It seems the only things more complex than wounds today are the rules about getting paid for treating them.
That’s likely what many smaller nursing home administrators will say as they ponder thin staffs and all the attendant disconnects that come from high turnover and a seemingly endless flow of too much information.
And under the specter of healthcare reform, and pressures to keep people out of hospitals, the situation gets more complex.
At the heart of it all is the Minimum Data Set, which the Centers for Medicare & Medicaid Services uses to mandate clinical resident assessments in Medicare- and Medicaid-certified nursing homes.
The late 2010 revision to the MDS guidelines on skin conditions, most commonly referred to as “Section M,” is intimidating, observers agree. The 52-page section in CMS’ 3.0 manual is almost entirely devoted to documenting the risk, presence, appearance and change of pressure ulcers. There is cursory attention to other skin ulcers, wounds, or lesions, and the revision documents some treatment categories related to skin injury or avoiding injury.
Some observers say the changes have created special challenges for long-term care providers. The requirements are so onerous, in fact, that they create exponential documentation demands many facilities are ill-equipped to handle, stakeholders say.
