Karen Eshraghi

There are a lot of swirling questions why certain residents develop pressure ulcers, which remain a costly and critical issue for long-term care providers, a leading wound care expert noted Wednesday.

“Currently, the best guesstimates are that we are spending $11 billion annually on pressure ulcer care,” said Janice Beitz, Ph.D., RN, a professor of nursing at Rutgers University, during the 9th annual free McKnight’s Online Expo. More research is needed to understand how nutrition, support surfaces and a patient’s physical make-up play a role in risk assessment for pressure ulcers, she added.

“We have seen patients where we would bet the farm they would break down and they don’t, and others where despite everything we do, they still break down,” Beitz said. “The science has not given us enough information.”

Participants also heard from National Investment Center for Seniors Housing & Care Chief Economist Beth Mace. She discussed capital, interest rates and her “cautiously optimistic” outlook for the seniors housing sector. The day concluded with Alliance Training Center Executive Director Leah Klusch, RN, BSN, tackling MDS 3.0 and common coding and assessment challenges.

“The RAI manual is a living document. It changes,” Klusch pointed out. “We want to make sure we take information out and our team members have current definitions. [Section] K-300 says residents should be weighed during current assessment period. Can we show that? Who does the interviews? When are they done?”

Surveyors will be interviewing administrators about the assessment process, and asking direct questions about the when, how and who of assessments, Klusch cautioned.

Additionally, therapy staff should be aware of the October 2014 update in Section O, 400 ABC, she said, which gives important guidance on skilled therapy minutes.

Residents who have indwelling catheters, restraints, urinary tract infections or who are receiving antipsychotics are going to be areas of focus for surveyors, she explained.

The Online Expo continues today with sessions on Quality and Technology. Participants can receive free continuing education credits. Registration can be completed here:

mcknights.com/Expo2015