Webinar Announcement: August 6, 2020 |
Please join us for this timely conversation with internationally recognized registered dietitian and wound care expert, Dr. Nancy Collins. This program will assist clinicians with nutritional challenges for patients and residents related to wounds and the COVID-19 pandemic. Content will be delivered in an interview format which will facilitate answers to some of the most important questions related to nutrition and wound healing in the era of COVID-19. |
OBJECTIVES:
At the end of this program participants will be able to:
FACULTY:
Dr. Nancy Collins. PhD, RDN, LD, NWCC, FAND is a wound care certified registered dietitian who is internationally known for her expertise in the complex relationship between malnutrition, body composition, and tissue regeneration. Dr. Collins has over 25 years of hands-on practitioner experience in clinical nutrition and industry consulting and is the founder of Nutrition411.com.
MODERATOR:
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA is board certified wound specialist currenting providing education, mentoring and leadership for the long-term, post-acute care industry in wound prevention and management from both clinical and regulatory perspectives. Dr. Scarborough stays current on this and related topics and passes on knowledge that serves clinicians, patients and residents in this specialty area of care, chronic wounds.
At the end of this program participants will be able to:
- Recognize nutritional challenges facing patients, residents and staff during the COVID-19 pandemic.
- Effectively address unintended weight loss and non-healing wounds with appropriate nutrition interventions.
- Discuss the role of protein and amino acids in wound healing.
FACULTY:
Dr. Nancy Collins. PhD, RDN, LD, NWCC, FAND is a wound care certified registered dietitian who is internationally known for her expertise in the complex relationship between malnutrition, body composition, and tissue regeneration. Dr. Collins has over 25 years of hands-on practitioner experience in clinical nutrition and industry consulting and is the founder of Nutrition411.com.
MODERATOR:
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA is board certified wound specialist currenting providing education, mentoring and leadership for the long-term, post-acute care industry in wound prevention and management from both clinical and regulatory perspectives. Dr. Scarborough stays current on this and related topics and passes on knowledge that serves clinicians, patients and residents in this specialty area of care, chronic wounds.
DATE & TIMES:
WEBINAR SPONSOR: Abbott Nutrition WEBINAR HOST: AMT |
REGISTRATION:
Space is limited and we encourage all to register early to secure a spot for this webinar. |
Hit Your Pressure Ulcer/Injury Prevention and Wound Management Targets:
Ensuring Reimbursement, Clinical and Regulatory Compliance
*** This Event Has Been Canceled ***
Due to the evolving situation with the novel Coronavirus, we are at an unprecedented time that is requiring unprecedented responses in order to protect our residents and our peers. Due to the restrictions and social distancing expectations we are cancelling this educational event.
SEMINAR DESCRIPTION
Long-term care buildings are having to admit sicker, frailer individuals than ever before in the 60-year history of this industry. The increased level of ill-health in our population with multiple comorbidities means our residents and patients are at greater risk for pressure ulcer/injuries (PU/PI) than in years past. Due to the higher acuity of facility admissions your clinical team needs to determine: “Is this resident’s wound actually due to pressure, or is it a Kennedy Terminal Ulcer a.k.a. Skin Failure” due to the multiorgan failure and the dying process?
This seminar will review business, clinical and regulatory components for prevention, treatments and reporting of skin issues with a focus on PU/PI prevention. The importance of staging for documentation and coding on the MDS for appropriate PDPM reimbursement will be reviewed. In addition, there will be focused content on the Root Cause Analysis (RCA) process, the construct CMS recommends buildings use as part of the QAPI process for the internal investigation of facility acquired PU/PIs. This RCA process will assist facilities in identifying the KTU from the avoidable PU/PI and will find the gaps in your PU/PI prevention program. Join us for this information-packed seminar to improve the clinical, reimbursement, and regulatory aspects of your building’s/organization’s wound prevention and management programs.
Long-term care buildings are having to admit sicker, frailer individuals than ever before in the 60-year history of this industry. The increased level of ill-health in our population with multiple comorbidities means our residents and patients are at greater risk for pressure ulcer/injuries (PU/PI) than in years past. Due to the higher acuity of facility admissions your clinical team needs to determine: “Is this resident’s wound actually due to pressure, or is it a Kennedy Terminal Ulcer a.k.a. Skin Failure” due to the multiorgan failure and the dying process?
This seminar will review business, clinical and regulatory components for prevention, treatments and reporting of skin issues with a focus on PU/PI prevention. The importance of staging for documentation and coding on the MDS for appropriate PDPM reimbursement will be reviewed. In addition, there will be focused content on the Root Cause Analysis (RCA) process, the construct CMS recommends buildings use as part of the QAPI process for the internal investigation of facility acquired PU/PIs. This RCA process will assist facilities in identifying the KTU from the avoidable PU/PI and will find the gaps in your PU/PI prevention program. Join us for this information-packed seminar to improve the clinical, reimbursement, and regulatory aspects of your building’s/organization’s wound prevention and management programs.
SEMINAR OBJECTIVES
- Describe pressure ulcer/injury etiologic factors
- Evaluate facility pressure ulcer/injury prevention program components
- Identify accurate staging definitions and MDS coding components for pressure ulcer/injuries reporting, documentation and reimbursement
- Verbalize the Root Cause Analysis (RCA) construct and components for investigating facility acquired PU/PIs as part of the QAPI process
- Discuss current evidence-based treatment interventions for chronic wounds
SEMINAR LOCATIONS & DATES
Wintergreen Resort and Conference Center
60 Gasser Rd. Wisconsin Dells, WI 53965
|
Alexian Village of Milwaukee
9301 N 76th St. Milwaukee, WI 53223
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* Continental breakfast & lunch will be provided to registered attendees at both of these events.
SEMINAR FACULTY Dr. Pamela Scarborough is the Director of Public Relations and Education for AMT. She is a physical therapist with over 35 years’ experience as a clinician, team leader, professional educator and mentor. In addition to holding a license to practice physical therapy in the state of Texas, Dr. Scarborough is board certified as a wound specialist (CWS). She presents nationally and internationally to multidisciplinary audiences in addition to publishing extensively on topics related to infection prevention and control, wound prevention and care, and diabetes management. |
CONTINUING EDUCATION CREDITS
- 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.
EDUCATIONAL COMMITMENT
This course is offered without charge to participants as part of AMT’s educational commitment to long-term care facilities across the United States.
This course is offered without charge to participants as part of AMT’s educational commitment to long-term care facilities across the United States.
Diabetes And The Diabetic Foot Ulcer In The Long-Term Care Setting
Diabetes is one of the most complicated and costly diseases of the 21st century. Many of our residents and patients in the long-term care setting have diabetes, which may cause complications such as diabetic foot ulcers and interfere with the healing of other chronic wounds etiologies. This program will discuss diabetes and wound healing in general, and how the foot is affected by the disease. Prevention, assessment and treatment strategies for diabetic foot ulcers will be included in the content.
OBJECTIVES:
OBJECTIVES:
- Identify the Standards of Practice for assessment and prevention of diabetic foot ulcers
- Discuss care practices to intervene for at risk feet for diabetic foot ulcers
- List treatment interventions for care of diabetic foot ulcers
FACULTY:
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA. Director Of Public Policy & Education, AMT
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA. Director Of Public Policy & Education, AMT
CONTINUING EDUCATION CREDIT:
- 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.
- This program has been approved for Continuing Education for 1 total participant hour from NAB/NCERS—approval #20210109-1-A62374-DL.
Image Credit: Licensed under the Creative Commons
Diabetic Foot Ulcer, Author: Milorad Dimic MD, Nis, Serbia January 2012. (https://commons.wikimedia.org/wiki/File:Diabetic_Wound_121.jpg)
Diabetic Foot Ulcer, Author: Milorad Dimic MD, Nis, Serbia January 2012. (https://commons.wikimedia.org/wiki/File:Diabetic_Wound_121.jpg)
Wound Care Documentation: It’s a Team Effort
Description:
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.
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.
Date & Times:
Continuing Education
|
Presenters:
Moderator:
Registration:
Space is limited to the first 1,000 participants. This will be a LIVE webinar and per CMS guidelines event recording will not be available. To reserve a spot, all are encouraged to register early. |
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:
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:
- Pressure ulcer/injury prevention
- Staging of pressure ulcer/injuries
- Framing your wound management program using the Wound Bed Preparation model of care
- The Kennedy Terminal Ulcer/Skin failure, unavoidable pressure ulcer
- The wound assessment
- Documents review that support CMS regulations for wound prevention and care in the Long-Term, Sub-Acute Care Setting
- Focus on F684, F686, and F687
Seminar Faculty:
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA, Director Of Public Policy & Education, AMT
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA, Director Of Public Policy & Education, AMT
Cincinnati Seminar Details: Receptions Conference Center – Western Hills 3302 Westbourne Drive Cincinnati, OH 45248 September 23, 2019 (Monday) Registration: 7:30 - 8:00 AM Course: 8:00 – 3:30 PM Continental breakfast and lunch provided at the event | Columbus / Dayton Seminar Details: Clark State Community College Brinkman Educational Center 4th Floor Conference Room 76 S Limestone Street Springfield, OH 45502 September 25, 2019 (Wednesday) Registration: 7:30 - 8:00 AM Course: 8:00 – 3:30 PM Continental breakfast and lunch provided at the event |
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.
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, CA
Description
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.
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.
Date & Time
Location
| Conference Faculty
Continuing Education 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 5 nursing contact hour by the California Board of Nursing. |
Registration
Space is limited for this educational event. To reserve a spot, all are encouraged to register early.
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.
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:
At the end of this program participants will be able to:
- Discuss debridement as a component of the Wound Bed Preparation paradigm;
- Recognize when and what to debride from the wound;
- Identify precautions and contraindications for debridement;
- Verbalize the different types of debridement.
FACULTY:
- Pamela Scarborough, PT, DPT, MS, CWS, CEEAA - Director Of Public Policy & Education, AMT
- Lynn A. Tabor, MS, RN, WCC - Vice President of Education & Training, AMT
DATE & TIME:
| COST & CE CREDITS:
Space is limited to the first 1,000 participants. To reserve a spot, all are encouraged to register early. |
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 regulations
Description
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.
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.
Date & Time
Location
Continuing Education 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 5 nursing contact hour by the California Board of Nursing. | Conference Highlights
Event Partnership This event is hosted by AMT in partnership with Flagstone Healthcare. |
Conference Faculty
- Pamela Scarborough, PT, DPT, MS, CWS, CEEAA
- Carla Kitten, MSN, RN, CWS

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.
Space is limited for this educational event. To reserve a spot, all are encouraged to register early.
AMT collaborates with Medicare for educational webinar
AMT 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.
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.
Date & Times
Presenters
Moderator
| Learn About Medicare Documentation Requirements For Wound Care Residents In This Live WebinarSpace is limited to the first 500 participants. To reserve a spot, all are encouraged to register early. |
Continuing Education
Additional Educational Resources
- 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.
Additional Educational Resources
- Centers for Medicare & Medicaid Services. Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual. Version 1.15. Released October 2017.
- State Operations Manual Appendix PP-Guidance to Surveyors for Long Term Care Facilities. Revised 11/22/17. pp. 248-266, 272, 273.
- State Operations Manual-Chapter 1 - Program Background and Responsibilities. Revised 10-3-14. p. 3.
- Pressure Ulcer/Injury Critical Element Pathway. Department of Health and Human Services Centers for Medicare and Medicaid Services. CMS Form 20078, 5/2017
- https://www.amtwoundcare.com/blog/documentation-standards-for-wounds-in-long-term-care
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.
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:
- Recognize the most common chronic wound etiologies including pressure injuries/ulcers
- Discuss pressure ulcer prevention strategies using a systems approach
- Identify MDS reporting mandates using Section M Coding instructions for reporting wound etiologies including pressure ulcer/injuries and other common wound etiologies
- Describe current treatment interventions for chronic wounds including: debridement, topical therapies, and biophysical agents (e.g. NPWT, E-Stim)
- List resources to assist in framing your wound prevention and management program
Content Includes:
- Review of most the common wound etiologies
- Pressure ulcer prevention program process design
- MDS Section M Reporting mandate including detailed descriptions and coding tips for staging and documentation
- Prevention and treatment interventions that meet practice standards and regulatory mandates
- Review of core resources for framing a functional wound prevention and management program.
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.
Event Dates & Locations:
July 19, 2019 - Sandy, UT
(Registration is now closed) Salt Lake Community College 9750 South 300 West. Sandy, UT 84070 (The Miller Campus in the Karen Gail Miller Conference Center Room #150) August 13, 2019 - San Antonio, TX
(Registration is now closed) San Antonio A&M Club Foundation (Aggie Park) 6205 West Avenue. San Antonio, TX August 30, 2019 - Fort Worth, TX
(Registration is now closed) Holiday Inn DFW Airport South 14320 Centre Station Drive Fort Worth, TX 76155 September 12, 2019 - Houston, TX
(Registration is now closed) Holiday Inn Southwest Sugar Land Hotel 11160 Southwest Freeway Houston, TX 77031 November 1, 2019 - Lubbock, TX
The American Windmill Museum 1701 Canyon Lake Dr. Lubbock, TX 79403 November 8, 2019 - Weslaco, TX
Knapp Conference Center at Knapp Medical Center 1401 E. Eighth Street Weslaco, TX 78596 |
Event Schedule:
Registration: 7:30 - 8:00 AM Course: 8:00 - 3:30 PM Seminar Cost:
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. This activity has been approved by the Texas Board of Physical Therapy Examiners for 6.00 CCUs for PTs and PTAs. If you need assistance during/after registration, please reach out to your local AMT Clinical Specialist or email us customer.care@amtwoundcare.com
Educational Handouts:
Attendees are requested to download or print the following educational handouts prior to arriving at the wound care seminar. |
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.
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.
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:
- Hands-On Skills Labs
- LTC Regulatory Considerations
- Industry Vendor Exhibits
- Breakfast & Lunch Provided
- Approved For 6.0 Hours Of Continuing Education For Nurses
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.
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.
Marksville Seminar Details:
| Baton Rouge Seminar Details:
|
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 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.
This is a basic to intermediate level course and is appropriate for the new wound care clinicians and seasoned wound management providers.
Topics Covered:
| Course Faculty: Dr. Pamela Scarborough is the Director of Public Relations and Education for American Medical Technologies. She is a physical therapist with over 35 years’ experience as a clinician, team leader, professional educator and mentor. In addition to holding a license to practice physical therapy in the state of Texas, Dr. Scarborough is board certified as a wound specialist (CWS). She presents nationally and internationally to multidisciplinary audiences and publishes extensively on topics related to infection prevention and control, wound prevention and care, and diabetes management. |
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.
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.
Michigan Seminar Details:
| Ohio Seminar Details:
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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.
- Title: Preventing Pressure Ulcer/Injuries From A Systems Perspective
- Date: Thursday, March 14, 2019
- Time: 2:00 – 3:15 pm Eastern
- Register: Click here
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.
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:
- Identify which tools and processes are currently in place to identify residents who have PU/PI risk, or experience a change in PU/PI risks;
- Discuss current PU/PI prevention practices in their building/company;
- Recognize gaps in current PU/PI prevention practices/processes;
- Formulate plans to improve pressure ulcer/injury prevention practices/processes and improve clinical interventions and outcomes
Webinar Faculty: Pamela Scarborough, PT, DPT, MS, CWS, CEEAA Director Of Public Policy & Education American Medical Technologies Jeanine Maguire, PT, MS, CWS Sr. Director Skin Integrity & Wound Management Genesis Healthcare | Date & Time:
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Continuing Education Credit: 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. | Webinar Registration: Space is limited to the first 500 participants nationally. To reserve a spot, all are encouraged to register early. To download flyer: Click here |
Today we will talk about staging pressure ulcers/injuries in long-term care environments. The objectives of this “on-demand” presentation are:
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7 STRATEGIES FOR INFECTION PREVENTION & CONTROL(1) HAND HYGIENE: Hand washing should be the cornerstone of reducing Healthcare Associated Infections (HAIs). This is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Wash hands with warm water and soap vigorously for at least 20 seconds. Also, all staff members and visitors in the facility should be encouraged to wash their hands before drinking, eating, providing care and between caring for patients. (2) USE GLOVES: Health care professionals may not always wear gloves when interacting with patients. But, if any contact with blood or bodily fluids is possible, such as when changing sheets or emptying trash, gloves should be worn. |
(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.
(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.
While seasonal influenza (flu) viruses are detected year-round in the United States, flu viruses are most common during the fall and winter. The exact timing and duration of flu seasons can vary, but influenza activity often begins to increase in October. Most of the time flu activity peaks between December and February, although activity can last as late as May. It has been recognized for many years that people 65 years and older are at greater risk of serious complications from the flu compared with young, healthy adults because human immune defenses become weaker with age. While flu seasons can vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. |
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
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
- Title: MDS, Section M Updates, Hints and Tips
- Date: Thursday, December 6, 2018
- Time: 2:00 – 3:15 pm Eastern
- Download flyer: Click here
- Register: Click here
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:
- Identify the most common mistakes when reporting pressure ulcer/injuries and other wound etiologies on the MDS, Section M.
- Verbalize the new pressure ulcer staging descriptions from the Resident Assessment Instrument for coding and reporting pressure ulcer/injuries for Section M.
Webinar Date & Times:
Continuing Education Credit:
| Course Faculty: Pamela Scarborough, PT, DPT, MS, CWS, CEEAA Director Of Public Policy & Education American Medical Technologies Jeanine Maguire, PT, MS, CWS Sr. Director Skin Integrity & Wound Management Genesis Healthcare Lynn Tabor, MS, RN, WCC, IP-BC, ASCOM Director Of Education & Training American Medical Technologies |
Space is limited to the first 500 participants nationally. To reserve a spot, all are encouraged to register early.
Seminar Title: Pressure Ulcer/Injury Prevention and Wound Care in the Long-Term Care Setting: Meeting Regulatory and Clinical Guidelines
Date: October 16 and 18, 2018 Location: Jackson, TN and Knoxville, TN 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. |
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:
- Pressure Ulcer/Injury Prevention
- Staging of Pressure Ulcer/Injuries
- Framing your wound management program using the Wound Bed Preparation model of care
- The Kennedy Terminal Ulcer/Skin Failure, Unavoidable Pressure Ulcer
- The Wound Assessment
- Documents review that support CMS regulations for wound prevention and care in the Long-Term, Sub-Acute Care Setting
- Focus on F684, F686, and F687
Objectives: At the end of this program participants will be able to:
- Recognize the components of the pressure ulcer/injury prevention program
- Stage pressure ulcer/injuries according to the State Operations Manual
- Define the Kennedy Terminal Ulcer, Unavoidable Pressure Ulcer/Injury
- Design the wound management plan of care using the Wound Bed Preparation model
- List components of F687 for care of the feet of people with diabetes
- Participate in a wound type/tissues recognition skills lab
Course Faculty:
Dr. Pamela Scarborough, Director of Public Relations and Education for American Medical Technologies.
Continuing Education Credits:
- AMT Education Division is a provider of Continuing Nursing Education by the California Board of Nursing. Provider Number CEP 15291.
- This course is approved for 6.0 hours of continuing education for nurses.
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!
The event will provide networking opportunities as well as a chance to learn from AMT's clinical and leadership teams. Stop by our booth to learn how we help facilities enhance the quality of resident care; manage wound care, infection management, ostomy, urological and tracheostomy related costs; provide educational resources and mandatory CMS documentation. To register for this event, please visit http://bit.ly/2xFY1YK | Win this Apple iPod Touch Meet us at booth #1837 to participate in the raffle or double your chances by requesting a meeting with AMT team. Request a meeting at AHCA/NCAL Expo |
Quarterly Webinar: Adapting the pressure ulcer/injury staging language into your clinical practice
9/5/2018
- Title: Adapting the pressure ulcer/injury staging language into your clinical practice and reporting mandates in long-term care
- Date: Thursday, September 20, 2018
- Time: 2:00 – 3:15 pm Eastern
- Download flyer: Click here
- Register: Click here
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:
- Recognize and compare the State Operations Manual’s Guidance to Surveyors and the National Pressure Ulcer Advisory Panel’s pressure ulcer/injury definitions and staging descriptions.
- Identify current CMS pressure ulcer/injury description and definitions for reporting and clinical best practices for documentation in the medical record.
Webinar Faculty:
Pamela Scarborough, PT, DPT, MS, CWS, CEEAA Director Of Public Policy & Education, American Medical Technologies | Lynn Tabor, MS, RN, WCC, IP-BC, ASCOM Director Of Education & Training, American Medical Technologies |
Webinar Date & Times:
| Continuing Education Credit: 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. |
Space is limited to the first 500 participants nationally. To reserve a spot, all are encouraged to register early.
BACKGROUND: Documentation is a critical component of resident care. The Office of the Inspector General (OIG) of the US Department of Health and Human Services has stated that providers carry the burden of proving that care was actually rendered to patients (residents). If health care providers are unable to prove that they rendered appropriate care because it was not documented, the OIG and other fraud enforcement agencies may conclude that claims submitted are false. Those who provide hands-on care also risk liability for negligence when they fail to document care provided. (2) |
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.
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:
- Type of injury (pressure-related versus non-pressure-related) because interventions may vary depending on the specific type of injury;
- PU/PI’s stage;
- Description of the PU/PI’s characteristics;
- Progress toward healing and identification of potential complications;
- If infection is present;
- Presence of pain, what was done to address it, and the effectiveness of the intervention; and
- Description of dressings and treatments (3)
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:
- Underlying condition contributing to the ulceration
- Ulcer edges and wound bed
- Location
- Shape
- Condition of surrounding tissues (3)
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:
- An evaluation of the ulcer, if no dressing is present;
- An evaluation of the status of the dressing, if present (whether it is intact and whether drainage, if present, is or is not leaking);
- The status of the area surrounding the ulcer (that can be observed without removing the dressing);
- The presence of possible complications, such as signs of increasing area of ulceration or soft tissue infection (for example: increased redness or swelling around the wound or increased drainage from the wound); and
- The presence of possible complications, such as signs of increasing area of ulceration or soft tissue infection (for example: increased redness or swelling around the wound or increased drainage from the wound); and
- Whether pain, if present, is being adequately controlled. (3)
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:
- Location, wound etiology and/or staging;
- Size (perpendicular measurements of the greatest extent of length and width of the ulceration), depth; and the presence, location and extent of any undermining or tunneling/sinus tract;
- Exudate, if present: type (serous, serosanguinous, purulent, etc.), color, odor and approximate amount;
- Pain, if present: nature and frequency (e.g., whether episodic or continuous);
- Wound bed: Color and type of tissue/character including evidence of healing (e.g., granulation issue), or necrosis (slough or eschar); and
- Description of wound edges and surrounding tissue (e.g., rolled edges, redness, hardness/induration, maceration) as appropriate. (3)
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
- Centers for Medicare & Medicaid Services. Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual. Version 1.15. Released October 2017.
- Office of Inspector General Website. Available at: https://www.oig.hhs.gov/fraud/strike-force/
- State Operations Manual Appendix PP-Guidance to Surveyors for Long Term Care Facilities. Revised 11/22/17. pp. 248-266, 272, 273.
- State Operations Manual-Chapter 1 - Program Background and Responsibilities. Revised 10-3-14. p. 3.
- Pressure Ulcer/Injury Critical Element Pathway. Department of Health and Human Services Centers for Medicare and Medicaid Services. CMS Form 20078, 5/2017.
Dear Partners in Care,
We have seen a tremendous interest in our Quarterly webinars as well as the presentations for some of our corporate clients related to Infection Management and Antibiotic Stewardship. This link and these handouts were mentioned and referenced in one of our last presentations and we wanted to take this opportunity to share them with all of you.
We have seen a tremendous interest in our Quarterly webinars as well as the presentations for some of our corporate clients related to Infection Management and Antibiotic Stewardship. This link and these handouts were mentioned and referenced in one of our last presentations and we wanted to take this opportunity to share them with all of you.

Here is the link to the National Healthcare Safety Network (NHSN) which has some great documents that will serve you related to surveillance. (https://www.cdc.gov/nhsn/ltach/index.html)
Below is the link from the CDC’s Antibiotic Stewardship page. This is a GREAT page for you to find documents to assist you and your team with education as you begin framing your antibiotic stewardship program. (https://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html)
Also remember to refer to the new State Operation Manual (November 2017) with the updates from the Final Rule. This is a critical document for every facility management team to have, as it contains the updated F-Tags. You should note that the new Infection Control tag, F880 (previously F441) has been significantly updated.
And lastly, remember to look at the infection prevention and control and antibiotic stewardship pilot survey that is being done this year. The surveyor worksheet in this document is very important for your program developers and management to review, as it guides the surveyor to review the building’s antibiotic stewardship program, which will be mandated for facilities to have in place by November 28, 2017 – just a few weeks away!
Please reach out to your AMT representative for education related to this or other topics pertinent to wound care and infection management.
Enjoy your week!
Lynn Tabor MS, RN, WCC
Director of Education & Training
Below is the link from the CDC’s Antibiotic Stewardship page. This is a GREAT page for you to find documents to assist you and your team with education as you begin framing your antibiotic stewardship program. (https://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html)
Also remember to refer to the new State Operation Manual (November 2017) with the updates from the Final Rule. This is a critical document for every facility management team to have, as it contains the updated F-Tags. You should note that the new Infection Control tag, F880 (previously F441) has been significantly updated.
And lastly, remember to look at the infection prevention and control and antibiotic stewardship pilot survey that is being done this year. The surveyor worksheet in this document is very important for your program developers and management to review, as it guides the surveyor to review the building’s antibiotic stewardship program, which will be mandated for facilities to have in place by November 28, 2017 – just a few weeks away!
Please reach out to your AMT representative for education related to this or other topics pertinent to wound care and infection management.
Enjoy your week!
Lynn Tabor MS, RN, WCC
Director of Education & Training