Bits & Bytes from Accu-Med
A newsletter for users of Accu-Care for Windows Software
CMS Launches 10 New
Quality Measures
Scores to be publicized for easy
consumer access
The pilot program of the Centers for Medicare & Medicaid
Services (CMS) has a new consumer quality initiative for
nursing facilities. CMS is currently wrapping up the pilot
study in six states. Several long term care advocacy
groups are pushing CMS to make changes to address
concerns uncovered by the pilot project.
National launch is set for November 2002.
Tom Scully, administrator of CMS, envisions providing
information about quality outcomes to consumers of all
types. At the recent Baltimore conference sponsored by
The American Health Quality Association (AHQA), he
announced the commitment of $30 million dollars to a
continuing ad campaign that will spread the word about
the quality initiative and give consumers contact
information for CMS.
The 10 Quality Measures (QMs) are for use by
consumers, news media and others who wish to evaluate
the quality of nursing facilities. They are:
*
*
*
*
*
*
*
Late-loss ADL worsening
Pressure ulcers
Pressure ulcers (with FAP)
Residents with pain
Physical restraints used daily
Infections
Failure to improve or manage delirium in short-stay
residents
* Failure to improve or manage delirium in short-stay
residents (with FAP)
* Short-stay residents with pain
* Short-stay residents with improvement in walking
(with FAP)
Accu-Med Services, Inc.
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Accu-Med... the right prescription for software!
Fall 2002
The pilot is testing ways to help the public understand the
quality measures, improve care through QIO/nursing home
quality improvement projects, and find better ways to
reach beneficiaries.
These new measures will not be incorporated into the
MDS survey process at this time; according to CMS.
Come November, you’ll wish you had this
Pro-Tracking’s comprehensive QM reports can help you
improve these 10 critical measures, before they become
part of the public record. If you score well on the
indicators, you are in possession of a powerful tool.
Positive score reports can be a strong base for press
releases and marketing materials.
In addition, you will want to check the QI scores of your
competitors. Where are the strengths and weaknesses
of competitors compared to yours? How can you use
this information to competitive advantage?
Get the competitive edge on the new CMS quality
measures.
Call Pro-Tracking at 800-445-3548 or visit our web site at
www.pro-tracking.com.
Pro-Tracking

Performance Related Outcomes
How To Reach Us
Support
800-777-9144 Option 7
Sales and Administration
800-777-9141
Internet
www.accu-med.com
Admission/Discharge/Status
Change Report Helps at
Survey Time
The “Admission/Discharge/Status Change” report
can be helpful to your facility during survey.
It gives you a quick and easy way to get a listing
of all residents who have been admitted and
discharged for a date range - which can be
requested many times during a facility survey.
To get the report, follow these steps:
1. Open the Admissions Module
2. Pull down the reports menu
3. Choose Daily Census
4. Choose Resident Status Change
Select your date range under the “conditions” tab.
You also have the ability to choose a sort order
by stay date (default), medical record number,
resident name, or location.
One important note to remember: include all
inactive residents to be sure to get all discharged
residents who have been made inactive since
their discharge.
Keeping up
with HIPAA
In July, we sent you a
packet of information
detailing our plans to
help you with HIPAA
compliance. Fact sheets
will be updated and sent to you periodically.
If your facility plans to file for a one-year HIPAA
transactions extension, you must do so before
October 15, 2002! The CMS website reads
“electronic filing is fast and easy” so here’s the
address if you still need it:
http://www.cms.gov/hipaa/hipaa2/ascaform.asp
Same words, different order,
different reports
The “Diagnoses by Resident” report (reports/diagnosis reports/diagnoses by resident) lets you print
all diagnoses for specific residents or for all residents.
By using “Resident by Diagnosis” (reports/diagnosis reports/resident by diagnosis) you can identify
which residents have a specific diagnosis code.
QM Help New Report Tracks Daily,
Frequent Pain
Pro-Tracking has developed a new report consolidating
MDS data as related to pain. To see how your facility
checks out, log in to www.Pro-Tracking.com and look under
“Reports” for “Pain Report.”
Although pain is not currently a QI, it is one of the 10
Quality Measures that will be publicized by CMS starting in
November, 2002.
Verify your MDS data. If some data elements on the MDS
are not completed correctly, the facility will appear worse on
the quality indicators than it should.
Another strategy is to improve performance in areas where
genuine problems or shortcomings exist. For example, if a
number of residents are experiencing frequent or severe
pain, a targeted effort may be needed to help manage pain
in facility residents.
This quality measure does not examine use of pain
medications or use of pain management strategies.
Rather, it simply evaluates whether residents report or
experience frequent or severe pain during the seven-day
assessment period when the MDS is completed.
This measure will identify residents who experience
moderate pain at least daily (MDS items J2a=2 and J2b=2)
or severe pain at any frequency (MDS item J2b=3).
Accuracy of the MDS items is critical for this indicator, and
these items are often incorrectly scored. The MDS
instructions state that the nurse should score these items
according to the resident’s actual pain experience during
the seven-day period, regardless of diagnosis or treatment
in progress. For example, the nurse might score a resident
with lung cancer, who takes narcotics for pain, as elevated
on pain frequency and intensity, even though the
medications are controlling the pain well. If the nurse scores
the MDS items using this philosophy, the facility will score
very poorly on the pain measure.
The next step is to ensure that the facility is accurately
identifying and treating residents who experience pain.
As a starting point, run the Pain Report and review those
residents to ensure they are receiving adequate pain
management. Use this report with the Facilities Pain
Management program. The MDS nurse should notify the
interdisciplinary team when a resident has unmanaged
pain. If a resident with a PRN pain medicine order is taking
the PRN medicine frequently, this is a trigger for the team to
discuss changing to a routine status.
Version 4.5 - Coming Soon!
Keep your eyes on the mailbox for
Accu-Care for Windows version 4.5.
This contains not only an important
regulatory update, but it has some great new
features, too.
HIPAA Privacy & Security Enhancements
Release 4.5 provides new Audit Controls to create
audit trails, which will enhance your HIPAA
compliance plans. You decide how deep you want the
audit trail to go. It can be as simple as tracking
Accu-Care log-ins and log-outs or it can be deep
enough to track who has viewed individual resident
information and reports on this information.
Flexible audit logs allow you to look at the audit trail
by user or by resident, and to view or print by
selected date range.
Assessment Enhancements
* NEW MPAF! The MPAF is ready for your
facility’s use. Check your state’s regulation
for when to use this shorter form.
* NEW Minnesota RUGs III calculator
* NEW Nebraska RUGs III calculator
* NEW Washington RUGs III Weight Set has
been implemented!
* Enhanced MDS Verson 1.20 error checking
Admission Face Sheet Enhancements
With the all-new “Print Studio” feature, you can
customize your face sheets on-screen and then print
your face sheets exactly the way you set them up on
the screen. This flexible tool lets you tailor your face
sheets to meet your facility’s needs. Want to add
information to your face sheet? Eliminate unwanted
data? Create a short-form face sheet for assisted
living or adult day care? Add your facility logo or a
resident photo? You can do all this and more with the
new “Print Studio” feature. Used in conjunction with
the “Face Sheet Studio,” you can rearrange the
appearance of the Admissions Module tabs to match
your new custom face sheets. We’ve also modified
the module to display the Code Status on the face
sheet by default.
Medical Records Enhancements
The big news in medical records is a new Behavioral
Monitoring feature for any medication. Use this
feature to define a list of behavior monitoring statements for psychotropic, pain or sleeping medication
orders and attach them to any medication order.
You can print these statements on a flow sheet with
custom titles or list them on your “behavior report.”
Progress Note Module Enhancements
The Progress Notes module now includes an option
for “No Change” in status. We made the module
more user-friendly: bold fonts are available for templates and the grey background has been replaced
with white for better printing clarity.
Squashing Bugs
In addition to all the great new stuff,
we’ve also done some house cleaning
and fixed some “bugs”. All customerreported issues from the 4.0 release
have been resolved in version 4.5.
TIPS and TRICKS
CMS 672 & 802 Reports
Situation: When surveyors arrive at your facility,
they require the facility’s most current data.
Accu-Care for Windows allows you to edit the CMS
(formerly HCFA) 672& 802 reports to reflect any
changes in your residents’ conditions since their
last MDS.
Possible Problem: When you go into the reports,
you will see the edit screen before printing.
However, edits made to this screen will not be
saved after you print and exit.
Solution: Since these reports get their information
from the ongoing assessment, update the ongoing
assessment frequently with current information for
the residents. Update the ongoing by opening
assessments and highlighting a resident. Then click
the “on-going” button. By doing this, current information will be reflected in the 672 & 802 when you
are ready to print.
Both reports can be found in “Assessments” under
“Reports” and “CMS Reports.”
Rapid Weight Entry utility saves time
Using “Rapid Weight Entry” in the Medical Records
Module to record your resident weights will save
your facility valuable data entry time. Rapid Weight
Entry allows you to enter the current weight for
each resident without opening his or her individual
account. This utility gives a listing of residents with
a field to enter their current weights, dates and
devices used. You can enter weights for one resident, multiple residents, or all residents. Sort and
filter options are available by location or resident
name. Find Rapid Weight Entry in the Medical
Records Module under “Tools”.
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