Issue: November 7, 2013

Published on November 7, 2013

Articles in this issue:

The Validation Method: A KHCA/KCAL Education Opportunity by Naomi Feil, MS


KHCA/KCAL is proud to present Naomi Feil, MS.  She will be presenting on her famous Validation Therapy method, in Wellsville, Kansas on December 10, 2013.

What is Validation Therapy? Validation is a tested model of practice that helps older adults who experience disorientation and memory loss to reduce stress and enhance dignity and happiness. Validation accepts the older adult who mentally returns to the past. Often, his/her retreat is not a form of mental illness or disease, it is a survival technique. They return to the past to relive the good times and resolve the bad times in this final struggle to find peace.

Purpose of Validation Workshop: This workshop is designed for health and human service workers, families and volunteers who wish to learn how to communicate with older adults who experience disorientation and memory loss. Its overall objectives are to restore dignity to the older adult, to teach empathy, to increase self-awareness of one’s own aging and to apply Validation Techniques.

About the Presenter: Naomi Feil, M.S., A.C.S.W, is the developer of Validation. She was born in Munich in 1932, and grew up in the Montefiore Home for the Aged in Cleveland, Ohio, where her father was the administrator and her mother, head of the Social Service Department. After graduating with a Masters degree in Social Work from Columbia University in New York, she began working with the elderly. Between 1963 and 1980 Mrs. Feil developed Validation as a response to her dissatisfaction with traditional methods of working with older adults who experience severe disorientation. In 1982 she published her first book, Validation: The Feil Method, which was revised in 1992. Her second book, The Validation Breakthrough, was published in 1993, and updated and revised in 2002. Mrs. Feil and her husband have made many films and videos about aging and Validation. Mrs. Feil is the Executive Director of the Validation Training Institute and a popular speaker in North America and Europe.

To download brochure click here

To register click here

October Survey Trends Report

Author: * Published in Survey Trends

On a quarterly basis, representatives from KHCA/KCAL, LeadingAge Kansas and KACE meet with representatives from KDADS to review survey trends in both skilled center and state licensed only. Click here for the full report.  Past reports are available on KHCA/KCAL website in the members only section

Special Note:

Don't forget about the facility standards call on the 15th of November at 11am. 

Call in: 888-450-5996 Passcode:946659

MDS Corner with Judy, RN


Judy Bagby, RN, is back for MDS Corner.  In this week's installment: Pain



MDS Corner:  Pain

Judith Bagby BSN, RAC-CT, C-NE, LNHA

  This week I would like to discuss Pain Management and Section J of the MDS.  The item sets in MDS 3.0 that are specific to pain coding are J0100, J0200, J0300-J0600, J0700, J0800 and J0850.  As you look at these questions it is easy to see items that should be noted not just during the week of observation but routinely.  During review of 2567s the citing for inadequate pain management processes have been noted.  The goal of this week’s tips is to assist with the reduction or elimination of this finding during the survey process.

  Management of pain is important because it impacts quality of life.  Vital signs (B/P, pulse, respiration, and temperature) establish baselines, effectiveness of treatment, and onset of infection.  Pain has been added to the vital sign activity to become known as the 5th vital sign because of its impact on one’s living.  When someone is experiencing pain there can be an adverse effect on their nutrition, sleeping, behavior, mobility, and socialization.  There can be negative outcomes that include weight loss, impaired skin/pressure ulcers, infection, decreased participation in rehab, and increased use of behavior medications.

  The RAI process includes the MDS3.0, CAA worksheets, and the Care Plan.  This process is a “living- breathing” document that requires ongoing evaluation in order that problems/concerns are identified and investigated, and approaches are implemented for the resident to have their highest level of function.  As we focus on the subject of pain it is best practice to collect information on the status through observation and interview.  This should not be limited to the MDS week of observation but should be ongoing to assist with identifying change in the resident. For best practice if pain medication is going to be administered, ( scheduled or PRN), there needs to be information in the clinical record that would reflect the pain rate, location, description (burning, knifelike, etc), and pattern of pain.  There should then be timely follow up evaluation on the success of the medication.  This evaluation process is a “root cause analysis” of resident’s pain management needs.  Question J0100 ask if there has been a review of pain management that includes non-medication interventions.

   Failing to manage resident’s pain could potentially cause early discharge from a medicare stay or a survey citation for actual harm.  Early detection of change will assist with review and adjustments to pain management needs.  It is the responsibility of all staff members to report changes that might be an early indicator of the presence of pain.  Staff taking vital signs need to remember that pain is a part of the vital sign collection.  The simple question of “are you having any pain?” can give a start to gathering information to benefit the resident.  Sometimes we forget that pain is the individual’s impression/opinion of what their pain rate is.  The staff’s communication needs to include observations of crying, groaning, facial grimacing, gait changes, pacing, refusing cares, not eating, and not sleeping as these may be related to a pain event.


1.     Implementation of INTERACT Stop and Watch will assist with early notification of changes and increase opportunities for intervention review and changes.

2.     Regular review of MARs to identify if there is ongoing assessment regarding pain management for the resident.

3.     Remember to try non-medication interventions before taking the medication approach.



AHCA Quality Awards- Intent to Apply



Commit to the Quality Journey today!

The 2014 National Quality Award program is gearing up for another exciting and competitive year.  Applications are available online. Don’t delay - the “Intent to Apply” deadline is Nov. 14, 2013, at 8p.m. EST. Centers that submit an Intent to Apply save $200 off the final Quality Award application fee and are signed up to receive exclusive tips from the Quality Award team to help with the application process. Intent to Apply forms are available on the Quality Award website: Questions about the Quality Award program or Intent to Apply process can be submitted to  





CMS Update- RAI Corrections


CMS corrects therapy coding examples in RAI Manual:



The Centers for Medicare & Medicaid Services has corrected some therapy coding information in the recently released Minimum Data Set 3.0 Resident Assessment Instrument manual.

The updates affect coding examples on pages 3, 5 and 6 of Chapter 3, Section O. CMS also corrected a Chapter 3 flowchart pertaining to activities for daily living, and the Section O change table on page G-7 of Section G.

The RAI Manual v1.11 was released in September. It includes new items to track distinct calendar days of therapy.

Click here to access the corrections, which were posted to the CMS website on Tuesday.

CMS also recently issued clarification to Medicare providers about revalidation of their enrollment information, which is necessary under the Affordable Care Act. All providers that enrolled in the Medicare program prior to March 25, 2011, must revalidate their enrollment information to make sure it meets new screening criteria.

 Medicare Administrative Contractors will send revalidation notices to providers by March 2015, according to CMS. The guidance issued on Monday explains the process for responding to these notices.

Center for Medicare & Medicaid Services Special Open Door Forum


Centers for Medicare & Medicaid Services Special Open Door Forum: ACA Section 3004: Quality Reporting Program for Long Term Care Hospitals

Thursday, November 21, 2013

12:00pm - 1:30pm

The purpose of this Special Open Door Forum (ODF) is to provide updated data collection and submission information to Long Term Care Hospital (LTCH) providers for the FY 2016 and FY 2017 payment update determination. It will also cover time frames and submission deadlines for the FY 2015, FY 2016, and FY 2017 payment update determinations. The Special ODF will also present a select number of frequently asked questions and answers related to the quality measures, data collection and submission mechanisms and invite questions and comments from stakeholders. Call in information: Participant Call in #: 1-866-402-6263; Conference ID #: 94517614. 

For full information, and downloads, click the link below: