Go Directly to the Clinical Updates Index

Compliance Monitoring Division
Clinical Web Window

The purpose of this "Window" is to create an easily accessible place where clinical issues can be presented on a regular basis. We hope that this will contribute to high quality care in the Long Term Care (LTC) continuum, will provide a forum for discussion of the regulatory approach to clinical issues and will, when possible, alert practitioners to clinical issues that may come under increased scrutiny during surveys. We will also place surveyor training resources on this site. While it is our goal to anticipate and alert providers to new clinical issues that may affect survey trends, standards for compliance continue to be based on the existing state and federal regulations. Contributors to this website will include Compliance Monitoring staff, and when available or needed, practitioners with a special interest or expertise. We invite comments, suggestions and requests that will enhance the dialogue among all stakeholders involved in LTC.

For more information regarding the clinical updates please contact:

Minnesota Department of Health
Compliance Monitoring Division
85 East Seventh Place, Suite 300
St. Paul, Minnesota 55101
Telephone: (651) 201-4101
Email: health.fpc-web@state.mn.us

Clinical Updates Index

Accidents and Supervision F323
Handouts/Training Materials for the September 17, 2007 Joint Guidance Training for Accidents and Supervision F323

Activities
Quality of Life Initiative for Activities F248/249 - An Interdisciplinary Approach. Toolkit - January 16, 2007

Activities of Daily Living
F312 Residents Unable to Carry Out Activities of Daily Living(PDF: 48KB/10 pages) - December 2006

F311 Activities of Daily Living (PDF: 42KB/1 page) - February 2006

Comprehensive Assessment
Summarizing Comprehensive Resident Assessment Information (PDF :40KB/5 pages) September 2007

Strategic Approaches to Improving the Care Delivery Process - May 2010
Joint Statewide Training - Dr. Steven Levenson, MD, CMD

Coordination Hospice & Nursing Home Services
Coordination of Hospice and Nursing Home Services (PDF: 40KB/5 pages) April 30, 2009

Dementia Care in Nursing Homes

Care of Persons with Dementia and Unnecessary Medication Use F309 Quality of Care and F329 Unnecessary Drugs

Educational Resources and Optional Tools/Forms:

  1. Advancing Excellence: Nursing Homes
    Advancing Excellence: CMS Launches Partnership to Improve Dementia Care in Nursing Homes
    Partnership to Improve Dementia Care in Nursing Homes Suggestions for Provider Checklist (PDF)
  2. Pharmacy Review Forms:
    Admit to Facility (PDF: 180KB/1 page)
    Facility Initiated (PDF: 186KB/1 page)
    Medication History (PDF: 179KB/1 page)
  3. Physician Round Tool and Instructions (Word file: 23KB/3 pages)

Letter from the MN Partnership to Improve Dementia Care to Medical Directors, Physicians, Physician Extenders (PDF: 87KB/1 Page)

Surveyor Training Presentation:

Revised Nursing Home Surveyor Guidance for Improved Resident Care: Care of Persons with Dementia and Unnecessary Medication (PDF: 79KB/5 pages)

CMS S&C Memos:

Request to Convey Information: Partnership to Improve Dementia Care in Nursing Homes (PDF)

“Hand in Hand: A Training Series for Nursing Homes,” on Person-Centered Care of Persons with Dementia and Prevention of Abuse (PDF)

Release of Mandatory Surveyor Training Program on Care of Persons with Dementia and Unnecessary Antipsychotic Medication Use – Release of Third Video (PDF)

Advanced Copy: Dementia Care in Nursing Homes: Clarification to Appendix P State Operations Manual (SOM) and Appendix PP in the SOM for F309 – Quality of Care and F329 – Unnecessary Drugs (PDF)

Checklist Review of Care and Services for a Resident with Dementia (PDF: 312KB/2 pages)

Diabetes
Minnesota Department of Health Diabetes Program

Diabetes Management in the Nursing Home Setting: Clinical Tips - July 21, 2004

Dignity
Nursing Home Surveyor Training Resources - December 2005
A training resource for surveyors regarding reviewing dignity during the nursing home survey process.

End of Life (F309), Advance Directives (F155), Feeding Tubes (F322/F321)

Statewide phone call January 16, 2013 Agenda (PDF)

March 18, 2013 Phone Call Agenda (PDF: 74KB/3 pages)

CMS Nursing Home Guidance Revision:

End of Life (F309)
Center for Clinical Standards and Quality/Survey & Certification Group: F tag 309—Quality of Care- Advance Copy (PDF)

Department of Health F309 WebEx. First click on this link, Second click on "recorded sessions" on the left side of the page, and Third click F309 WebEx. This WebEx is meant to be viewed with the F309 Script and Handout.

F309 WebEx Script (PDF: 74KB/17 pages)

F309 WebEx Handout (PDF: 350KB/21 pages)

F309 and F155 Questions and Answers (PDF: 65KB/6 pages)

Advance Directives (F155),
Center for Clinical Standards and Quality/Survey & Certification Group - F tag 155-- Advance Directives- Revised Advance Copy (PDF)

Department of Health WebEx. First click on this link, Second click on "recorded sessions" on the left side of the page, and Third click F155 WebEx. This WebEx is meant to be viewed with the F155 Script and Handout.

F155 WebEx Script (PDF: 68KB/17 pages)

F155 WebEx Handout (PDF: 134KB/20 pages)

F309 and F155 Questions and Answers (PDF: 65KB/6 pages)


Feeding Tubes (F322/F321)
Center for Clinical Standards and Quality/Survey & Certification Group - F tag 322—Naso-Gastric Tubes - Revised Advance Copy (PDF)

Department of Health WebEx. First click on this link, Second click on "recorded sessions" on the left side of the page, and Third click F322 WebEx. This WebEx is meant to be viewed with the F322 Script and Handout.

F322 WebEx Script (PDF: 68KB/14 pages)

F322 WebEx Handout (PDF: 183KB/22 pages)

F322 Questions and Answers (PDF: 45KB/2 pages)

CMS QIS Survey Forms on CMS website

See: Critical Elements for Hospice and/or Palliative Care
See: Critical Elements for Tube Feeding Status

Web Based Resources (PDF)

Federal Ambulatory Surgical Centers (ASC)/State Licensed Outpatient Surgical Centers

Updated Information from CMS

Please Note: It is recommended that providers check the CMS Web Site Addresses weekly for new program letters, for information regarding the State Operations Manual updates
See Program Letters

Federal Regulations
CMS Manual System - Revised Appendix L, Interpretive Guidelines for Ambulatory Surgical Centers

Federal Abuse, Mistreatment, Neglect, Misappropriation of Property
Compliance with Federal Nursing Home Regulations :
F223,F224,F225,F226 and F323 in part.

Please see June 2011, Provider Statewide Call

Tool: Federal Long Term Care Reportability for Abuse Under F225 Resident to Resident Altercations (PDF: 77KB/1 page)

Tool: Federal Long Term Care Reportability Under F225 Injuries of Unknown Source (PDF: 105KB/2 pages)

Federal Infection Control Surveyor Worksheet
Worksheet (PDF: 240KB/ 15 pages)

Minnesota State Regulations
Minnesota Chapter 4675 - Outpatient Surgical Centers

Training Documents
Appendix L, Ambulatory Surgical Centers Comprehensive Revision (PPT: 1MB/ 36 pages)

Infection Control Program (PPT: 958KB/ 36 pages)

Flash Sterilization
CMS - Flash Steriliza tion Clarification - FY 2010 Ambulatory Surgical Center (ASC) Surveys (PDF)

Food and Drug Administration
Food and Drug Administration for Health Professionals
This is a site that may be useful as a bookmark.
Publication provides information to healthcare professionals to enhance communication of new drug safety information, raise awareness of reported adverse events, and stimulate additional adverse event reporting.

Acetaminophen Alert – February 6, 2004
This is the first in a series of periodic clinical updates FPC will make available to practitioners in LTC.

Health Care Reform/Affordable Health Care Act
Health Care Reform/Affordable Health Care Act - Leadership Summit April 26, 2010
(PDF:772k/44 pages)

Infection Control
CMS - Nursing Homes - Issuance of Revisions to Interpretive Guidance at F Tag 441, as Part of Appendix PP, State Operations Manual (SOM), and Training Materials (PDF)

Revisions to Appendix PP - Interpretive Guidelines for Long-Term Care Facilities, Tag F441 Infection Control (Transmittal 55 - December 2, 2009 (PDF:479KB/ 38 pages)

F441 Infection Control Training Handouts - November 12 & 13, 2009

Nutrition and Food Sanitation
A Statewide video conference training session will be conducted the morning of October 3, 2008. The following handouts pertain to this training. MDH will be implementing these guidelines on October 20, 2008.

Pain Management/F309

Advancing Excellence in Nursing Homes: Implementation Guide Improving Pain Management (PDF)

Agenda - Minnesota's Call to Action - F309 Quality of Care: Pain Management and End of Life Issues (PDF:12KB/ 1 page)

Implementation Guide: Goals 3 and 4: Improving Pain Management (PDF:215KB/ 19 pages)

42CFR 483.25 (F309) - Quality of Care Changes to Interpretive Guidance (PDF:146KB/ 31 pages)

Cam Basics (PDF:181KB/ 5 pages)

Stage II - Critical Elements for a Resident Who Receives Dialysis Treatments (PDF:114KB/ 17 pages)

Stage II - General Critical Element Pathway (PDF:83KB/ 10 pages)

State II - Critical Elements for Hospice and/or Palliative Care (PDF:92KB/ 12 pages)

State II - Critical Elements for Pain Management (PDF:89KB/ 11 pages)

CMS GRID (PDF:269KB/ 1 page)

Managing Individuals With Pain in LTC (S. Levenson) (PDF:251KB/ 42 pages)

Transmittal 41 - Revisions to Appendices P and PP (PDF:995KB/ 45 pages)

F309 Scenarios - MDH Letter (PDF:79KB/ 4 pages)

Becoming Well Within Minnesota (PDF:90KB/ 2 pages)

Training Scenarios and Questions for Pain Management (PDF:15KB/ 1 page)

Pressure Ulcers
A Physician's, Practitioner's & Clinician's Reference Guide for Pressure Ulcer Prevention & Treatment - March 2005 (PDF: 39KB/2 pages)  
Printable Brochure. May be downloaded and copied back to back.

Pressure Ulcer Questions and Answers - September 28, 2005
This listing of frequently asked questions and answers was compiled by Stratis Health in response to Minnesota providers' questions related to pressure ulcers.

Pressure Ulcer/Non-pressure Ulcer Follow-up Training - January 2006 (PowerPoint presentation)

CMS Regional Office Long-Term Care Provider Associations Meeting (PowerPoint) - Pressure Ulcer PowerPoint Training - August 2007

Quality of Life

Range of Motion
F317/F318 Range of Motion (PDF: 3 pages)  - June 2007

Root Cause Analysis

Presentations: Updated July 2010

Handouts

Unnecessary Medications F329
Paginated materials extracted from CMS Transmittal 22- Pharmacy Training- January 2007

Dr. Steve Levenson Power Points: Medications F329 (PDF: 310KB/23 pages) - July 2007

Dr. Steve Levenson F329 materials for September 6, 2007 phone conference (4:30 to 6:30 pm)

Urinary Incontinence
Urinary Incontinence and Catheters - September 12, 2005
Documents, forms and information provided for a joint MDH and provider video conference training session on urinary incontinence and catheters.

 

Updated Thursday, October 02, 2014 at 08:19AM