CMS Tightens Up Pressure Ulcer Classification in Long-term Care
Revised Minimum Data Set (MDS) 3.0 Section M: Skin Conditions greatly expands the process of skin assessment in nursing homes. The accompanying Resident Assessment Instrument (RAI) Instruction Manual has instructions on how to identify and code pressure ulcers and other wounds using a methodology that is explicitly stated. These instructions include the following: “If an ulcer arises from a combination of factors which are primarily …Read More
Updated Pressure Ulcer Guide Goes into Second Printing
The Document Dermis™ Pocket Guide to Pressure ulcers authored by myself and Elizabeth Ayello RN PhD has sold over 11,000 copies and is now going into its second printing. Published by the New Jersey Hospital Association, the new version has been updated with consideration of Centers for Medicare and Medicaid (CMS) staging guidelines and MDS 3.0: Skin Conditions, which applies to long-term care facilities. In …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
Determining the Avoidability of Pressure Ulcers
One of the biggest challenges in caring for patients with pressure ulcers from a risk-management standpoint is determining whether the ulcer was avoidable. The National Pressure Ulcer Advisory Panel has recently come out with a statement that “Not all pressure ulcers are avoidable.” As a reference point, we can look at the Interpretive Guidelines for F-Tag 314 issued by the Department of Health & Human …Read More
Pocket Guide to Pressure Ulcers: How I Took Those Photos
Many people have asked how I took the high quality photos of wounds in my recently published Pocket Guide to Pressure Ulcers. I’ve been photographing pressure ulcers and other skin conditions in elderly persons since my geriatric fellowship in 1985. The photos in this book were chosen from hundreds in my wound library, reviewed by Elizabeth Ayello and myself, and picked for the most typical example of …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
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
Popularity Grows for “The Pocket Guide to Pressure Ulcers”
The Document Dermis Pocket Guide to Pressure Ulcers, authored by myself and Elizabeth Ayello RN, PhD, continues to grow in popularity. Published by the New Jersey Hospital Association, the Guide covers staging and identification of pressure ulcers and other wounds. This book is being purchased in bulk by several major health care organizations, to be utilized by clinicians working in home care, skilled nursing, …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
