In February 2013, the Office of Inspector General (OIG) released a report entitled Skilled Nursing Facilities Often Fail to Meet Care Planning Requirements, in which they found that 26% of facilities fail to meet care planning requirements. Is your facility meeting federal guidelines for care planning? This presentation discusses the important link between the MDS 3.0, the Care Area Assessments (CAAs) and the care plan. Learn the essential components of a resident-centered care plan, how to develop a care plan that supports the clinical care that is provided to the patient, and how to proactively maintain a care plan that will meet annual survey requirements. The presentation discusses strategies for completing the CAAs more effectively, and how the CAA process can be used to create a more resident-specific care plan. Learn to develop a resident centered known as ( I careplan) through a workshop discussing different elements of the careplan, from profile, interim, and diagnosis.
1. Gain an understanding of the purpose of a Care Plan.
2. Learn to define the purpose of the discharge Care Plan and Summary.
3. Learn to to articulate the link between the MDS 3.0 assessment, the nursing Care Plan, the discharge Care Plan, and accurate RUG-IV classification.
4. Understand the the correlation between the MDS 3.0 assessment, the Care Area Assessments (CAAs), and the Care Plan.
This document discusses intravenous (IV) fluids, including their composition and uses. It covers:
- Body water content and its compartments, including intracellular and extracellular fluid.
- Homeostatic mechanisms that regulate fluid levels, including ADH, renin-angiotensin system, and aldosterone.
- Common IV fluid types like normal saline, Hartmann's solution, dextrose, and their indications. Normal saline can cause hyperchloremic acidosis in large volumes.
- Guidelines for calculating fluid maintenance needs and deficits to replace through IV fluids over 1-2 days while monitoring the patient's response. Potassium needs special consideration due to risks of too rapid administration.
Le Comptoir OCTO - ChatGPT : Menace ou opportunité ?OCTO Technology
Par Nicolas Cavallo (Head of Natural Language Processing @OCTO Technology)
Vous aussi, votre grand-mère vous a parlé de chatGPT ? Ce perroquet, qualifié d’approximatif, a rendu public et accessible les modèles de langages conversationnels. Rejoignez nos experts pour un échange ouvert et interactif, où nous détaillerons l’histoire et le fonctionnement de ces modèles pour appréhender au mieux les opportunités et les défis que présente ChatGPT.
Vidéo Youtube : https://www.youtube.com/watch?v=WsVOoiSeL_I&list=PLBD8R108T9T4D3mcLiDpT67f9ERg1Hm2r&index=44
Compte-rendu : https://blog.octo.com/compte-rendu-le-comptoir-octo-chatgpt/
Short and brief presentation of anatomy, physiology , disorder and management of parathyroid glands.
management of MEN syndrome, hyper and hypoparathyroidism.
disorder of calcium metabolism like tetany,.
surgical steps of parathyroidectomy with indication and complications
This document summarizes hypocalcemia in goats and sows. It describes the condition as acute hypocalcemia around the time of parturition, characterized by nervous system signs like ataxia and recumbency. Causes include low serum calcium due to heavy lactation demands, low parathyroid function, and estrogen effects. Treatment involves calcium supplementation, such as calcium borogluconate intravenously. Prevention focuses on dietary calcium intake and vitamin D supplementation in the weeks before parturition.
How to care plan: when, where, how, why, who. Learm how to create person centered care plans that imporve quality of life, satisfy regulators, and make areal difference
The management of the Minimum Data Set (MDS) 3.0 assessment schedule is complex and time consuming. Combining scheduled MDS assessments with unscheduled Prospective Payment System (PPS) Other Medicare Required Assessments (OMRAs) correctly will lead to accurate reimbursement and can ease the MDS workflow burden on the entire team, and save the facility costly mistakes due to noncompliance. Practitioners need to know what to do if the MDS schedule is not followed correctly, and how to regain compliance with the schedule as quickly as possible. This presentation reviews the scheduled and unscheduled PPS assessment requirements and describe how to select and set Assessment Reference Dates (ARDs) strategically and accurately. The presentation also discusses implications of not following the assessment schedule correctly, and how to regain compliance once an error in assessment scheduling is discovered. The Correction Process of existing MDS assessments, including modification, inactivation, and manual correction request will be discussed. This all-important information will help the MDS coordinator to maintain and regain federal compliance with the PPS assessment schedule.
1. Learn to outline the scheduled PPS assessment schedule and unscheduled PPS assessment requirements and explain the correct Assessment Reference Date selection for each assessment type.
2. Learn to state the correct application of default or provider liable days for an early, late, or missed scheduled or unscheduled assessment.
3. Learn to identify the appropriate use of the Start of Therapy OMRA, End of Therapy OMRA, End of Therapy-Resumption OMRA, and Change of Therapy OMRA.
4. Learn the eight criteria for a Medicare Short-Stay assessment.
5. Learn to identify the difference between a MDS modification and a MDS inactivation and recognize when to choose modification or inactivation.
This document discusses intravenous (IV) fluids, including their composition and uses. It covers:
- Body water content and its compartments, including intracellular and extracellular fluid.
- Homeostatic mechanisms that regulate fluid levels, including ADH, renin-angiotensin system, and aldosterone.
- Common IV fluid types like normal saline, Hartmann's solution, dextrose, and their indications. Normal saline can cause hyperchloremic acidosis in large volumes.
- Guidelines for calculating fluid maintenance needs and deficits to replace through IV fluids over 1-2 days while monitoring the patient's response. Potassium needs special consideration due to risks of too rapid administration.
Le Comptoir OCTO - ChatGPT : Menace ou opportunité ?OCTO Technology
Par Nicolas Cavallo (Head of Natural Language Processing @OCTO Technology)
Vous aussi, votre grand-mère vous a parlé de chatGPT ? Ce perroquet, qualifié d’approximatif, a rendu public et accessible les modèles de langages conversationnels. Rejoignez nos experts pour un échange ouvert et interactif, où nous détaillerons l’histoire et le fonctionnement de ces modèles pour appréhender au mieux les opportunités et les défis que présente ChatGPT.
Vidéo Youtube : https://www.youtube.com/watch?v=WsVOoiSeL_I&list=PLBD8R108T9T4D3mcLiDpT67f9ERg1Hm2r&index=44
Compte-rendu : https://blog.octo.com/compte-rendu-le-comptoir-octo-chatgpt/
Short and brief presentation of anatomy, physiology , disorder and management of parathyroid glands.
management of MEN syndrome, hyper and hypoparathyroidism.
disorder of calcium metabolism like tetany,.
surgical steps of parathyroidectomy with indication and complications
This document summarizes hypocalcemia in goats and sows. It describes the condition as acute hypocalcemia around the time of parturition, characterized by nervous system signs like ataxia and recumbency. Causes include low serum calcium due to heavy lactation demands, low parathyroid function, and estrogen effects. Treatment involves calcium supplementation, such as calcium borogluconate intravenously. Prevention focuses on dietary calcium intake and vitamin D supplementation in the weeks before parturition.
How to care plan: when, where, how, why, who. Learm how to create person centered care plans that imporve quality of life, satisfy regulators, and make areal difference
The management of the Minimum Data Set (MDS) 3.0 assessment schedule is complex and time consuming. Combining scheduled MDS assessments with unscheduled Prospective Payment System (PPS) Other Medicare Required Assessments (OMRAs) correctly will lead to accurate reimbursement and can ease the MDS workflow burden on the entire team, and save the facility costly mistakes due to noncompliance. Practitioners need to know what to do if the MDS schedule is not followed correctly, and how to regain compliance with the schedule as quickly as possible. This presentation reviews the scheduled and unscheduled PPS assessment requirements and describe how to select and set Assessment Reference Dates (ARDs) strategically and accurately. The presentation also discusses implications of not following the assessment schedule correctly, and how to regain compliance once an error in assessment scheduling is discovered. The Correction Process of existing MDS assessments, including modification, inactivation, and manual correction request will be discussed. This all-important information will help the MDS coordinator to maintain and regain federal compliance with the PPS assessment schedule.
1. Learn to outline the scheduled PPS assessment schedule and unscheduled PPS assessment requirements and explain the correct Assessment Reference Date selection for each assessment type.
2. Learn to state the correct application of default or provider liable days for an early, late, or missed scheduled or unscheduled assessment.
3. Learn to identify the appropriate use of the Start of Therapy OMRA, End of Therapy OMRA, End of Therapy-Resumption OMRA, and Change of Therapy OMRA.
4. Learn the eight criteria for a Medicare Short-Stay assessment.
5. Learn to identify the difference between a MDS modification and a MDS inactivation and recognize when to choose modification or inactivation.
This document discusses missed opportunities in skilled nursing facilities related to therapy services. It identifies nurses having control over documentation as the number one missed opportunity, since nursing documentation is essential for justifying skilled care. Rehabilitation departments are identified as the number two missed opportunity, as they function as a business within the business but are often underutilized. Incomplete therapy documentation is identified as the number three missed opportunity, as it can result in denied claims and violates standards of practice. The document provides tips for improving documentation to support skilled care and medical necessity.
One of the major goals in MDS 3.0 is to give residents and families a more active voice in the care delivered. Interviewing processes are provided in the MDS 3.0 RAI user’s manual to help caregivers obtain quality, accurate information from patients with focused scripted interview questions. This presentation discusses techniques for interviewing that will assist with achieving more accurate data for physical therapy care and MDS coding. The presentation reviews key sections of the MDS that are coded based on direct patient interviews.
1. Learn to identify the MDS Sections which are coded based on scripted resident interview.
2. Learn to describe three specific techniques that can be used to achieve accurate interview results.
3. Gain an understanding of key RUG reimbursement and quality measure impacts of the resident interviews.
4. Learn to summarize strategies for utilization of resident interview data to drive quality of care and improve quality of life in the SNF.
Proposed Reform of Requirements for LTC FacilitiesBrett Seekins
We propose to add a requirement that facilities must employ or obtain the services of a physician
assistant or nurse practitioner to the extent necessary to meet resident needs.
Physician Delegation of Tasks: We propose to clarify that physicians may delegate tasks to physician assistants,
nurse practitioners, and other qualified health professionals under State law.
Physician Visits: We propose to modify the requirements for physician visits to require that the physician
document the rationale for determining the medical care and treatment of each resident at the time of each visit.
Physician Orders: We propose to require that physician orders be legible, clear, concise, specific, and limited in
duration to the expected period of need.
Physician
This document discusses the need for person-centered care approaches in long term care settings for individuals with dementia. It outlines key concepts of person-centered care including validating individual experiences and meeting underlying needs to reduce behaviors. Effective training models like VIPS and assessments like Dementia Care Mapping are described. Barriers to implementation include staff turnover, but research shows person-centered care can improve outcomes for residents and staff.
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
Top 10 mds coordinator interview questions and answersrichforido
The document provides resources for preparing for an MDS coordinator interview, including common interview questions, examples, and tips. It lists 10 frequently asked interview questions for an MDS coordinator role and provides detailed answers for each. Additionally, it provides many links to ebooks and articles on the website topinterviewquestions.info that cover additional interview questions, preparation materials, and other useful resources for the MDS coordinator interview process.
Meaningful Use Stage Two: The Future of Care CoordinationGreenway Health
The future of Meaningful Use has many over-arching effects on the health care industry beyond Stage Two measures. Care coordination teams, technology partnerships, data capture, practice redesign, and provider assessment are a few others to be considered when moving forward.
Presentation made by Lynne Seward, CEO, A Grace Place Adult Care Center and Jay White, MS, Virginia Commonwealth University, Department of Gerontology, October 31, 2012. Review recording of webinar at www.alzpossible.org
This presentation was developed by the Texas Culture Change Coalition to serve as a tool to inform others about the background and principles of culture change in long term care.
Please feel free to use it as a whole or in part to inform others about the benefits of culture change.
Coding of activities of daily living (ADLs) on the MDS is complex and often misunderstood by those engaged in completing the assessment. In addition to affecting care, public information and survey, this area of the MDS has a tremendous financial impact. During this session, the speaker will define the late loss ADLs and provide insights aimed at helping facility staff document resident status accurately. Calculating the ADL score for the RUG-IV system will be reviewed and implications of inappropriate coding will be demonstrated. Using dollar-impact case studies, the attendee will learn why this section is critical for the facility’s financial success.
This document discusses different methods of nursing documentation. It describes narrative documentation, problem-oriented medical records (POMR), SOAP/IER notes, PIE notes, and focus charting. It also defines different types of nursing diagnoses like actual, risk, and potential complications. Nursing documentation is an important part of ensuring high-quality patient care. Proper documentation includes recording assessments, care provided, and evaluation of outcomes.
This nursing care plan document contains sections for demographic data, medical history, investigations, medications, nursing care plan, health education provided, and records of nursing notes. The nursing care plan section lists assessment of the patient, nursing diagnoses identified, goals of care, plans for intervention, and rationales. This document aims to comprehensively outline all relevant clinical information and nursing interventions for a patient during their admission and recovery.
Based on the information provided:
- Mrs. Tigist's drug-related need is for effective treatment of her depression
- Recommending an OTC sleep aid would not meet this need and could potentially cause harm
- The appropriate action would be to advise Mrs. Tigist that her symptoms suggest she may be depressed and recommend she see her physician for evaluation and treatment
The document discusses various uses and guidelines for medical record documentation. It covers tracking patient progress, sharing information between providers, maintaining patient confidentiality, ensuring quality of care through audits, meeting requirements for insurance reimbursement, using records for research, and providing legal evidence. Key aspects that must be documented include assessments, nursing diagnoses, interventions, patient responses and outcomes. The document also reviews different charting styles like SOAP and problem-oriented documentation.
The nursing care plan addresses a patient complaining of dizziness. It assesses the patient's risk for hypertension due to lack of disease knowledge. The diagnosis is risk for hypertension. The plan includes defining hypertension and its treatment regimen to the patient, identifying modifiable risk factors like diet and stress, and suggesting lifestyle changes to control blood pressure such as rest, exercise, and limiting sodium and caffeine. The rationale is to educate the patient and decrease risk of end-organ damage from long-term high blood pressure. The evaluation will assess the patient's understanding after interventions.
This document discusses recreation and activities for older adults in long-term care facilities. It outlines the purposes of activities, which include obtaining well-being, self-esteem, pleasure and fulfillment. Activities, social services and rehabilitation all aim to maximize independence, self-esteem and quality of life. Activities differ in allowing more personal choice, while social services and rehabilitation focus more on intervention. Programming considerations include residents' ages, abilities and needs. Activities should promote total well-being through physical, cognitive, social, emotional and spiritual engagement. Evaluation ensures programming meets expected outcomes and improves quality. Volunteers are an important part of linking residents to the community.
In February 2013, the Office of Inspector General (OIG) released a report entitled Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements, in which they found that 26% of facilities fail to meet care planning and discharge planning requirements. Is your facility meeting federal guidelines for care planning?
Download the ABC’s of Care Planning presented by Beckie Dow, RN, RAC-MT for an overview of Care Planning in the Skilled Nursing Facility. Beckie discusses the important link between the MDS 3.0, the Care Area Assessments (CAAs) and the Care Plan.
Learn the essential components of a resident-centered care plan and how to develop a care plan that supports the clinical care that is provided to the patient. Beckie also discusses strategies for completing the CAAs more effectively and using the CAA process to create a more resident-specific care plan.
Learn How To:
1. Define the purpose of a Care Plan.
2. Define the purpose of the Discharge Care Plan and Summary.
3. Identify the correlation between the MDS 3.0 Assessment, the Care Area Assessments (CAAs), accurate RUG-IV Classification, and the Care Plan.
4. List three components of a Resident-centered Care Plan.
Partnering for Population Health: Strategies to Promote Collaboration Among t...Conifer Health Solutions
A patient-centered approach to care delivery will bring the best health outcomes for individuals, as well as the community. While it is clear that effective population health management is integral to better health, providers can no longer be the sole proprietors of data and information. Improving a population’s health will depend on strong alliances with community stakeholders that generally have not experienced a strong history of collaboration. In the new healthcare landscape, providers, payers and employers must partner to reduce cost, boost quality and improve the health of their shared populations. These new partnerships may start with a few glitches. However a strategic plan, clear objectives and an engaged, informed patient will smooth the path to improved outcomes.
This document discusses missed opportunities in skilled nursing facilities related to therapy services. It identifies nurses having control over documentation as the number one missed opportunity, since nursing documentation is essential for justifying skilled care. Rehabilitation departments are identified as the number two missed opportunity, as they function as a business within the business but are often underutilized. Incomplete therapy documentation is identified as the number three missed opportunity, as it can result in denied claims and violates standards of practice. The document provides tips for improving documentation to support skilled care and medical necessity.
One of the major goals in MDS 3.0 is to give residents and families a more active voice in the care delivered. Interviewing processes are provided in the MDS 3.0 RAI user’s manual to help caregivers obtain quality, accurate information from patients with focused scripted interview questions. This presentation discusses techniques for interviewing that will assist with achieving more accurate data for physical therapy care and MDS coding. The presentation reviews key sections of the MDS that are coded based on direct patient interviews.
1. Learn to identify the MDS Sections which are coded based on scripted resident interview.
2. Learn to describe three specific techniques that can be used to achieve accurate interview results.
3. Gain an understanding of key RUG reimbursement and quality measure impacts of the resident interviews.
4. Learn to summarize strategies for utilization of resident interview data to drive quality of care and improve quality of life in the SNF.
Proposed Reform of Requirements for LTC FacilitiesBrett Seekins
We propose to add a requirement that facilities must employ or obtain the services of a physician
assistant or nurse practitioner to the extent necessary to meet resident needs.
Physician Delegation of Tasks: We propose to clarify that physicians may delegate tasks to physician assistants,
nurse practitioners, and other qualified health professionals under State law.
Physician Visits: We propose to modify the requirements for physician visits to require that the physician
document the rationale for determining the medical care and treatment of each resident at the time of each visit.
Physician Orders: We propose to require that physician orders be legible, clear, concise, specific, and limited in
duration to the expected period of need.
Physician
This document discusses the need for person-centered care approaches in long term care settings for individuals with dementia. It outlines key concepts of person-centered care including validating individual experiences and meeting underlying needs to reduce behaviors. Effective training models like VIPS and assessments like Dementia Care Mapping are described. Barriers to implementation include staff turnover, but research shows person-centered care can improve outcomes for residents and staff.
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
Top 10 mds coordinator interview questions and answersrichforido
The document provides resources for preparing for an MDS coordinator interview, including common interview questions, examples, and tips. It lists 10 frequently asked interview questions for an MDS coordinator role and provides detailed answers for each. Additionally, it provides many links to ebooks and articles on the website topinterviewquestions.info that cover additional interview questions, preparation materials, and other useful resources for the MDS coordinator interview process.
Meaningful Use Stage Two: The Future of Care CoordinationGreenway Health
The future of Meaningful Use has many over-arching effects on the health care industry beyond Stage Two measures. Care coordination teams, technology partnerships, data capture, practice redesign, and provider assessment are a few others to be considered when moving forward.
Presentation made by Lynne Seward, CEO, A Grace Place Adult Care Center and Jay White, MS, Virginia Commonwealth University, Department of Gerontology, October 31, 2012. Review recording of webinar at www.alzpossible.org
This presentation was developed by the Texas Culture Change Coalition to serve as a tool to inform others about the background and principles of culture change in long term care.
Please feel free to use it as a whole or in part to inform others about the benefits of culture change.
Coding of activities of daily living (ADLs) on the MDS is complex and often misunderstood by those engaged in completing the assessment. In addition to affecting care, public information and survey, this area of the MDS has a tremendous financial impact. During this session, the speaker will define the late loss ADLs and provide insights aimed at helping facility staff document resident status accurately. Calculating the ADL score for the RUG-IV system will be reviewed and implications of inappropriate coding will be demonstrated. Using dollar-impact case studies, the attendee will learn why this section is critical for the facility’s financial success.
This document discusses different methods of nursing documentation. It describes narrative documentation, problem-oriented medical records (POMR), SOAP/IER notes, PIE notes, and focus charting. It also defines different types of nursing diagnoses like actual, risk, and potential complications. Nursing documentation is an important part of ensuring high-quality patient care. Proper documentation includes recording assessments, care provided, and evaluation of outcomes.
This nursing care plan document contains sections for demographic data, medical history, investigations, medications, nursing care plan, health education provided, and records of nursing notes. The nursing care plan section lists assessment of the patient, nursing diagnoses identified, goals of care, plans for intervention, and rationales. This document aims to comprehensively outline all relevant clinical information and nursing interventions for a patient during their admission and recovery.
Based on the information provided:
- Mrs. Tigist's drug-related need is for effective treatment of her depression
- Recommending an OTC sleep aid would not meet this need and could potentially cause harm
- The appropriate action would be to advise Mrs. Tigist that her symptoms suggest she may be depressed and recommend she see her physician for evaluation and treatment
The document discusses various uses and guidelines for medical record documentation. It covers tracking patient progress, sharing information between providers, maintaining patient confidentiality, ensuring quality of care through audits, meeting requirements for insurance reimbursement, using records for research, and providing legal evidence. Key aspects that must be documented include assessments, nursing diagnoses, interventions, patient responses and outcomes. The document also reviews different charting styles like SOAP and problem-oriented documentation.
The nursing care plan addresses a patient complaining of dizziness. It assesses the patient's risk for hypertension due to lack of disease knowledge. The diagnosis is risk for hypertension. The plan includes defining hypertension and its treatment regimen to the patient, identifying modifiable risk factors like diet and stress, and suggesting lifestyle changes to control blood pressure such as rest, exercise, and limiting sodium and caffeine. The rationale is to educate the patient and decrease risk of end-organ damage from long-term high blood pressure. The evaluation will assess the patient's understanding after interventions.
This document discusses recreation and activities for older adults in long-term care facilities. It outlines the purposes of activities, which include obtaining well-being, self-esteem, pleasure and fulfillment. Activities, social services and rehabilitation all aim to maximize independence, self-esteem and quality of life. Activities differ in allowing more personal choice, while social services and rehabilitation focus more on intervention. Programming considerations include residents' ages, abilities and needs. Activities should promote total well-being through physical, cognitive, social, emotional and spiritual engagement. Evaluation ensures programming meets expected outcomes and improves quality. Volunteers are an important part of linking residents to the community.
In February 2013, the Office of Inspector General (OIG) released a report entitled Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements, in which they found that 26% of facilities fail to meet care planning and discharge planning requirements. Is your facility meeting federal guidelines for care planning?
Download the ABC’s of Care Planning presented by Beckie Dow, RN, RAC-MT for an overview of Care Planning in the Skilled Nursing Facility. Beckie discusses the important link between the MDS 3.0, the Care Area Assessments (CAAs) and the Care Plan.
Learn the essential components of a resident-centered care plan and how to develop a care plan that supports the clinical care that is provided to the patient. Beckie also discusses strategies for completing the CAAs more effectively and using the CAA process to create a more resident-specific care plan.
Learn How To:
1. Define the purpose of a Care Plan.
2. Define the purpose of the Discharge Care Plan and Summary.
3. Identify the correlation between the MDS 3.0 Assessment, the Care Area Assessments (CAAs), accurate RUG-IV Classification, and the Care Plan.
4. List three components of a Resident-centered Care Plan.
Partnering for Population Health: Strategies to Promote Collaboration Among t...Conifer Health Solutions
A patient-centered approach to care delivery will bring the best health outcomes for individuals, as well as the community. While it is clear that effective population health management is integral to better health, providers can no longer be the sole proprietors of data and information. Improving a population’s health will depend on strong alliances with community stakeholders that generally have not experienced a strong history of collaboration. In the new healthcare landscape, providers, payers and employers must partner to reduce cost, boost quality and improve the health of their shared populations. These new partnerships may start with a few glitches. However a strategic plan, clear objectives and an engaged, informed patient will smooth the path to improved outcomes.
Under the scrutiny of review, rehabilitation and nursing documentation must support skilled coverage criteria. This presentation covers skilled coverage criteria and documentation by rehabilitation professionals and nursing to support clinically appropriate levels of care.
1. Learn to define skilled coverage criteria.
2. Learn to define key elements of documentation.
3. Learn examples of rehabilitation and nursing documentation to support Medicare coverage criteria.
This presentation provides a comprehensive pro-active review of program development for long-term care patients in the SNF. The course outlines suggestions for how rehabilitation team members can strengthen the Medicare Part B programming in the nursing facility. An overview of the Medicare Part B Guidelines, Part B Caps, Functional Limitation G-Codes, and Manual Reviews is also provided. The presentation also discusses Medicare Part B documentation, goal writing and reasons for denied claims.
1. Gain an understanding of Proactive Medicare Part B Program Development and how to strengthen the program components.
2. Gain a better understanding of Medicare Part B documentation components, goal writing and potential risk for receiving denied claims.
3. Gain an understanding of Medicare Part B Guidelines, Medicare Part B Caps, Functional Limitation G-Codes and Medical Reviews.
Readmissions are a heightened focus under the Affordable Care Act. Initiatives are in place to reduce hospital admission through improving transition in care. During this course the speaker will discuss CMS quality initiatives, care transition, projects and barriers. This presentation reviews the key elements to tackling Avoidable Readmissions.
1. Learn to summarize the CMS quality initiative for healthcare reform related to hospital readmissions
2. Learn to identify underlying causes and barriers related to readmissions
3. Learn to state current CMS research projects and pilot programs
4. Learn to identify hospital and SNF strategies for collaboration
This document provides information about the Medicare appeals process from additional development requests (ADRs) to administrative law judge (ALJ) hearings. It includes biographies of the two speakers, Elisa Bovee and Carrie Mullin, who have extensive experience in long-term care and denials management. The document outlines the different levels of the Medicare appeals process and provides guidance on responding to ADRs and preparing appeal packages to contest claim denials.
Can your Skilled Nursing Facility (SNF) afford to provide care to Medicare patients and not receive accurate and appropriate reimbursement? The resources utilized to respond to additional documentation requests, manage denials and the loss of revenue for care provided can have a devastating impact on your facilities budget. In addition, early identification of potential issues and prompt resolution of actual issues reduces a facilities risk of hefty fines and penalties related to non-compliance.
Skilled Nursing Facilities are required to have a compliance program effective March 2013. Compliance programs strengthen and document a SNFs efforts to prevent and reduce Medicare fraud and abuse and ensure accurate and appropriate reimbursement for quality care provided. Under SNF compliance regulations Medicare has redefined the definition of fraud. When a facility has not taken all the necessary steps to ensure all the technical and clinical qualifications are supported by your medical records to prevent improper billing, fines and penalties may be applied. The critical components of an effective compliance program include monitoring and auditing to ensure Skilled Nursing Facility provider's have a formalized and proactive approach towards detecting fraud, abuse, and waste of precious company resources.
This presentation includes a detailed review of changes and updates discussed to the MDS 3.0 item set effective October 1, 2013. The presentation provides an overview of the most recent MDS 3.0 User’s Manual updates and reviews key elements for MDS coding, which will impact reimbursement based on the Federal Regulations in the FY 2014 Final Rule.
This New York Medicaid Nursing Facility Case Mix Seminar discusses the necessary documentation needed to support the assigned Medicaid RUG to ensure accurate reimbursement for care provided. New York OMIG Auditors are focused on auditing "high risk" Medicaid Case Mix MDSs for Nursing Facilities with a change in CMI by more than five percent for 2012.
1. Learn to identify the specific components of NY RUG-III 53 categories.
2. Learn to identify high risk NY RUG-III 53 categories.
3. Learn to identify documentation requirements to support the RUG components.
4. Learn to identify strategies for organization of the Medical Record in preparation for OMIG Audits.
The presentation details the value of standardized therapy assessment as it relates to patient care treatment planning and evidencing Medicare audits. Standardized assessments can help evidence your patients’ progress. In addition, standardized assessment can better define deficits and assist in treatment planning.
1. Learn to identify the Benefits of utilizing Standardized assessments
2. Learn to summarize appropriate use of standardized therapy assessments
3. Learn the reasons standardized assessments can be used to evidence progress and support Medicare Part G-codes
Skilled Nursing Facilities have seen a significant increase in Medicare Part A and Part B Therapy denials. The goal of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation. The speaker will begin this seminar by discussing recent national trends in Medical Review, Reasons for increased review and the various Medical Review programs. The speaker will present specific denial trends with examples of denial statements. The presentation will culminate in a review of the keys to responding to a medical record request and appeal tips and strategies.
“Documentation not supportive of the RUG-IV classification billed…” is cited as the reason for multiple post-payment medical record review denials. Accurate and concise documentation to support the RUG-IV classification billed is a critical element in gaining accurate reimbursement, and supporting that reimbursement level during a medical review. This presentation covers the technical and clinical requirements for Medicare coverage, and requirements of skilled nursing documentation. The presentation identifies areas of the MDS 3.0 that are vulnerable to error and critical to accurate RUG-IV classification and identify strategies for better supporting these areas in medical record documentation. The correlation between the MDS 3.0 assessment and publicly reported information for the Quality Measures and 5 Star Quality Reporting are discussed.
1. Learn to describe the technical and clinical requirements for Medicare coverage.
2. Understand the goal of supportive skilled nursing documentation.
3. Develop a clear understanding of accurate coding in Section M.
4. Learn to identify sections of the MDS 3.0 assessment that are vulnerable to error and articulate strategies to support these areas in medical record documentation.
5. Learn to identify the correlation between medical record documentation, the MDS 3.0, and publicly reported information for the Quality Measures and 5 Star Quality Rating.
Skilled Nursing Facilities have seen a significant increase in Medicare Part A and Part B Therapy denials. The goal of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation. The speaker will begin this seminar by discussing recent national trends in Medical Review, reasons for increased review and the various Medical Review programs. The speaker will present specific denial trends associated with Medicare Part B Claims. The presentation will culminate in a review of the keys to responding to a medical record request and appeal tips and strategies.
Coding of activities of daily living (ADLs) on the MDS is complex and often misunderstood by those engaged in completing the assessment. In addition to affecting care, public information and survey, this area of the MDS has a tremendous financial impact. This presentation defines late loss ADLs and provide insights aimed at helping facility staff document resident status accurately. Calculating the ADL score for the RUG-IV system is reviewed and implications of inappropriate coding will be demonstrated.
This presentation provides a comprehensive review and forecast of the trends in Medicare Medical Review by numerous Medicare Contractors and is appropriate for all SNF Management, nursing staff, and therapy professionals. The presentation provides insight on the tidal wave of newly exposed compliance issues at the eye of the storm, leading to remote and on-site audits in the long-term care industry. Presentation highlights the historical drought in audits and the tornado effect the current scrutiny is causing amongst the SNF providers. Learn strategies to prepare records before the impending audit storm. Avoid slip ups on the seemingly invisible black ice of Medicare non-compliance. Become aware of the most recent CMS updates impacting the RAI process and subsequently reimbursement. Create an anemometer for Managers and staff to read the winds of change and create clear visibility for accurate and compliant records.
1. Learn to summarize the multiple types of Medicare Contractor Audits and associated Compliance themes.
2. Understand the trends and triggers in Compliance Audits and Common Provider Pitfalls.
3. Learn strategies for appealing Medicare Claim Denials.
Provisions set forth in the Affordable Care Act (ACA) require the Centers for Medicare and Medicaid Services (CMS) to broaden quality improvement activities in nursing homes. Although the mandatory implementation date for nursing homes to provide evidence of a systematic Quality Assurance and Performance Improvement (QAPI) program has been delayed, but facilities should not delay in implementing a detailed and well-documented QAPI program. This presentation moves beyond the five elements of a QAPI and begins to drill down to practical concepts for “beefing up” an existing Quality Improvement program to meet QAPI standards. Learn how to objectively assess where your facility is in the QAPI journey, and gain a deeper insight into how practical implementation of QAPI activities can be a part of the culture of excellence that is part of all successful nursing homes.
1. Learn to detail the five elements of QAPI and correlate the five elements to the twelve step action plan for QAPI implementation.
2. Learn to articulate the steps to evaluating their facilities progress in QAPI efforts.
3. Understand Performance Improvement Projects (PIPs).
4. Learn the five steps of Root Cause Analysis (RCA) and learn how to apply the RCA process to adverse events in their facility routinely.
Drug Medi-Cal's ODS Waiver: Is Your Organization Ready for the Next Steps?Epstein Becker Green
Webinar presented by Kathryn F. Edgerton (Partner, Nelson Hardiman) and attorney Kevin J. Malone (Epstein Becker Green).
Part of a "first Thursdays" fall webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/one-in-three-californians-is-a-medi-cal-beneficiary-is-your-organization-ready-for-the-next-steps-in-drug-medi-cals-ods-waiver/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
The market shift toward value-based care presents unprecedented opportunities and challenges for the US health care system. Instead of rewarding volume, new
value-based payment models reward better results in terms of cost, quality, and outcome measures. These largely untested models have the potential to upend health care stakeholders’ traditional patient care and business models.
CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
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On July 31, 2014, the Centers for Medicare and Medicaid Services (CMS) issued the Final Rule under the Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities to be implemented on October 1, 2014. This seminar will discuss the impact of Fiscal Year 2015 Medicare payment rate increases for Skilled Nursing Facilities (SNFs) and will review the most recent Office of Management and Budget (OMB) statistical area delineations affecting the SNF PPS Wage Index. Learn about the revision to the existing COT OMRA policy. Additionally attendees will be apprised of updates to Chapter 8, Section 30 of the Medicare Benefit Policy Manual (Pub. 100-02) which directs providers on coverage decisions for reasonable and necessary treatment of patient’s illness or injury.
This document discusses strategies for appealing denied Medicare claims. It begins with an introduction to the presenter, Carrie Mullin, and her experience reviewing denied claims. The objectives are then outlined as understanding Medicare medical review goals, identifying documentation to support skilled care, and strategies for appeals. The document goes on to list common denial reasons from Medicare and provides suggestions for additional documentation to address potential denial issues in an appeal. It emphasizes understanding Medicare guidelines and policies to effectively argue that skilled services were necessary.
The Skilled Nursing Facility (SNF) “Program for Evaluating Payment Patterns Electronic Report” (PEPPER) was released in April 2014 by CMS. Join Keri Hart, MS, CCC-SLP, CHHRP-QT, RAC-CT, in this in-depth interpretation of the elements of the PEPPER. Keri will detail how to interpret your PEPPER and discuss the practical application of this critical information to your Skilled Nursing Facility’s practice. Follow along with your own PEPPER report to develop an action plan to ensure compliance with Medicare regulatory requirements and ensure accurate reimbursement for clinically appropriate care provided.
CMS introduced this new annual report for Skilled Nursing Facilities in August 2013. PEPPER data is shared with both Medicare Administrative Contractors (MACs) and the Medicare Recovery Audit Contractors (RACs). This important report details your facility-specific Medicare claims data in certain targeted areas and compares your facility to other SNFs Nationally, by State and by Jurisdiction (Medicare Administrative Contractors/Fiscal Intermediaries).
The Skilled Nursing Facility (SNF) “Program for Evaluating Payment Patterns Electronic Report” (PEPPER) was released in April 2014 by CMS. CMS introduced this new annual report for Skilled Nursing Facilities in August 2013. PEPPER data is shared with both Medicare Administrative Contractors (MACs) and the Medicare Recovery Audit Contractors (RACs). This important report details your facility-specific Medicare claims data in certain targeted areas and compares your facility to other SNFs Nationally, by State and by Jurisdiction (Medicare Administrative Contractors/Fiscal Intermediaries).
The goal of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation. The speaker will begin this seminar by discussing the goals of Medical Review and various Medical Review programs including Recovery Audit Contractor (RAC) and Carrier (Medicare Administrative Contractor or Fiscal Intermediary) Medical Review programs.
As digitization of the healthcare industry increases, the need to safeguard electronic patient data is also becoming increasingly important. Electronic protected health information (ePHI) is not just in the electronic medical records (EMRs). It also resides in emails, in documents and images on computers, servers, printer hard drives and mobile devices like laptops, cell phones, tablets and USB memory sticks. Healthcare professionals are also using texting and online file sharing services to conveniently share confidential information. The loss of this confidential patient health information is disastrous for patients and healthcare organizations.
Survey preparation is a never ending process and with the new QIS survey process in transition, it represents a new paradigm shift. This presentation will provide insight into key elements, tips and strategies that providers should use as part of their quality assurance survey preparation efforts. Learn from this multi-level licensed nursing home administrator with expertise in regulatory compliance sharing his lessons learned through the years.
This document summarizes a presentation about healthcare compliance for skilled nursing facilities (SNFs). It discusses the impact of Office of Inspector General (OIG) audits finding high rates of billing errors in SNF Medicare claims. It reviews the Program for Evaluating Payment Patterns Electronic Report (PEPPER), which analyzes SNF claims data to identify outlier facilities. It emphasizes the importance of SNFs developing compliance programs to regularly audit claims and ensure appropriate billing. It also notes increased government scrutiny of healthcare fraud and changes to false claims acts that expand liability for incorrect billing.
Improve participation and functional outcomes through creativity out of the gym. Functionally based treatment will ensure patients receive medically necessary physical therapy, occupational therapy and speech services. The presentation reviews practical application to Medicare requirements.
1. Learn to identify creative treatment strategies.
2. Learn to define Medicare coverage and Medicare documentation.
3. Learn to identify the clinical benefits of Functional Based Therapies.
Preventing falls in the SNF environment can be a challenge. Learn how to become a fall CSI and inspire your interdisciplinary team to meet the challenge of Falls Reduction. Improve patient care and survey outcomes.
1. Learn to detail the Benefit of Root Cause analysis.
2. Gain an understanding of the Fall Investigation process.
3. Develop a clear understanding of accurate coding in Section M.
4. Learn how to verbalize the benefit of interdisciplinary involvement and follow-up for Fall Events.
A comprehensive review of the Medicare appeal process. Appropriate for all SNF nursing staff, management, and therapy professionals. The presentation discusses the level of Medicare appeal, how facilities can thoroughly and timely manage the appeal process, and how facilities can participate in a successful ALJ hearing.
This document provides an overview and agenda for a presentation on successfully preventing and appealing denied Medicare claims. The presentation will cover audit triggers, contractor findings, medical record review preparedness, appeal tools, and strategies for successful appeals. It will discuss the admission documentation requirements, skilled care qualifications, and appeal processes to facilitate preventing and appealing denied claims.
The MDS 3.0 has an impact on every aspect of care in a LTC or SNF. Reimbursement, Quality Measures, Five Star rating, Care Planning, and resident-centered care all begin with an accurate, standardized, and reproducible assessment.
Download the MDS 3.0: A Guide To Coding Accuracy by Beckie Dow, RN, RAC-MT for an overview of MDS 3.0. Beckie reviews the MDS 3.0 sections most vulnerable to error, while highlighting strategies for increased accuracy. Beckie also provides the MDS scheduling clinical qualifiers for each of the 66 RUG-IV categories and examples of potential financial losses due to inaccurate coding.
Learn How To:
1. Identify three MDS 3.0 Sections vulnerable to error.
2. Identify strategies for accurate reimbursement through the MDS 3.0 process.
3. Articulate three recent MDS 3.0 Coding instruction updates.
Managing the medical complexities of patients with cognitive and behaviors requires an interdisciplinary approach to care. The presentation details strategies and hands-on examples of management techniques for practical application in the SNF setting to ensure patients receive medically necessary Rehabilitation and Nursing Service.
1. Learn to identify underlying deficits leading to Behaviors.
2. Learn to define interdisciplinary assessment techniques.
3. Learn Management Strategies.
Keep your MDS Coordinators and nursing staff up to speed in understanding the significance of accurate coding in section M and the required corresponding documentation. This presentation enables healthcare providers to provide quality healthcare through an understanding of wound coding in relationship to skin presentation for Section M on the MDS assessment.
1. Gain an understanding of the RAI User’s Manual intent of Section M.
2. Gain an understanding of the documentation required to support Coding in Section M.
3. Develop a clear understanding of accurate coding in Section M.
4. Learn to identify the significance of care planning and utilizing an interdisciplinary approach.
The Centers for Medicare and Medicaid Services (CMS) recently released S&C Memo 13-35-NH, which discusses the use of psychopharmacological medications and behavioral management in America’s Nursing Homes. The management of behavioral or psychological symptoms of dementia (BPSD) is a challenge in Nursing Homes. In this presentation viewers will learn valuable behavioral management techniques that can be utilized to decrease patient dependency on psychopharmacological medication. Important government initiatives, including The Partnership to Improve Dementia Care in Nursing Homes are discussed. The presentation also discusses the recent updates to interpretive guidelines of F309 (Quality of Care) and F329 (Unnecessary Drugs), and details the Seven Dementia Care Principles provided by CMS to assist nursing homes to manage behavioral or psychological symptoms of BPSD.
1. Learn the content of S&C Memo 13-35-NH and the implications of this memo on daily resident care
2. Learn to articulate the intent and impact of F309 and F329 on resident health and well-being, and identify strategies to maintain compliance with the regulatory intent of these regulations
3. Learn about the seven Dementia Care Principles provided by CMS to assist nursing homes to manage behavioral or psychological symptoms of BPSD
4. Identify the seven Dementia Care Principles provided by CMS to assist nursing homes to manage behavioral or psychological symptoms of BPSD
Managing the medical complexities of patients with cognitive and behaviors requires an interdisciplinary approach to care. The presentation details strategies and hands-on examples of management techniques for practical application in the SNF setting to ensure patients receive medically necessary Rehabilitation and Nursing Service.
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The RAI Process: CAAs, Care Planning and Beyond
1. The RAI Process:
CAAs, Care Planning and Beyond
HARMONY UNIVERSITY
The Provider Unit of
Harmony Healthcare International, Inc. (HHI)
Presented by:
Coleen Deschenes, RAC-CT
Regional Consultant
and
Christine Twombly, RN, RAC-MT, LHRM
Regional Consultant / Trainer