 Meet our team at the National PACE Association (NPA) annual conference scheduled to be held in New Orleans, LA from October 13-16, 2019. Stop by booth #219 to learn how we help Program of All-Inclusive Care for the Elderly (PACE) enhance quality of resident care with our wound care, infection management, ostomy, urological, and tracheostomy programs. This is your chance to meet with our team members, namely Greg Brodersen, AMT Director of Payer Contracting and Stephanie Hodges, AMT Regional Manager. Additionally, you can receive complimentary educational materials and pick some of our conference giveaways. Image and knowledge credit: National PACE Association (NPA)
 Meet our team at the upcoming American Health Care Association and National Center for Assisted Living (AHCA/NCAL) annual convention & expo scheduled to be held in Orlando, FL from Oct 13 – 16, 2019. AMT will be exhibiting in the expo hall, so please visit booth #1738 to learn how we help facilities manage risks and enhance quality of resident care with our wound care, infection management, ostomy, urological, and tracheostomy programs specifically designed for long-term care and post-acute facilities.
Image & knowledge credits: Amazon and AHCA/NCAL
 Wound Care Documentation: It’s a Team EffortDescription: The documentation requirements for Medicare reimbursement of durable medical equipment (DME) can be overwhelming. Having the necessary documentation is a shared responsibility between the clinical community and the DME suppliers. Join the DME MACs to learn more about these documentation requirements as they pertain to beneficiaries with wounds. This training will focus on the types of dressings covered by Medicare as well as the documentation required by the treating clinician/practitioner.
 Pressure Ulcer/Injury Prevention & Wound Care in Long-term Care Setting: Meeting Regulatory & Clinical Guidelines This information-packed, full-day seminar will provide up-to-date evidence-based recommendations and CMS mandated regulations for pressure ulcer prevention, recognition, assessment, and treatment. In addition, the most frequent non-pressure etiologies (e.g. venous and arterial insufficiency, diabetic neuropathic foot ulcers, and skin tears) will be reviewed. Focused content on the Unavoidable Pressure Ulcer aka the Kennedy Terminal Ulcer/Skin Failure will be included to assist buildings in recognizing skin failure at life’s end for the clinical team to address Quality of Life issues for residents with these unavoidable pressure ulcer/injuries. The regulatory focus of the course will be on F-Tags F684, F686, and F687. This is a basic to intermediate level course and is appropriate for the new wound care clinicians and seasoned wound management providers. Topics Covered:
Seminar Faculty: Pamela Scarborough, PT, DPT, MS, CWS, CEEAA, Director Of Public Policy & Education, AMT
Registration:
This course is presented without charge as part American Medical Technologies’ educational commitment to long-term care facilities across the country. AMT Education Division is a provider of Continuing Nursing Education by the California Board of Nursing. Provider Number CEP 15291. This seminar is approved for 6.0 hours of continuing education for nurses. Web-registration is now closed for this educational event. To request registration or other questions about this event, please call Beth Sherman at 412-699-0425. Foundations for wound prevention & management according to the standards of practice and CMS regulations Seminar: Brea, CADescription This program will address pressure ulcer prevention and management risks from the legal, clinical standards of practice, and regulatory perspectives, providing content that addresses a building’s Pressure Ulcer/Pressure Injury prevention program from a system’s perspective and as a component of the Quality Assessment and Performance Improvement (QAPI) process. In addition, content will include a thorough review of coding mandates and tips from Section M of the MDS. Correct coding of the MDS is a primary factor of the new PDPM system of reimbursement. This program is basic to intermediate level, appropriate for the Nursing Directors, Treatment Nurses, interdisciplinary clinical leadership, MDS coordinators, and others responsible for ensuring clinical practice standards and regulatory mandates are in place for their buildings.
Registration
Space is limited for this educational event. To reserve a spot, all are encouraged to register early. Debridement: Who, When & How in Long-Term Care Debridement is a fundamental component of wound management and a standard of practice. Preparing the wound bed for healing must be done adequately to facilitate the best outcomes and provide opportunities for closure and subsequent healing. This program will discuss the: Who, When and How components of chronic wound debridement — specifically for the population residing in the long-term care setting. Content will include assessment prior to debridement (e.g., vascular studies to the lower extremity), types of debridement and precautions/contraindications of debridement. Attend this session to better recognize which wounds will benefit from debridement and how to best accomplish this in the long-term care setting. OBJECTIVES: At the end of this program participants will be able to:
FACULTY:
AMT Education Division is a provider of Continuing Nursing Education by the California Board of Nursing, Provider Number CEP 15291. This program is approved for 1 nursing contact hour by the California Board of Nursing.
 Foundations for wound prevention & management according to the standards of practice and CMS regulationsDescription This program will address pressure ulcer prevention and management risks from the legal, clinical standards of practice, and regulatory perspectives, providing content that addresses a building’s Pressure Ulcer/Pressure Injury prevention program from a system’s perspective and as a component of the Quality Assessment and Performance Improvement (QAPI) process. In addition, content will include a thorough review of coding mandates and tips from Section M of the MDS. Correct coding of the MDS is a primary factor of the new PDPM system of reimbursement. This program is basic to intermediate level, appropriate for the Nursing Directors, Treatment Nurses, interdisciplinary clinical leadership, MDS coordinators, and others responsible for ensuring clinical practice standards and regulatory mandates are in place for their buildings.
Conference Faculty
 Dr. Scarborough is currently Director of Public Policy and Education for American Medical Technologies. Her clinical career spans more than 35 years, having practiced in a variety of settings. Her clinical experience is vast and includes traditional physical therapy, orthopedics and sports medicine, cardiac rehabilitation, and wound management across the continuum of care. Pamela is published in wound book chapters, has written articles, and monographs on the various topics related to wound management and is a highly sought-after speaker, invited to present to interdisciplinary audiences nationally and internationally. Her current focus of education/training and mentoring is clinical best-practices and CMS regulatory components related to wound prevention and management in the long-term care setting.  Carla Kitten is the Regional Clinical Manager of the West Coast for American Medical Technologies. She is a master’s prepared registered nurse with over 35 years’ experience in nursing. Specialty areas include over 10 years in the legal nurse consulting arena serving both plaintiff and defense firms, over 10 years in critical care and the emergency department, and 15 years in the area she is most passionate about, nursing education and wound care. Registration
Space is limited for this educational event. To reserve a spot, all are encouraged to register early.  AMT collaborates with Medicare for educational webinarAMT has partnered with Durable Medical Equipment Medicare Administrative Contractors (DME MACs), Noridian Healthcare Solutions and CGS Administrators, to host a live educational webinar covering Medicare’s documentation requirements for wound care residents. Documentation is a critical component of resident care. To help ensure regulatory compliance regarding wound care provided, a facility should make sure their documentation meets or exceeds the requirements set forth by Medicare. This webinar is developed to help participants learn critical information that they can apply directly within their facilities. Trina St. Ours - Education Consultant DME Outreach and Education with Noridian Healthcare Solutions along with Michael Hanna MPA, CDME - Provider Relations Senior Analyst with CGS Administrators will present their insights. This presentation will be focused on the long-term care facilities’ responsibilities in creating/maintaining the necessary documentation for reimbursement of surgical dressings and supplies. Emphasis and specific detail will be provided on preliminary orders, detailed written orders and the importance of thoroughly completed monthly/weekly evaluations. Webinar registration is free and Continuing Education (CE) credits will be available for attendees of the live webinar. A recorded version of the presentation will also be provided for those unable to attend the live event.
Continuing Education
Additional Educational Resources
 Seminar Focus: Wound Prevention and Management in the Post-Acute, Long-Term Care Setting: Meeting the Clinical and Regulatory Guidelines and Mandates Providing wound prevention and management in the long-term, sub-acute care setting is challenging for many reasons including, but not limited to; the population (older and/or more acute than years past), the regulations, reimbursement constraints, and clinical knowledge challenges regarding this mammoth topic. For all these reasons, and more, wound care in the PAC/LTC is demanding for building management, leadership, and clinical and support staff. This program will integrate clinical best practices with regulatory (survey) and reporting (MDS, Section M) mandates for wound prevention and care, providing the attendees with up to date information to assist clinical teams, building management and leadership with tools and direction for creating functional wound prevention and care programs. This course will support the PDPM and QAPI mandates by CMS related to skin integrity. Objectives: At the end of this program participants will be able to:
Content Includes:
Course Faculty: Dr. Pamela Scarborough is the Director of Public Policy and Education for American Medical Technologies. Her clinical career spans more than 35 years, having practiced in a variety of settings including acute, outpatient, home health, and long-term care. Her clinical experience has included traditional physical therapy, orthopedics and sports medicine, cardiac rehabilitation, and wound management. Pamela has published book chapters, articles, and monographs on the topics of diabetes and wound care, in addition to being a highly sought-after speaker, invited to present to interdisciplinary audiences at conferences, on webinars, and at wound management educational activities around the country. Her focus is currently clinical best-practices and CMS regulatory components for wound prevention and management in the long-term care setting.
Driven by our mission to improve the quality of life for senior patients, AMT is proud to serve over 6,250 facilities across the nation. We could not do this without the support of the long-term care facilities and their dedicated staff. We thank you!
 Course Description: This information-packed, one-day seminar provides participants current up-to-date information regarding recognition, assessment, and treatment of lower extremity and foot wounds from common etiologies such as arterial and venous insufficiency, diabetic neuropathic foot ulcers, and lymphedema. Content includes information on how the disease state of diabetes impacts all wound etiologies. The skills lab portion of the course provides attendees with hands-on training in Doppler screening, sensory testing, and other tests and measures commonly used for lower extremity and foot examinations. In addition, a compression skills lab for kinesthetic learning of multi-layer compression wrap application for treatment of venous insufficiency wounds will be offered. This is a basic to intermediate level course. Course Faculty: Dr. Pamela Scarborough is the Director of Public Policy and Education for American Medical Technologies. Her clinical career spans more than 35 years, having practiced in a variety of settings including acute, outpatient, home health, and long-term care. Her clinical experience has included traditional physical therapy, orthopedics and sports medicine, cardiac rehabilitation, and wound management. Pamela has published book chapters, articles, and monographs on the topics of diabetes and wound care, in addition to being a highly sought-after speaker, invited to present to interdisciplinary audiences at conferences, on webinars, and at wound management educational activities around the country. Her focus is currently clinical best-practices and CMS regulatory components for wound prevention and management in the long-term care setting. Course Highlights:
This course is presented without charge as part American Medical Technologies’ educational commitment to long-term care facilities across the country. AMT Education Division is a provider of Continuing Nursing Education by the California Board of Nursing. Provider Number CEP 15291. This seminar is approved for 6.0 hours of continuing education for nurses.
Due to high-demand, we have reached the registration capacity for this educational event. To be informed about our next seminar, we encourage you to sign-up for our company newsletter.
 Pressure Ulcer/Injury Prevention And Wound Care In Long-term Care Setting: Meeting Regulatory and Clinical GuidelinesThis information-packed, full-day seminar will provide up-to-date evidence-based recommendations and CMS mandated regulations for pressure ulcer prevention, recognition, assessment, and treatment. In addition, the most frequent non-pressure etiologies (e.g. venous and arterial insufficiency, diabetic neuropathic foot ulcers, and skin tears) will be reviewed. Focused content on the Unavoidable Pressure Ulcer aka the Kennedy Terminal Ulcer/Skin Failure will be included to assist buildings in recognizing skin failure at life’s end for the clinical team to address Quality of Life issues for residents with these unavoidable pressure ulcer/injuries. The regulatory focus of the course will be on F-Tags F684, F686, and F687. This is a basic to intermediate level course and is appropriate for the new wound care clinicians and seasoned wound management providers.
Our Commitment: This course is presented without charge as part of AMT’ educational commitment to long term care facilities across the country. AMT Education Division is a provider of Continuing Nursing Education by the California Board of Nursing. Provider Number CEP 15291. This seminar is approved for 6.0 hours of continuing education for nurses.
Due to high-demand, we have reached the registration capacity for this educational event. If you like to request an invitation, please contact Beth Sherman, AMT Regional Manager at 412-699-0425.
Webinar Handouts: Pressure ulcer/injury (PU/PI) prevention is considered a quality measure in most care settings—including long-term nursing facilities. To comply with federal regulations, a facility must demonstrate, through the resident assessment processes, care plan documentation and clinical outcomes, that the only facility acquired PU/PIs are unavoidable. Providing this level of care (prevention of all PU/PIs, except those produced by the resident’s failing physiology) requires that the facility have processes and protocols in-place to move the entire staff towards the goal of PU/PI prevention. The faculty of this webinar will use a Self-Assessment Worksheet to help facilities identify current processes, gaps and places for improvement. Whether a facility has a root cause analysis program firmly in-place, are just beginning, or are working toward their PU/PI Quality Assurance and Performance Improvement process, this program has content to help inform and support the goal of PU/PI prevention. At the end of this presentation participants will be able to:
(3) DISINFECT AND KEEP SURFACES CLEAN: Between patients, every room in a facility should be cleaned thoroughly with a US EPA approved healthcare grade disinfectant. This helps to prevent accidental transmission of infections as new patients are admitted. Furthermore, non-patient areas, such as the breakroom and nurses’ station should be cleaned daily. (4) USE PERSONAL PROTECTIVE EQUIPMENT: Appropriate personal protective equipment (PPE), such as gowns, gloves, masks and face shields, should be readily available to staff for usage. (5) PROVIDE INFECTION CONTROL EDUCATION: Staff members need to know how to identify common infections and help prevent their spread. In addition, your organization should provide continued, recurring education on infection control. This includes training on bloodborne pathogen and droplet-borne infections. (6) DEVELOP AN INFECTION PREVENTION AND CONTROL POLICY: The facility must establish and maintain an Infection Control Program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection. (7) ANTIBIOTIC STEWARDSHIP: The misuse and overuse of antibiotics can put patients at a risk of contracting infections. Inappropriate antibiotic use may also result in patients becoming resistant to some drugs. If those patients contract an infection, it becomes harder to treat them and the risk of it spreading increases. You can get to the root of infections with AMT's comprehensive infection management program, which utilizes rapid molecular diagnostic testing to quickly identify over 90% of the pathogens that cause two of the most common and life-threatening infections in long-term care, i.e. respiratory and gastrointestinal infections. To learn more, call (800) 232-9266 or visit our infection management page. Each of these strategies can help your healthcare facility keep the spread of infections at bay. When implemented in unison, these 7 strategies can be instrumental in ensuring the success of an infection prevention program in your facility.
The American Board of Wound Management elected Gayle C. Lindsey, PT, MBA, MHSM, CWS®, Methodist Mansfield Medical Center, Burleson, TX as President at the November 9, 2018, Board of Directors meeting. When asked about being elected president, Lindsey said, “I am grateful for this opportunity to lead the ABWM over the next two years! I look forward to hearing ideas from our diplomates on how we can improve the value delivery of our certifications. I am also excited about improving our interactions with our diplomates and mining their input and ideas on advancing the ABWM recognition with clinicians, patients, and the general public. Healthcare is in an exciting time, and we have an ideal opportunity to focus on the importance of wound management and the benefits of clinician specialty certification in the care of our patients.”
The purpose of the American Board of Wound Management is to establish and administer a certification process to elevate the standard of care across the continuum of wound management. The ABWM is dedicated to an interdisciplinary approach in promoting prevention, care and treatment of acute and chronic wounds. The ABWM currently offers the Certified Wound Care Associate® (CWCA®), Certified Wound Specialist® (CWS®), and Certified Wound Specialist Physician® (CWSP®) credentials.
For more information on the American Board of Wound Management, the Certified Wound Care Associate®, Certified Wound Specialist®, or the Certified Wound Specialist Physician® credentials please visit www.abwmcertified.org Knowledge credit: American Board of Wound Management
The CDC estimates last year, about 79,000 people died & 960,000 people were hospitalized from flu-related complications. So, what can you do? According to the CDC, when you’re vaccinated against flu, you protect yourself and lower the chances of infecting others, including people at high risk of developing potentially serious flu complications. In addition to getting the flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends of everyone, including covering coughs, washing hands often, and avoiding people who are sick.
Knowledge credit: https://www.cdc.gov/flu/about/disease/65over.htm https://www.cdc.gov/flu/about/season/flu-season.htm https://www.cdc.gov/flu/professionals/vaccination/social-media-toolkit.htm 
The MDS, Section M has been updated as of October 1st, 2018. New pressure ulcer/injury definitions and staging descriptions have been adapted by CMS from the National Pressure Ulcer Advisory Panel and included in the updated Resident Assessment Instrument for coding the M-Section. Attend this 90-minute fast-paced, information-packed webinar to get up to speed on the new reporting mandates and the most frequent mistakes when reporting wounds, including pressure ulcer/injuries to CMS. In addition, you are invited to be part of this interactive program where you may bring your questions about the M-Section or add your knowledge and understanding to the discussion. At the end of this presentation participants will be able to:
Space is limited to the first 500 participants nationally. To reserve a spot, all are encouraged to register early.
Knowledge & photo credit: National Pressure Ulcer Advisory Panel
Topics Covered:
Objectives: At the end of this program participants will be able to:
Course Faculty: Dr. Pamela Scarborough, Director of Public Relations and Education for American Medical Technologies. Continuing Education Credits:
Meet the AMT team at the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) annual convention & expo scheduled to be held in San Diego, CA from October 7-10, 2018. We will be exhibiting in the expo hall - please stop by booth #1837 to get complimentary educational materials, learn about our senior care solutions and win an Apple ipod!
Quarterly Webinar: Adapting the pressure ulcer/injury staging language into your clinical practice9/5/2018
This program will assist clinicians in differentiating between the CMS State Operation Manual’s and the National Pressure Ulcer Advisory Panel’s pressure ulcer/injury definitions and staging descriptions. Content will guide the attendee in how to adapt this information into clinical and reporting practices for long-term care. This information is valuable to both new and seasoned wound care clinicians in the long-term care setting. At the end of this presentation participants will be able to:
Webinar Faculty:
Space is limited to the first 500 participants nationally. To reserve a spot, all are encouraged to register early.
Meet the AMT team at the Oregon Healthcare Association (OHCA) annual convention & tradeshow scheduled for September 17 and 18, 2018. Our team will be exhibiting at the trade show - please stop by booth #400 to get complimentary educational materials and learn about our senior care solutions.
About OHCA:
Founded in 1950, OHCA improves the lives of seniors and people with disabilities by promoting quality long term care in Oregon. A statewide, nonprofit trade association, OHCA is the largest long term care trade association in Oregon, representing more than 1,000 organizations and 90 percent of long term care providers in the state.
The Social Security Act mandated “the establishment of minimum health and safety standards that must be met by providers and suppliers participating in the Medicare and Medicaid programs”. The Centers for Medicare and Medicaid Services (CMS) has been tasked by the Secretary of the Department of Health and Human Services (DHHS) to administer these programs and ensure compliance. CMS therefore provides regulatory guidance to providers and suppliers through a document known as the State Operations Manual (SOM). Appendix PP of the SOM contains, among other items, minimum standards for wound care documentation in the long-term care setting. (4) These standards are specifically found in Section 483.25 of Appendix PP of the SOM which gives rise to multiple F-tags, including the F-tag 686 (F686: Treatment/Services to Prevent/Heal Pressure Ulcers) and the F-tag 684 (F684: Quality of Life). F686 specifically addresses the minimum assessment, daily monitoring, and weekly documentation requirements when a pressure ulcer/injury is present. F684 then addresses documentation requirements for any skin ulcer/wound. (3,5) In addition to the SOM, other regulatory documents, such as the Resident Assessment Instrument (RAI), provide guidance to providers and suppliers on minimum wound documentation and reporting requirements in long term care. As such, it is important to be aware of these various documents and comply with the directions for each. (1,3) RECOMMENDATIONS: To help ensure compliance regarding care provided, a facility should make sure their documentation meets or exceeds, the requirements set forth in the F686. These requirements can be distilled down into three main elements: assessment, daily monitoring and weekly documentation. It is important that the facility have a system in place to assure that the protocols for daily monitoring and for periodic documentation of measurements, terminology, frequency of assessment, and documentation are implemented consistently throughout the facility for all wound types. The minimum content of each element is outlined below. F686 – Pressure Ulcers/Injuries It is important that each existing pressure ulcer/injury be identified, whether present on admission or developed after admission, and that factors that influenced its development, the potential for development of additional injuries or for the deterioration of the pressure ulcer/injury be recognized, assessed and addressed. Any new pressure ulcer/injury suggests a need to reevaluate the adequacy of the plan for preventing pressure ulcers/injuries. When assessing the ulcer/injury itself, it is important that documentation addresses:
F684 – Non-Pressure Ulcer/Injury Wounds Residents may develop various types of skin ulcerations. At the time of the assessment, clinicians (physicians, advance practice nurses, physician assistants, registered nurses and certified wound care specialists, etc.) should document the clinical basis for any determination that an ulcer is not pressure- related, especially if the injury/ulcer has characteristics consistent with a pressure ulcer, but is determined not to be one. At minimum, documentation should address:
It is important that the facility have a system in place to assure that the protocols for daily monitoring and for periodic documentation of measurements, terminology, frequency of assessment, and documentation are implemented consistently throughout the facility. When a pressure injury is present, daily monitoring, (with accompanying documentation, when a complication or change is identified), should include:
The amount of observation possible will depend upon the type of dressing that is used, since some dressings are meant to remain in place for several days, according to manufacturers’ guidelines. With each dressing change or at least weekly (and more often when indicated by wound complications or changes in wound characteristics), an evaluation of the pressure ulcer should be documented. At a minimum documentation, in the medical records, should include the date observed and:
Photographs may be used to support this documentation, if the facility has developed a protocol consistent with accepted standards (e.g., frequency, consistent distance from the wound, type of equipment used, means to assure digital images are accurate and not modified, inclusion of the resident identification/ulcer location/dates/etc. within the photographic image, and parameters for comparison). Download this article here. REFERENCES
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