What you need to know: CMS made changes to the §483.30-Physician Services and §483.35 Nursing Services guidance. Changes include the following citations:
F712 – Physician Visits-Frequency/Timeliness/Alternate NPPs includes an update to the authority for non-physician practitioners (NPPs) to perform visits, sign orders, and sign Medicare part A certifications and re-certifications when permitted by the state.
F725 – Sufficient Staff and F727 – Registered Nurse provide guidance on procedures, probes, and deficiency categorization.
F729 – Registered Verification adds new procedures and probes.
F732 – Nurse Staffing Information clarifies the use of Payroll Based Journal (PBJ) data by surveyors to identify concerns with staffing.
Action for facilities:
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Examine your existing policy and/or process related to physician an NPPs to ensure visits, signing of orders, and signing of Medicare Part A certifications and recertifications are conducted according to regulation/state law.
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Make sure PBJ data is submitted on time and accurately.
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Review CASPER Reports for PBJ.
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Verify that the following is posted daily in a visible location:
- Facility name
- Current date
- The total number and actual hours worked by the following categoies of licensed and unlicensed nursing staff directly responsible for resident care per shift: RNs, LPNs, and CNAs.
- Resident census
Remember: Survey enforcement for the standards will begin on October 24, 2022.
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