See below for a list of steps that need to be taken to remain in compliance.

1. Remember, only antigen tests and PCR tests are permitted to be used to meet the testing requirement – antibody tests are not acceptable forms of testing.

2. Testing is based on three different triggers:

Symptomatic Individual Identified

  • Staff with signs/symptoms must be tested
  • Residents with signs/symptoms must be tested

Outbreak

  • Test all staff with previous negative results until no new cases identified
  • Test all residents that previously tested negative until no new cases identified

Routine Testing

  • Test staff according to County Positivity Rate in the past week
  • Resident testing not recommended unless resident leaves the facility routinely

3. Routine testing must be completed of staff according to the table below and is based on the facility’s county positivity rate in the prior week. These county-level positive rates are available here (last modified Sept. 8, 2020). The below table identifies minimum testing frequency related to the county positivity rate within the past week.

*Source: https://www.cms.gov/files/document/qso-20-38-nh.pdf

4. There is a 48-hour time requirement for results of COVID-19 testing. If for any reason, this is unable to be met, the facility should have documentation of efforts to obtain results as quickly as possible. Also, document the lab the facility is using and any contact the facility has had with local and state health departments. Criteria for the inability to meet testing result time requirements may include supply shortages, limited access, or labs failing to process tests within 48 hrs.

5. The newest F-Tag (F-866) is related to noncompliance with new testing requirements. However, if the facility has documentation supporting their attempts to adhere to new testing parameters such as timely contacting state officials and inquiries with labs that can provide results within 48 hours, then surveyors should not tag the facility. Instead, they are to inform state and/or local health departments of the facility’s lack of resources.

Hoping & Coping:  Smiling Faces

This story from the field focuses on the new “HTS Hoping & Coping Series”. This series emphasizes all the wonderful HTS therapists and the extraordinary lengths taken to assure quality services and patient well-being are maintained during the PHE.

Meet Alexis Jackson, OT and Rehab Manager at Good Sam Home in Evansville, Indiana. Alexis found herself reimagining the work environment during the PHE after watching the May “HTS Lunchtime Learning: COVID-19 & The New Normal”. That very afternoon, Alexis knew The Smiling Faces Initiative described on the webinar was one that would improve morale at Good Sam Home. Smiling face nametags encourage facility staff members to post pictures of themselves on their nametags so that patients are able to more easily identify them and, of course, see their smiling faces! This initiative eliminates a created barrier, real or perceived, between staff and patients. “I feel strongly that our patients deserve to see who we are in order to make a connection that is needed to deliver quality therapy” said Alexis Jackson, OT.

Alexis and the Good Sam Home therapists were the drivers of The Smiling Faces Initiative. Their mission was to bring out smiles from underneath masked faces. First, Alexis trolled Facebook and found pictures of each therapist. Then, after the pictures were included on their nametags, the therapy team began wearing them on a daily basis. “Once we therapists starting wearing smiling face nametags, the initiative just took off!” said Alexis. Soon the facility’s DON, Admission’s Coordinator, Nursing, and Staff Development Coordinator were all wearing a smiling face nametag. We can all use a few more smiles and thanks to the Good Sam Home therapy team, patients are now getting them!

From left to right: Alexis Jackson, OTR/L, Sherri Moore, PTA, Becky Williamson, COTA/L, Rachel Runyon Lortie, OTR/L.


Past Stories From the Field can be found on the HTS Portal. Have a great “Hoping & Coping Story from the Field ” you would like to share with fellow HTS therapists?

Email Sheena Mattingly, Director of Clinical Outcomes at sheena@htstherapy.com for your chance to be featured in a “Story from the Field!”

On July 24, 2020 CMS released a SNF QRP COVID-19 Tip Sheet. Here’s what you need to know:

  • Starting on July 1, 2020, SNFs are expected to resume timely quality data collection and submission of measure and patient assessment data for the MDS/RAI.
  • Specific quarters requiring reporting of data for the QRP program for CYs 2019 and 2020 are listed below:October 1, 2019–
    • December 31, 2019 (Q4 2019)
    • January 1, 2020–March 31, 2020 (Q1 2020)
    • April 1, 2020–June 30, 2020 (Q2 2020)
  • The MDS should be submitted for all new admission records and discharge records that occur on or after July 1, 2020.
  • Timely submission and acceptance requirements of MDS data to meet the 80-percent threshold are unchanged. SNFs are required to submit at least 80 percent of the necessary data to calculate the SNF QRP quality measures.
  • Before QM data is publicly reported on Nursing Home Compare, SNFs have the opportunity to review and correct and/or preview their data. A quarterly Provider Preview Report can be accessed via the Certification and Survey Provider Enhanced Reports (CASPER) application which is accessible from a SNF’s “Welcome to the CMS QIES Systems for Providers” page. Full instructions are available here.

 

Did You Know?

As part of the HTS Partner Plus Program you get access to multiple MDS specialists and nursing consultants to assure your coding is accurate which not only impacts PDPM reimbursement but also QRP? Contact HTS Director of Clinical Outcomes today for more details at sheena@htstherapy.com.

CMS posted initial data analytics on COVID-19. Data was collected from nursing home reports to the CDC’s National Healthcare Safety Network. Data will be updated on a weekly basis moving forward.

COVID-19 Focused Survey Items for Nursing Homes to be Completed by July 31, 2020

Indiana COVID-19 Updates and Resources

Kentucky COVID-19 Updates and Resources

What can providers do?

For questions or additional information, contact your Regional Director or Cassie Murray.

Blog by Cassie Murray, OTR, MBA, QCP, Chief Operating & Clinical Officer

During the May 12th CMS Office Hours broadcast, CMS provided guidance for SNF therapists to include the time spent donning and doffing PPE in the MDS Section O minutes. Therapists should begin including this time in the total treatment time for each session. This topic is covered in the recorded podcast between time markers 3:02 and 3:54. The link below is to the recording and written transcript.

Tuesday, May 12, 2020, CMS Office Hours (ZIP)

For questions or additional information, contact your Regional Director or Cassie Murray.

HTS Celebrates National Skilled Nursing Week

In recognition of National Skilled Nursing Week, Healthcare Therapy Services, Inc. celebrated with their partners by honoring our aging in addition to the health care heroes for their unwavering commitment to improving the lives of those served. National Skilled Nursing Care Week was established by the American Health Care Association (AHCA) in 1967. National Skilled Nursing Week ran from May 10-16, 2020. Inspired by this years’ theme “Sharing Our Wisdom”, HTS created an art activity for residents and staff to participate. “It’s more important than ever to celebrate our skilled nursing communities. This year’s celebration looks a little different than in year’s past since we have social distancing and other restrictions in place. We wanted to do something that everyone could participate in. Reading the heartfelt words of wisdom from our residents has been one of the most rewarding parts of all of this. We are just thrilled with the participation that we received!” -Holly Skidmore, Director of Marketing

Congratulations to our winners!

Congratulations to the following winners of the National Skilled Nursing Week “Sharing Our Wisdom” contest. We had great participation from our homes and many residents shared their wonderful words of wisdom. Thank you to all who participated!

1st Place Winner: Heritage Pointe of Huntington, Huntington, IN
2nd Place Winner: The Cedars of Lebanon, Lebanon, KY
3rd Place Winner: Golden Years Homestead, Fort Wayne, IN

Click here to view the video showcasing photos for the contest.

Some inspiring words of wisdom from the residents of our partner communities:

Barb F: “Be Happy. Smile more and worry less.”

Mary M: “Do your very best in everything you do.”

Clara F: “Enjoy the little things in life. Don’t take anything for granted.”

Jonetta W: “Do unto others as you would have them do unto you.”

Georgette P: “Love your family, everybody, and the Lord. Haste makes waste. Love your neighbor as yourself. I love everyone.”

Cathy S: “Strength doesn’t come from what you can do. It comes from overcoming the things you once thought you couldn’t.”

Cleola: “Take care of people and God will take care of you!”

Herb: “Never stop learning.”

Lewis: “Accept Christ as your Savior and you will live life in security. Watch your money. Never go for revenge.”

Ron: “Enjoy your life when you are young!”

Helen: “Be nice to people.”

Deloris: “Make life fun, never stop playing!”

Fay: “Always start your prayer with “Thank you Lord, for all you’ve done for me” before you ask for anything.”

 

#NSNCW

Blog by:  Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

As part of President Trump’s Guidelines for Opening Up America Again, the Centers for Medicare and Medicaid Services (CMS) announced new nursing home reopening recommendations for state and local officials. These recommendations detail criteria for relaxing certain restrictions and mitigating the risk of resurgence, visitation and service considerations, and restoration of survey activities.

The guidance encourages state leaders to collaborate with the state survey agency and state and local health departments to decide how these criteria or actions should be implemented in their state and provides examples of how a State may choose to implement the recommendations, which includes options of states to require that all facilities go through each phase at the same time, allowing facilities in a certain region within the state to enter each phase at the same time, or permitting individual facilities to move through each phase based on their status for meeting the criteria for each phase.

Click here to continue reading this blog.

 

About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

Blog by the Centers for Disease Control and Prevention

SEQUENCE FOR PUTTING ON PERSONAL PROTECTIVE EQUIPMENT (PPE)

The type of PPE used will vary based on the level of precautions required, such as standard and contact, droplet or airborne infection isolation precautions. The procedure for putting on and removing PPE should be tailored to the specific type of PPE.

  1. GOWN

    • Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back Fasten in back of neck and waist
  2. MASK OR RESPIRATOR

    • Secure ties or elastic bands at middle of head and neck Fit flexible band to nose bridge Fit snug to face and below chin Fit-check respirator
  3. GOGGLES OR FACE SHIELD

    • Place over face and eyes and adjust to fit
  4. GLOVES

    • Extend to cover wrist of isolation gown

USE SAFE WORK PRACTICES TO PROTECT YOURSELF AND LIMIT THE SPREAD OF CONTAMINATION

  • Keep hands away from face
  • Limit surfaces touched
  • Change gloves when torn or heavily contaminated
  • Perform hand hygiene

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 1

There are a variety of ways to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Here is one example. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GLOVES

    • Outside of gloves are contaminated!
    • If your hands get contaminated during glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Using a gloved hand, grasp the palm area of the other gloved hand and peel off first glove
    • Hold removed glove in gloved hand
    • Slide fingers of ungloved hand under remaining glove at wrist and peel off second glove over first glove
    • Discard gloves in a waste container
  2. GOGGLES OR FACE SHIELD

    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band or ear pieces
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container
  3. GOWN

    • Gown front and sleeves are contaminated!
    • If your hands get contaminated during gown removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Unfasten gown ties, taking care that sleeves don’t contact your body when reaching for ties
    • Pull gown away from neck and shoulders, touching inside of gown only
    • Turn gown inside out
    • Fold or roll into a bundle and discard in a waste container
  4. MASK OR RESPIRATOR

    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container
  5. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 2

Here is another way to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GOWN AND GLOVES
    • Gown front and sleeves and the outside of gloves are contaminated!
    • If your hands get contaminated during gown or glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp the gown in the front and pull away from your body so that the ties break, touching outside of gown only with gloved hands
    • While removing the gown, fold or roll the gown inside-out into a bundle
    • As you are removing the gown, peel off your gloves at the same time, only touching the inside of the gloves and gown with your bare hands. Place the gown and gloves into a waste container
  2. GOGGLES OR FACE SHIELD
    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band and without touching the front of the goggles or face shield
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container
  3. MASK OR RESPIRATOR
    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container
  4. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

Click here to view the pdf.