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Vol. 22 Issue 22


Welcome to ICD-10 (Sean Cavanaugh, Deputy Administrator and Director,Center for Medicare) – Today, the U.S. health care system moves to the International Classification of Diseases, 10th Revision – ICD-10. We’ve tested and retested our systems in anticipation of this day, and we’re ready to accept properly coded ICD-10 claims.

The change to ICD-10 allows you to capture more details about the health status of your patients and sets the stage for improved patient care and public health surveillance across our country. ICD-10 will help move the nation’s health care system to better, smarter care.

You may wonder when we’ll know how the transition is going. It will take a couple of weeks before we have the full picture of ICD-10 implementation because very few health care providers file claims on the same day a medical service is given. Most providers batch their claims and submit them every few days.

Even after submission, Medicare claims take several days to be processed, and Medicare – by law – must wait two weeks before issuing payment. Medicaid claims can take up to 30 days to be submitted and processed by states. Because of these timeframes, we expect to know more about the transition to ICD-10 after completion of a full billing cycle.

Because we know this is a major transition, we’ll be:

  • Monitoring the transition in real time.
  • Watching our systems.
  • Addressing any issues that come to the ICD-10 Coordination Center.

The Coordination Center is a dedicated group of Medicare, Medicaid, billing, coding, and information technology systems experts drawn from across CMS. They have the full support of the entire CMS staff to address any issues quickly and completely.

It’s important that you know help’s available if you have problems with ICD-10:

This important moment is possible because we’ve all worked together to make it happen. We’re grateful for your support and look forward to working with you as we make this transition.

CMS: Nursing Homes Should Start Submitting Staffing Data
(Emily Morgan, Staff Writer, McKnight’s, September 17) – Skilled nursing facilities should start submitting electronic staffing data Oct. 1 for the best results, federal officials said. Please click here to read the entire article.

CDC Releases Core Elements of Antibiotic Stewardship for Nursing Homes
(Evvie Munley, LeadingAge) – On Sept. 15, the Centers for Disease Control and Prevention (CDC) released the Core Elements of Antibiotic Stewardship for Nursing Homes, a new set of materials designed to help nursing homes improve antibiotic prescribing practices and reduce their inappropriate use to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile. Please click here to view the materials from the CDC.

CDC anticipates that implementation will vary based on facility staffing and resources, and encourages nursing homes to work in a step-wise fashion, implementing 1 or 2 activities to start and gradually adding new strategies from each element over time.

"Superbugs that are hard to treat pose a health risk to all Americans, particularly the elderly whose bodies don't fight infection as well," said CDC Director Tom Frieden, M.D. "One way to keep older Americans safe from these superbugs is to make sure antibiotics are used appropriately all the time and everywhere, particularly in nursing homes."

Summary of Core Elements for Antibiotic Stewardship in Nursing Homes

The Core Elements provide practical ways for nursing homes to initiate or expand antibiotic stewardship activities. According to the CDC, nursing home antibiotic stewardship activities should, at a minimum, include the following:

1. Leadership commitment: Demonstrate support and commitment to safe and appropriate antibiotic use.

2. Accountability: Identify leaders who are responsible for promoting and overseeing antibiotic stewardship activities at the nursing home.

3. Drug expertise: Establish access to experts with experience or training in improving antibiotic use.

4. Action: Take at least one new action to improve the way antibiotics are used in the facility.

5. Tracking: Measure how antibiotics are used and the complications (e.g., C. difficile infections) from antibiotics in the facility.

6. Reporting: Share information with healthcare providers and staff about how antibiotics are used in the facility.

7. Education: Provide resources to healthcare providers, nursing staff, residents and families to learn about antibiotic resistance and opportunities for improving antibiotic use.

Nursing homes are encouraged to use the companion checklist, which can be used to assess policies and practices already in place and to review progress in expanding stewardship activities on a regular basis.

“We encourage nursing homes to work in a step-wise manner implementing one or two activities at first, then gradually adding new strategies from each core element over time,” said Nimalie Stone, M.D., CDC medical epidemiologist for long-term care. “Taking any of these actions to improve antibiotic use in a nursing home will help protect against antibiotic-resistant infections and more effectively treat infections. This could lead to better recoveries from infections and ultimately improve health outcomes for all residents.”

The release of CDC’s Core Elements for Nursing Homes is one step in achieving the objectives set out in the National Action Plan for Combating Antibiotic-resistant Bacteria.

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