• Will there be an influx of people who have been on ventilators, are now recovering and will need skilled care?
• Will there be an influx of people who are recovering from COVID that need skilled care?
• Are SNF’s adapting to serve the changing population, for example set up COVID wings?
• In states that are not seeing high numbers of COVID cases, will these states initiate elective surgeries earlier, if so when?
• In states that are seeing higher volumes of COVID cases, what has there been any discussion as to when elective surgeries will be resumed? 
• Prior to COVID, what percentage of elective surgeries resulted in skilled stays for rehabilitation services?  In the future, do we anticipate this to be the same, or decrease?
• Are you experiencing staffing shortages due to the coronavirus in your facilities?  If so, what mitigation steps have you put into place in an effort to prevent pressure injuries?

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Our healthcare world has certainly changed.  Partnership, community and collaboration are imperative as we navigate these new waters together.  I look forward to hearing your replies!
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Sarah holds a Bachelor of Science in Physical Therapy from and has been an adjunct faculty at Northeastern University, assisting with developing and lecturing the wound care curriculum.  She has also been a guest speaker for various organizations focusing on the area of wound care and management.

What Is Pressure Injury
A pressure injury is localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, co-morbidities and condition of the soft tissue. The full list of NPIAP pressure injury definition stages can be found here.

What We Know
Promoting a “prevention mindset” for you staff is key in preventing pressure injuries and reducing the financial burden caused by pressure injuries.  The goal is to keep the Resident moving as much as possible increasing blood flow, while reducing shearing and friction forces. Consistent, good skin care is just as important.  Keeping the skin clean, dry, and moisturized, while managing the microclimate will promote quality skin care management. The pressure injury prevention list can be found here.

Remove the Cause
Pressure Injuries can develop at any age, but more commonly it is the senior population that uses wheelchairs, is bedbound and wears medical devices and who, are therefore at highest risk. If a pressure injury does develop, you first want to identify the cause while using a holistic approach. You will want to investigate the cause from every angle. Until the cause of the pressure injury is removed, the pressure injury will not heal. Encourage your nursing staff to focus more on a prevention mindset while encompassing ongoing education.

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. 
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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.

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.

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.
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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.

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.
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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:

• 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.

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.

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.
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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.

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. ​

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.

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:

• 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.

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.

This course is presented without charge as part American Medical Technologies’ educational commitment to long-term care facilities across the country.
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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.

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.
 
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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