Harmony Healthcare Blog

Pam Duchene

Recent Posts

Immunization: What does “up to date” mean?

Posted by Pam Duchene on Fri, Jun 14, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


The World Health Organization identifies Vaccine hesitancy as one of the top threats to global health.  While the target of education is largely centered around education for parents of young children, vaccinations for preventable disease is an important concept for all individuals.  Older adults, in particular, are at risk for communicable disease since immune systems weaken with age.  The Centers for Disease Control and Prevention (CDC) recommends the Shingles vaccine for individuals over 50 years of age, and Pneumococcal vaccines for adults over 65 and for those under 65 with certain chronic health conditions. 

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Topics: Immunizations

Restorative Nursing: Crucial for Patient Quality, Critical for PDPM

Posted by Pam Duchene on Tue, Jun 04, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


What patients can do today and what they will be able to do tomorrow may be the result of Restorative Nursing Programs.  That’s been the conclusion of multiple research studies, including a study from Johns Hopkins in which 31% of patients improved their ADL self-performance at 6 months with 15 minutes of Restorative Nursing daily. 

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Topics: Patient-Driven Payment Model

Transition to Patient Driven Payment Model (PDPM): Nurse Leader Strategies

Posted by Pam Duchene on Fri, May 10, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


When you think of October, you may think about cooler weather, brightly colored leaves, crisp apples and stocking up on candy for Halloween.  Unless of course, you are working in post-acute or sub-acute care, in which case, you are probably contemplating the massive change involved in conversion from RUGS to PDPM.  During a recent MDS Competency course, several nurse leaders from New England took time to share their strategies for preparing for the Patient Driven Payment Model.  Following are some of their thoughts.  

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Topics: Patient-Driven Payment Model

ICYMI: Competency Assessment for Nursing Homes

Posted by Pam Duchene on Thu, May 02, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


According to William Glasser, 

“No human being will work hard at anything unless they believe that they are working for competence.”

This is particularly true with healthcare.  Nurses and staff in long term care work to make a difference in the lives of those entrusted into their care.  While nursing in skilled care may not be packed with the adrenaline rush of the emergency department, it is filled with adventure and activity and an opportunity to deliver person-centered, compassionate care to those in need. 

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Topics: Core Competencies

Antipsychotic Medications: Expectations, Regulations, and Strategies

Posted by Pam Duchene on Thu, Apr 18, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


The Expectations 

In CMS’s latest blog, antipsychotic medications, again, are in the spotlight.  In her April 15th update, CMS Administrator Seema Verma mentioned antipsychotic medications five times: 

  • Updating Nursing Home Compare to make it easier for consumers to identify non-compliance related to inappropriate antipsychotic medication use.
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Topics: Antipsychotics

ICYMI: Five Strategies for Pain Management

Posted by Pam Duchene on Fri, Apr 12, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


A key area of concern within the IMPACT (Improving Medicare Post-Acute Transformation) act is that of preventing pain and alleviating suffering occurring in older adults in skilled nursing facilities.  The Nursing Home Quality Improvement Campaign provides ongoing reporting on state and national rates of Quality Measures, including the rate for residents self-reporting moderate to severe pain. 

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Topics: Pain Management

Infection Prevention: Four Key Actions

Posted by Pam Duchene on Tue, Mar 26, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


Mom was Right - the Answer is in Your Hands

Septicemia and urinary tract infections are identified as the primary reasons for patients to require care in a skilled nursing facility after a hospitalization.[1]  In the report, Adverse Events in Skilled Nursing Facilities (Levinson, D, & General, I, 2014), 26% of the adverse events identified for individuals entering nursing facilities were infection related.  These two factors are key reasons why the changes to the Requirements of Participation focused on prevention and addressing infection control. 

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Topics: Infection Prevention

Antipsychotic Medications: Risks and 5 Components to Consider for Minimized Usage

Posted by Pam Duchene on Thu, Mar 14, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


Antipsychotic medications pose tremendous risks for older adults, which is illustrated in the black box warnings issued by the U.S. Food and Drug Administration which identify increased risk of death in elderly patients with dementia [1].  

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Topics: Antipsychotics

Top 4 QAPI Requirements due November 28, 2019

Posted by Pam Duchene on Tue, Feb 26, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


Five years ago, the Office of the Inspector General received a difficult report stating that one in three residents admitted to a skilled nursing facility experienced an adverse event resulting in harm within the first 35 days of their stay.  The report estimated that 60% of such events were preventable.  The IMPACT Act of 2014, and subsequent changes in the Requirements of Participation for Skilled Nursing Facilities are results of this monumental and eye-opening report.  

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Topics: QAPI

Competency Assessment for Nursing Homes

Posted by Pam Duchene on Thu, Feb 21, 2019

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory/Rehab • Education/Efficiency


According to William Glasser, 

“No human being will work hard at anything unless they believe that they are working for competence.”

This is particularly true with healthcare.  Nurses and staff in long term care work to make a difference in the lives of those entrusted into their care.  While nursing in skilled care may not be packed with the adrenaline rush of the emergency department, it is filled with adventure and activity and an opportunity to deliver person-centered, compassionate care to those in need. 

Read More

Topics: Core Competencies

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