C.A.R.E.

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

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Continued from the last post, lets tie all of the pieces together when coding Pressure Ulcers (Long Stay).  Understanding the RAI Guidelines for completion of Section M is the third and final key to assist with managing this Quality Measure. 

In order to ensure accurate coding and documentation, it is important to understand the intent of each area of Section M. Harmony Healthcare International (HHI) provides the following helpful tips to assist with this process: 

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C.A.R.E.

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

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As discussed with the short stay Quality Measure for Pressure Ulcers/Injury, we have seen that it is all about understanding different ulcer types and staging, which directly impacts Documentation and MDS Accuracy. 

1)  Root Cause Analysis

The first step in drilling down to the root cause of this Quality Measure is to understand how the measure is calculated.  This Long Stay Quality Measure is calculated and used both in the Five Star reporting system and the Public Reporting Nursing Home Compare website. The measure specifically focuses on High Risk Residents who have Stage 2 up to Stage 4 Pressure Ulcers (Injuries). 

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