Simmons Healthcare Consulting, LLC - Social Service consulting, QIDP reviews, & Activities oversight
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Indiana FSSA Division of Aging Issues Updates to e450B Process
'Why' I Originally Chose to Work in Long-Term Care
ISDH Publishes Update to Advance Directives Brochure
CMS QAPI Material Rollout for Nursing Homes
National Nursing Home Week - Team*Care - 10 Simple Ways to Work as a Team


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CMS Updates Forms for QIS Survey Process

CMS has posted changes to a few QIS forms.  Full information can be found at  

Resources - 

Entrance Conference - 

Mandatory Facility Task Pathway Forms - 

Stage I Forms - 

Stage 2 CE Pathways Forms - 

Triggered Facility Tasks Pathway Forms - 

Need assistance with preparation for QIS?  Does your nursing facility need increased support while awaiting a PSR?  Contact Simmons Healthcare Consulting, LLC, to discuss many options that can assist with regulatory compliance.

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Recent ISDH and CMS Updates / Resources for Nursing Facilities

Several important pieces of information to pass on to our long-term care followers today - 

  • ISDH (Indiana State Department of Health) has recently increased the number of survey areas to 10. They have released an updated map and the roster of surveyor assignments / supervisors.  If you need assistance obtaining the new map and roster, send us an email ( and we'll get that information to you in the form of a Word document.

  • CMS (Centers for Medicare & Medicaid Services) has stated that under healthcare reform there must be regulations requiring nursing facilities to have an effective compliance and ethics program by March 23, 2013.  CMS is expected to publish a 'draft' regulation by December 31, 2012.  
  • The "Hand in Hand" training materials should be arriving to nursing facilities shortly from CMS.  If you're not familiar, the program focuses on person-centered care for residents with Dementia and abuse prevention.  All facilities are supposed to receive one free copy of the training program.  SHC would like to hear feedback from facilities once you review the toolkit.  Contact SHC if you need assistance with implementation of the program.  
  • The most recent information that SHC has on the top F-tag citations for Indiana - F441 (Infection Control), F323 (Supervision/Accidents), and F282 (Comprehensive Care Plans).
  • CMS has released a webinar (available via YouTube at this link) on the CMS National Partnership to Improve Dementia Care in Nursing Homes - formally referred to as the Initiative to Improve Behavioral Health and Reduce the Use of Antipsychotic Medications in Nursing Home Residents.  The webinar provides an overview of the national partnership, resources for technical assistance, and plans for upcoming educational offerings.
  • CMS has also released a "Discharge Planning" booklet (ICN 908184).  It is designed to provide education on Medicare discharge planning.  Again, email SHC if you need assistance obtaining a copy of the booklet and we'll send you the PDF version.  

Hope everyone stays safe and has provisions in place for staffing today & tomorrow with the pending winter storm!

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Don't Overlook the "Easy" F-tags in Your #SNF

Many of us know that there are certain F-tags that are difficult to avoid no matter how fantastic the nursing facility is.  F309, F329, and F441 come to mind.  However, there are citations that can be avoided with little effort.  Several different tags deal with the posting of information and information provided to residents/families.  For example, F156 (Notice of Rights, Rules, Services, Charges) has seemed to be an issue recently in some areas.  

  • Assign rotating staff in your facility to conduct a regular walk-through to look for the required postings.
  • Do the required postings have the correct information?  Example, current Ombudsman / Administrator, correct phone numbers?
  • Are the postings printed with a larger font?
  • Are the postings at an appropriate height?
  • Are residents being given a copy of the facility charges along with their Medicare denial letters?
  • Is the facility using the most recent Medicare denial letter?
  • Is the facility using the most recent Notice of Transfer/Discharge and Request for Hearing?
  • Is information on how to obtain Medicaid assistance posted?
  • Is the required staffing information posted in an accessible area?
  • If your facility has an electronic wandering system, is information available that those residents would have access to also?

Taking a few minutes each week to ensure compliance with these areas can potentially save a lot of headaches once the surveyors enter the home.  Need assistance with your Social Service or Activity department?  Is your Indiana facility in compliance with required QMRP visits?  Contact Simmons Healthcare Consulting, LLC, and we will schedule a visit to help continue improving Quality of Life services for your residents.

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Upcoming IHCA QIS Intermediate Training

IHCA (Indiana Health Care Association) has QIS Intermediate Training sessions scheduled for next week  -  December 11 in Merrillville and December 13 in Edinburgh.  Information on IHCA's website can be found at this link and a PDF flyer can be found here.  If you haven't signed up yet, I believe that there's still time to do so.  And if you are planning to attend the Merrillville session, look for SHC and say 'hello'.  

If your facility is needing assistance with ISDH survey preparation, survey management, or achieving regulatory compliance following a survey, contact SHC and we'll schedule a visit to help continue improving Quality of Life services for your residents.

Have a great weekend everyone!

Top 10 #LTC Deficiencies, Top 10 Troubled States

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The latest Top 10 regarding nationwide nursing facility survey citations is out.  Indiana makes the list as one of the states with the most serious deficiencies.  Having participated in survey management in several states, ISDH surveyors consistently are definitely thorough, in my experience.  F-tags among the top 10 include F241 (Dignity), F329 (Unnecessary Medication), F279 (Develop Comprehensive Care Plans), F309 (Highest Practicable Well-Being), F323 (Accidents and Hazards) and F281 (Professional Standards).  

Social Service staff has the potential to be directly involved in these 6 tags.  A functioning Behavior Management program helps with F323 and F329, timely and accurate documentation assists with F279 and F281, and proper observations and psychosocial interventions can cover F309 and F241.  

  • Is your Behavior Management program truly working?  
  • Is it utilized effectively and do the direct caregivers understand the potential benefits of behavioral interventions?  
  • Are Social Service staff made aware of important resident changes in order to intervene and update care plans as appropriate?  
  • Does the Social Service department have systems in place for time management in order to be able to document in a timely manner?  

If your facility needs assistance with Social Service and/or survey management,
contact SHC and we'll schedule a visit to continue improving Quality of Life services.