Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - News on Dr. Levine's medical and consulting practice, and reflections on our healthcare system.

Category: Long-Term Care

New Government Report on Dying in America has Implications for Wound Care

A recently released report on Dying in America has important implications for the standard of care for persons with chronic wounds who are approaching life’s end. It was published by the prestigious Institute of Medicine and written by a panel of recognized experts on the topic of end-of-life care. The Institute is the health arm of the National Academy of Sciences and acts under a …Read More

Webinar on Wound Care for Medical Directors in LTC

Later this month I will be giving a free webinar sponsored by McKnights Long-Term Care News & Assisted Living entitled Wound Care: What the Medical Director Needs to Know. This Webinar will be part of McKnights 8th Online Expo, that will feature other webinar topics including MDS 3.0 update, technology in LTC, and survey preparation.  McKnight’s Long-Term Care News is a news magazine serving the institutional …Read More

Research Links Nursing Home Staffing to Death from Viral Gastroenteritis

Low staffing levels in nursing homes have long been linked to adverse outcomes such as pressure ulcers, urinary tract infections (UTIs), weight loss, dehydration, and deterioration in ADL’s, but new research published in the latest issue of the Journal of the American Medical Association links mortality from viral gastroenteritis to nurse-to-patient ratios. This is the first time this outcome is linked to RN staffing levels …Read More

Healthcare Reform Provision Helps Lawsuits Against Nursing Homes

A little known provision of President Obama’s Healthcare Reform Act is designed to help plaintiffs and their attorneys bring legal action against nursing homes for alleged neglect and abuse.  With the demographic transformation of America toward an aging society, lawsuits against nursing homes have surged.  In response some privately owned nursing homes have developed complex corporate structures that obscure who controls the facilities, making it difficult for attorneys …Read More

Downloadable Resources for MDS 3.0 Section M: Skin Conditions

I received so many inquiries about resources for skin assessment in the nursing home that I devoted this blog post to providing links and downloads useful to wound care clinicians.  Below you can access PDFs which contain important information related to skin, pressure ulcer, and wound assessment that will be helpful to nurses, doctors, medical directors, inservice directors, MDS coordinators, and anyone else interested in this very important topic.  As you probably know, …Read More

Teaching America How to Assess Wounds

Last week I presented at the Center for Medicare and Medicaid Service’s (CMS) Train-the-Trainer program in Las Vegas for the introduction of Minimum Data Set (MDS) 3.0 which will go into effect October 1, 2010.  This assessment tool will impact 17,000 nursing homes and 1.6 million people who reside in them across America.  My assignment was to introduce Section M: Skin Condition, which represents the assessment for pressure …Read More

Long-Term Care Update: Resident Assessment Radically Changes with MDS 3.0

Hear ye!  Hear Ye!  RAPs are out!  CATs and CAAs are in! I chuckle as I write this blog post knowing that few of my regular readers will understand, and have probably clicked off by now.  But the few of you who remain know how important this topic is to long-term care.  On October 30, 2009 CMS finally released the RAI Users Manual V 3.0 which …Read More

Update on Blister Pressure Ulcer Staging from CMS for MDS 3.0 Section M: Skin Conditions

Another guest blog post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN Good news! Since the educational training programs held last March and April, CMS has reconsidered its original guidance regarding how to code blister pressure ulcers on the revised Minimum Data Set (MDS) version 3.0. Previously, CMS directed that any pressure ulcer that presents as a blister regardless of what type of …Read More

Elizabeth Ayello PhD, RN Blogs on MDS 3.0 sDTI Coding

Another guest post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN. I was pleased with the response to my first guest post on Dr. Levine’s healthcare blog.  One question in particular regarding suspected deep tissue injury (sDTI), written by Laura DiGiulio CWOCN, particularly deserves comment.  Laura asked: “I would like some guidance about how to integrate the new MDS3.0 guidelines related to staging …Read More

Long Term Care Preparing for MDS 3.0

Guest Post by Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN. Are you ready for the changes in MDS 3.0, Section M: Skin Condition? Having just developed the slide materials and provided the instruction on this for the CMS “Train the Trainer” programs in April 2010, I strongly believe that because section M is expanded to three pages, now is the time for clinicians, …Read More