© 2017 eHealth Solutions, All Rights Reserved, For Licensed SigmaCare® Users Only

Updated: 07/07/2017

Table of Contents

RELEASE RESOURCES ............................................................................................................................................. 3

SIGMACARE LEARNING CENTER......................................................................................................................................... 3 PRACTICE SITE ............................................................................................................................................................... 3 JOB AIDS ...................................................................................................................................................................... 4 ONLINE HELP ................................................................................................................................................................ 5

ENHANCEMENT DETAILS ........................................................................................................................................ 6

GENERAL ENHANCEMENTS ............................................................................................................................................... 6 Navigation Bar Collapsible and Customizable ...................................................................................................... 6 Login to LMS from SigmaCare Login Page ............................................................................................................ 8 Validate Browser Session Update ......................................................................................................................... 8 Bed Certification Naming Change ......................................................................................................................... 9 ICD-10 Diagnosis Reporting .................................................................................................................................. 9 Diagnostic Results Added to Outbound CCDs ..................................................................................................... 10

PROGRESS NOTE ENHANCEMENTS ................................................................................................................................... 11 Progress Note Sign Off Indication ....................................................................................................................... 11

ADMISSION, DISCHARGE, TRANSFER ENHANCEMENTS ......................................................................................................... 12 Admission – Referral Tab Updates ...................................................................................................................... 12 Discharge Disposition Field Renamed Discharge Reason .................................................................................... 15 Discharge Reason field added to Transfer to Hospital – Start ............................................................................ 16 Discharge Reason Customization ........................................................................................................................ 16

ADMINISTRATION RECORD ENHANCEMENTS ...................................................................................................................... 18 Clinical Monitoring Follow-up for Routine Orders Included on Surveyor Report ................................................ 18

REHABILITATION ENHANCEMENTS ................................................................................................................................... 19 Specified Physician on Rehabilitation Clarification Order ................................................................................... 19

MDS ENHANCEMENTS .................................................................................................................................................. 20 Signature Capture Enhancements ....................................................................................................................... 20 MDS Question Level Auditing .............................................................................................................................. 23 Assigning Specific Disciplines to Individual Data Points in Question O0400 ....................................................... 24 MDS Question Links ............................................................................................................................................ 25 Limited Access to Completion Dates ................................................................................................................... 26 New York Case Mix Index Report ........................................................................................................................ 27

CARE PLAN ENHANCEMENTS .......................................................................................................................................... 29 Problems Renamed Focuses ................................................................................................................................ 29 Structured Care Plans .......................................................................................................................................... 29

CLINICAL ASSESSMENT ENHANCEMENTS ........................................................................................................................... 31 Suspended/Not Needed Clinical Assessments – Specify Scheduling Impact ....................................................... 31 Clinical Assessment Section Assignment ............................................................................................................. 32

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NURSE INSTRUCTION & CNA ASSIGNMENT ENHANCEMENTS ................................................................................................ 33 CNA Configuration Update .................................................................................................................................. 33 ADL Documentation Logic ................................................................................................................................... 35 CNA Question Updates ........................................................................................................................................ 37 ADL (Activities of Daily Living) Summary Report ................................................................................................. 41

ELECTRONIC PRESCRIBING ENHANCEMENTS ....................................................................................................................... 43 Require Dispense Quantity and Refills for Controlled Substance Orders ............................................................ 43 Script Sent to Selected Physician ......................................................................................................................... 44

INTERACT© ................................................................................................................................................................ 44 Medical Record Printing ...................................................................................................................................... 44

CARE MANAGEMENT AND CRM SYSTEMS ........................................................................................................................ 45 Cancel Pre-Admission Reasons ............................................................................................................................ 45

CARE MANAGEMENT AND REVENUE CYCLE MANAGEMENT SYSTEMS ..................................................................................... 46 Admission Source and Discharge Reason Synchronization ................................................................................. 46

SYSTEM REQUIREMENTS ................................................................................................................................................ 50

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SIGMACARE LEARNING CENTER The SigmaCare Learning Center is available to help support and prepare your facility for this release. The SigmaCare Learning Center will contain an overview training course of enhancements that are being launched. You may access the SigmaCare Learning Center website through SigmaCare by clicking on Support, then clicking SigmaCare Learning Center. Users may also select Learning Center from the drop-down on the SigmaCare Login page and login in from inside or outside the facility. (This login method is a new feature as part of the 20.6 release and is detailed on page 7.)

PRACTICE SITE The SigmaCare Practice website is always available for in-servicing staff. To access the practice website: Web Address: https://training.sigmacare.com Account: practice2 Username : stu01 (through stu20) Password: Passwords are updated quarterly. Please refer to the Job Aid on Accessing the Training Website for the most up-to-date password. To find this job aid in SigmaCare, complete the following steps:

1. Click Help. 2. Click Directory at the bottom left of the Help window. 3. Click Job Aid Directory. 4. Select Learning SigmaCare from the Topics. 5. Click Accessing the Training Website.

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JOB AIDS General

SigmaCare Basics: Navigation Bar NEW

SigmaCare Basics for the Department of Health Surveyors UPDATED

SigmaCare Learning Center Overview UPDATED

Progress Notes

Progress Notes UPDATED

Admission, Discharge, Transfer

ADT: Admitting a New Resident UPDATED

ADT: Transfers UPDATED

ADT: Discharge UPDATED

Cancel/Delete Incomplete Admission UPDATED

MDS

Completing and Signing Off UPDATED

Audit Log UPDATED

New York - Case Mix Index NEW

Completion Dates UPDATED

Care Plans

Care Plans – Creating UPDATED

Care Plan History UPDATED

Care Plans – Viewing, Activating, Discontinuing, Deleting UPDATED

Care Plan – Reactivating a Care Plan UPDATED

Clinical Assessments

Dashboard – Assessments Notification Box UPDATED

Managing Clinical Assessments UPDATED

Nurse Instructions and CNA Assignments

Activities of Daily Living - ADL Compressed Summary Report UPDATED

ADL Summary Report (MMQ) NEW

Setup

Admissions and Discharges UPDATED

Care Plan Library UPDATED

Care Plan Conversion to Structured Care Plans NEW

Clinical Assessments Library UPDATED

MDS Section Assignment Setup UPDATED

MDS Assigning Disciplines and Auto Signature Capture NEW

CNA Configuration Form NEW

Permissions UPDATED

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ONLINE HELP Enhancements will also be communicated in Online Help. Online Help can be accessed from most pages on the SigmaCare website to assist users with any questions they have while documenting in SigmaCare. The Help link is located in the upper right hand corner, and when clicked will open a window allowing a user to navigate to instructions on how to perform tasks in SigmaCare. To view all of the 20.6 changes in Online Help, simply search for “20.6”.

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GENERAL ENHANCEMENTS

With this release, SigmaCare has updated the look of the left-hand Navigation Bar and made it customizable and collapsible.

Here are the details of the new look and functions:

The Resident and Logs sections will be minimized on login.

Clicking on Resident or Logs will expand the section and display the options.

A new Menu icon has been added at the top of the page beside the user’s name.

Clicking this icon will collapse the Navigation Bar to give the user a full screen view of SigmaCare.

Clicking the icon again will expand the Navigation Bar.

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The user can customize what is included in their Navigation Bar. o Clicking the Change link under My Preferences and clicking the new Customize Menu

tab will open a list of all available menu items.

o Checked menu items will be displayed on the Navigation Bar, while unchecked items will not.

o The user must use the right-hand scroll bar to view all of the items. o Once items are checked and unchecked, the user must click Save. o Included or excluded items can be changed at any time. o Upon upgrade, all items will be checked and included on the Navigation Bar.

All users will see an alert for the new Navigation Bar upon first login after the 20.6 upgrade.

The user can click the link included on this alert to open online Help and view instructions on how to use and customize the Navigation Bar.

Set up: None User Education Needed: Notification

Release Note Online Help “Navigation Bar” Job Aid: Basics – Navigation Menu

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With this release, SigmaCare has added the ability to login to the Learning Center from the SigmaCare Login Page. This will allow users to login to the Learning Center from home or elsewhere, without logging into the SigmaCare application, whether that user has remote access permissions or not. Please Note: This update will not be available until mid-August. The SigmaCare Care Management Login page has been updated as follows:

On the SigmaCare Login page, a new field was added where the user can indicate if they want to login to SigmaCare Care Management or the Learning Center.

This field will default to Care Management, but the user can click the drop-down arrow and select Learning Center.

If the user is logging in for the first time, they will need to accept the End User License Agreement and set their security questions before the Learning Center will open. Set up: None User Education Needed: Notification

Tools:

Online Help “SigmaCare Learning Center” Learning Center Trackers Job Aid : SigmaCare Learning Center Overview

To ensure security, SigmaCare will now automatically log a user out of any open session when another user logs in on the same workstation in the same browser. Users should always logout of their browser before another user logs in. This validation will be applicable if logging in to the Kiosk or a mobile device. Set up: None User Education Needed: None

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To be more aligned with bed certification descriptions in MDS 3.0, we have renamed the Certification field option Federal and State to Medicare and/or Medicaid on the Room Setup page. Upon upgrade, any beds that previously had a certification listed as Federal and State on the Room Setup page will now have a certification listed as Medicare and/or Medicaid. Set up: None

User Education Needed: None

With this release, the ICD-10 Diagnosis Reporting has been updated to include diagnoses from the resident's most recent encounter by default. Because any previous diagnoses are copied into the most recent episode, this list of diagnoses will typically contain the full history. This update was made to provide a more readable report that will eliminate duplicate diagnoses being displayed from different episodes. Here are the details of the update:

On the Diagnosis Report page, a new Most Recent Only? checkbox has been added, which will default to checked.

If a Date Type of Current is selected, this box cannot be unchecked.

If Active as of or Historical is selected, this box can be unchecked to include results from previous encounters as well as current encounters. This may result in duplicate diagnoses being included on the report.

The following reports will be affected by the change: o Diagnosis Report – will use the most recent by default but can be changed by the user

as explained above. o UTI and Medical Record Diagnosis Report – will include the most recent episode.

There were no options added to include other encounters from the Full Medical Record (FMR) only from Diagnosis reporting.

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A Question Mark icon was added beside the new check box. Clicking this icon will display the following message:

Set up: None

User Education Needed: Notification Release Note

Online Help: Reports

SigmaCare has added diagnostic results to the CCD’s that it generates. If your organization uses SigmaCare’s Diagnostic module these results will be included in both the manual On-Demand CCD and the standard outbound CCD Integration. The diagnostic results will also be sent if your organization uses SigmaCare’s Standard Outbound CCD integration. The addition of the diagnostic results will provide a more comprehensive summary of the resident’s condition, as well as reduce the number of duplicate tests that are done today because that information is not included. Here are the details of the enhancement:

Results include both laboratory and radiology results.

Results will be sent for a resident’s current episode only.

If your organizations use SigmaCare’s On-Demand CCD functionality, the CSV file that is created will contain the diagnostic results.

If your organization uses SigmaCare’s Standard Outbound CCD Integration diagnostic information will be sent.

o Not all vendors are configured to receive this information, so please confirm with your vendor what results they can receive.

Upon upgrade, SigmaCare will include diagnostic results in the CCD’s that is creates. Set up:

For the integration, coordinate with the vendor that receives the CCD to ensure they can accept the diagnostic results.

No setup required to include Diagnostic results in the On-Demand CCD csv file.

User Education Needed: Notification

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PROGRESS NOTE ENHANCEMENTS

Progress Notes will now indicate that they were electronically signed. This will ensure that facility documentation is compliant with CMS requirements.

The Save button has been changed to Sign.

In progress note details and reports the following will be displayed: o Progress notes signed off on after the 20.6 Release will display Electronically Signed

By: (User’s Name) and Electronically Signed On: (Date/Time). o Progress notes saved (not queued) or signed off on prior to the 20.6 Release will

display Signed Off By: (User’s Name) and Signed On: (Date/Time).

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o There will be no change to progress notes queued for sign off. They will still display Entered by.

Upon upgrade, users that can enter, save, and/or sign off on progress notes will now see the Sign button in place of the Save button. Set up: None

User Education Needed: Notification Release Note

Job Aid: Progress Notes

ADMISSION, DISCHARGE, TRANSFER ENHANCEMENTS

Admitted from Field Renamed Admission Source For consistency across the product, Admitted From has been renamed Admission Source in the Care Management System.

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Here are the details of this change:

On the Referral tab, the Admitted From field is now named Admission Source.

This naming change will also apply to any reports that previously included Admitted From data. That data will now be included under Admission Source.

When the Referral tab is first opened, a callout will open to inform users of the change.

Admitting Hospital A new Hospital drop-down field will be available in the Admission Source section when the user enters Acute care hospital or Inpatient rehabilitation facility in the Admission Source field. This will allow for more detailed referral information on admissions.

All outside facilities will be included in the Hospital drop-down menu.

In the Previous Hospitalization section the Hospital field will be read only and will be populated with the information entered in the new Hospital drop-down.

Set up: None

User Education Needed: Notification

Release Note

Online Help “Admit a Resident: Referral”

Job Aid: Admitting a New Resident

Customizable Admission Sources The ability to customize the facility’s Admission Sources has been added as part of this upgrade. By customizing these sources, your facility can create more detailed, customized data for reporting and analysis.

Here are the details of this functionality:

As part of this update, the setup option Admission Setup was renamed ADT Setup.

Sources can be customized by navigating to Setup > ADT Setup > Admission Sources and

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clicking Add New Admission Source.

When an admission source is setup, more details about the source can be included.

The setup page will include the following fields: o Description: This will be what is displayed in the Admission Source drop-down menu. o Short Description: This field will feed over to the Revenue Cycle Management system. o CMS Type: Select the CMS type from this drop-down. This CMS type will also feed into

UB04 form when a bill is generated in the Revenue Cycle Management System. o Allow entry of Facility / Hospital? check box: If checked, when the user indicates the

source is a facility or hospital, a drop-down menu will display where the user will select the exact facility or hospital. The drop-down menu will include all of the facilities and hospitals associated with your account (both inside and outside facilities).

o Require Comment check box: If checked, this will require a user to add a comment on the Referral Tab.

During the admissions process, when the Referral tab is first opened, a callout will inform users of the new customizable sources option.

A link to configuration instructions is included in the message. Clicking it will open instructions for a system administrator to customize the source list.

Set up: Optional

Navigate to Setup > ADT Setup > Admission Sources and click Add New Admission Source.

For detailed setup instructions, refer to the Job Aid: Setup – Admission Discharge.

User Education Needed: None

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For consistency across the product, discharge fields and references previously titled Discharge Disposition have been renamed Discharge Reason in the Care Management System.

Here are the details of this change:

This naming change will impact the Discharge page, the ADT History/Details page, Bed Hold Disposition page, and any reports that include Discharge Disposition data.

This change will not impact any triggers previously based on Discharge Disposition. Those triggered items will still be created based on the Discharge Reason.

Discharge Reasons will be included in any Continuity of Care Documents sent from your facility.

When the Discharge page is first opened, a message will open to inform users of the change. The message will include a link to customization instructions for the facility’s system administrator to customize the discharge reasons and their requirements.

Upon upgrade, all existing options that were previously in the Discharge Disposition field will now be in the discharge Reason field. Set up: Required for customization

Navigate to Setup > ADT Setup > Discharge Reasons and click Add New Discharge Reason or click the Magnifying Glass to view/edit existing reasons.

User Education Needed: None

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For detailed instructions refer to the Job Aid: Setup – Admission Discharge.

With this upgrade, when a user enters a Transfer to Hospital – Start they will have the ability to select a Discharge Reason in the newly added Discharge Reason drop-down.

Here are the details of this enhancement:

The Discharge Reason drop-down menu will include only those discharge reasons that have a hospital type specified.

The Facility drop-down will include all facilities, both outside and account facilities.

When a resident who was transferred to the hospital is discharged, the discharge Reason and Facility will feed over to the discharge.

o These fields can be edited if necessary. Any changes will update the transfer event in ADT History.

Please Note: If your facility is using both Care Management and Revenue Cycle Management, please refer to the Care Management and Revenue Cycle Management section of the release notes (pages 48-49), as setup is required to have discharge reason options available on the Transfer to Hospital page.

Set up: None

User Education Needed: Notification Tools:

Release Note Job Aid: Transfers

With this upgrade, facilities can now customize the discharge reasons available to users. New Discharge Reasons can be added and existing Discharge Reasons (previously Dispositions) can be edited. By

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customizing these reasons, your facility can create more detailed, customized data for reporting and analysis.

Here are the details of this enhancement:

Sources can be customized by navigating to Setup > ADT Setup > Discharge Reasons and clicking Add New Discharge Reason.

If your facility is using SigmaCare’s Revenue Cycle Management System, some of these details will feed over to that system.

The setup page will include the following fields: o Description: This will be what is displayed in the Admission Source drop-down menu. o Short Description: This field will feed over to the Revenue Cycle Management system. o CMS Type drop-down: Select the CMS type from this drop-down.

o At facilities using both SigmaCare’s Care Management and Revenue Management systems, this CMS type will feed into the Revenue Cycle Management System.

o Facility Entry Required? check box: If checked, when the user selects this discharge reason, the Facility field will be required to complete.

o Hospital Type drop-down: If applicable, select the hospital type from this drop-down menu.

Items that triggered based on discharge dispositions will also trigger for new customized discharge reasons based on the CMS Type selected during setup.

Once added, a Discharge Reason cannot be deleted

Bed Hold Rules can be setup based on any of the Discharge Reasons.

When the Discharge page is first opened, a callout will inform users of the new customizable reasons option.

o A link to configuration instructions is included in the message. o Clicking it will open instructions for a system administrator to customize the reasons.

Upon upgrade: o If your facility is not using SigmaCare’s Revenue Cycle Management system, the

admission source options will remain unchanged. o Current Discharge Reasons will be assigned the following CMS codes:

Discharge Reason CMS Code

Account facility 3 Discharged/transferred to a skilled nursing facility (SNF) with Medicare Certification

Acute care hospital 2 Discharged/transferred to another short-term general

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hospital for inpatient care

Against medical advice 7 Left against medical advice or discontinued care

Another nursing care facility 3 Discharged/transferred to a skilled nursing facility

(SNF) with Medicare Certification

Board and care / assisted living 6 Discharged/transferred to home under care of

organized home health service organization

Deceased 20 Expired

Deceased in outside facility 20 Expired

MR / DD facility 6 Discharged/transferred to home under care of

organized home health service organization

Other NULL

Private home / apartment with home health service

6 Discharged/transferred to home under care of organized home health service organization

Private home / apartment with no home health service

1 Discharged to home or self care

Psychiatric hospital

5 Inpatient Psychiatric Hospital, Inpatient Psychiatric Distinct Part Unit of a Hospital, Children’s Hospital, Cancer Hospital

Rehabilitation hospital 62 Inpatient Rehabilitation Facility, including

rehabilitation distinct part unit of hospital

Set up: Optional

Navigate to Setup > ADT Setup > Discharge Reasons and click Add New Discharge Reason.

For detailed instructions, refer to the Job aid: Setup – Admission Discharge.

User Education Needed: Notification Tools:

Release Note

ADMINISTRATION RECORD ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

When printing resident records from the Resident Summary, the Surveyor – Admin Record Report will now include Clinical Monitoring Follow-Up documentation for routine orders as well as PRN orders. This report is commonly used by Department of Health Surveyors during facility visits. This enhancement will make it possible for surveyors to access necessary data independently and efficiently.

This report is accessed by clicking the Print Records icon and selecting the Admin Record tab.

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Set up: None User Education Needed: Notification Release Note

Job Aid: SigmaCare Basics for the Department of Health Surveyors

REHABILITATION ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

With this release, updates were made to physician options on clarification orders. The updates are as follows:

When a clarification order is entered or changed, the user entering it can select which physician that order or order change should be queued to.

o Previously, when a therapist entered a rehabilitation clarification order, the physician who was specified when the original rehabilitation order could not be changed.

o Now, the physician from the original order will be displayed in a drop-down field that can be edited.

The Physician drop-down field is required to complete the order.

The facility can specify if all clarification orders should default to the resident’s attending physician, regardless of which physician was selected when the original order was entered.

o A new Use Attending Physician instead of Order Physician for Clarification Order? box was added on the Facility Setup page.

o If this box is checked, the resident’s attending physician will default on all clarification

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orders and clarification order changes.

Set up: Optional

To set clarification order to default to the Attending Physician:

o Navigate to Setup > Account Setup > Facilities.

o Select the facility. o Locate and check the Use Attending

Physician instead of Order Physician for Clarification Order? Box.

o Click Save.

User Education Needed: Notification Release Note

MDS ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

Prior to this upgrade, when a user marked their MDS Section complete, their signature was applied to all questions in that section. With this upgrade, the system can add signatures to questions assigned to the user’s discipline only, not to all questions in the section (capturing signatures at the question level instead of the section level). If your facility assigns questions within a section to specific disciplines and uses automatic signature capture, this will make the process of signature capture more efficient and more accurate. Here are the details of how the Signature Capture will function when enabled at the question level:

If a user checks their discipline’s Completed? box for a section – Their signature will be added only to the questions to which their discipline is assigned.

They will also receive and Attestation message which will specify which questions in the section they are signing off on.

The user must click the Sign button on this message to sign the questions.

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If a user unchecks their discipline’s Completed? box for a section – previously added signatures will be removed.

If a user attempts to change a question(s) previously entered and signed off by another user – They will receive a warning stating, “{section/question} have already been signed off by another user, are you sure you want to save your changes? If you proceed, their signature will be removed and the question will need to be signed off again from the signature page.”

If a user saves changes to a question(s) that was previously entered and signed off by another user – The original user’s signature will be removed from the changed questions, and the questions will require sign off again from the signature page.

If a user saves changes to a question(s) that was previously entered and signed off by themselves – Their signature date for that question(s) will be updated upon save.

*If your facility has assigned data points O0400A-O0400F to specific disciplines, the signature functionality will behave this way for each of those data points.

Configuration details:

Upon upgrade, there will be no change to the facility’s current signature capture configuration.

The previous option of Automatic has been renamed Automatic – Section.

A new option, Automatic – Question Level, has been added to the User Tracking for Z0400 drop-down menu. When selected, this option will enable the enhanced signature functionality.

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When Automatic – Question Level is selected, each question may not have more than one discipline assigned to it. The system will automatically verify if any question has more than one discipline assigned. If it finds multiple disciplines assigned, the following will occur:

o The user will not be able to save the configuration. o The user will receive an error:

For Question Level Automatic signature tracking to work properly, MDS questions cannot be assigned to more than one discipline. The following sections contain questions that are assigned to more than one discipline: {section}.

This validation will occur in reverse as well. Once question level tracking is enabled, a user cannot edit a section assignment to include more than one discipline per question. If the user attempts to do so the following will occur:

o The section assignment will not be saved. o The user will receive the following error:

This questions is already assigned to "{discipline}" MDS questions cannot be assigned to more than one discipline as this question assignment is being used for MDS configuration "{configuration name}" which uses "Automatic - Question Assignment" for Z0400 user tracking.

Set up: Optional Options To assign data points to specific disciplines:

1. Navigate to Setup > MDS Setup > MDS 3.0 Configuration Setup.

2. Select your facility’s MDS configuration. 3. Click the User Tracking for Z0400: drop-down. 4. Select Automatic – Question Level. 5. Click Save.

For detailed instructions, refer to job aid Setup MDS Assigning Disciplines and Auto Signature Capture

User Education Needed: Notification Release Note

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With this upgrade, SigmaCare will track changes made to data at the question level for MDS assessments. This information can be viewed from the Assessment Audit Log for any MDS assessment. It will provide MDS Coordinators with a more detailed audit of changes to MDS assessments. Here are details of this enhancement:

Upon saving an MDS section, the following information will be tracked and included in the MDS audit: o User Name o Date/Time of Change o Changed Data

The audit tracking will also include changes to Z400 dates, Completion Dates, and CAA completions.

The Question Level Audit Details will include the Data Point, Previous Value, and New Value.

There are two ways to view question level changes, by accessing it from the Audit Log or by accessing it from within the MDS assessment.

From the Audit Log: o Clicking the Magnifying Glass for a section will display the questions that were changed.

o If it is a modification assessment, this view will only include changes to the modifications, not all previous changes from the original assessment.

From the MDS Assessment: o A new Actions drop-down menu is available above any question in the MDS Assessment.

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o This drop-down includes an option to Show Question History.

o If it is a modification assessment, this view will include both modification changes and changes to from the original assessment.

Set up: None

User Education Needed: Notification Details/tools: Release Notes

Online Help: Assessment Audit Log Job Aid: MDS Audit Log

SigmaCare has expanded its ability to assign MDS questions to a specific discipline by making it possible to assign O0400A, O0400B, O0400C, O0400D, O0400E, O0400F to specific disciplines. Assigning these data points will be useful if your facility chooses to use the new Question Level Signature enhancement mentioned above. Here are the details:

Data points O0400A, O0400B, O0400C, O0400D, O0400E, O0400F can be assigned to individual disciplines.

Once these data points are assigned, the assigned discipline’s Dashboard will display when the MDS is due, until they have completed all of their assigned questions.

All existing rules and behaviors of the MDS section/question assignment will be the same they were before the upgrade.

Upon upgrade, the prior MDS Section Assignment configuration is retained. The system will NOT unassign or reassign O0400A-F upon upgrade. To use this new enhancement, disciplines must be assigned data points for question O0400 under the MDS Section Assignment setup. Set up: Optional Options To assign data points to specific disciplines: o Navigate to Setup > MDS Setup > Section

Assignment.

User Education Needed: Notification Release Note

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o Click your facility’s MDS Section Assignment name (typically your facility’s name).

o Locate the discipline to whom you want to assign data points.

o Click the Magnifying Glass for section O. o Click the Red X for each of the data points you

want to assign to the discipline.

Refer to the Job Aid – Setup: MDS Assigning Disciplines and Auto Signature Capture

As part of the 20.6 upgrade, a new Actions menu was added to each question within the MDS. This was made to improve usability by providing all question actions in one menu.

Within any section of the MDS, a new Actions drop-down menu has been added to replace the Show Previous Data link and Pre-Population data icon.

This Actions menu will allow users to do the following:

o View Pre-population Data: To view pre-population data as well as the source of that data, if applicable to the question.

o Refresh Data: This option will refresh pre-population data for questions that support the refresh option.

o Show Previous Data: To view data for this question from a previous assessment. o Show Question History: To view an audit of data additions and changes for this question.

Upon upgrade, users will see these new Actions menu. There is also an alert that includes a link to online Help on this topic.

Set up: None

User Education Needed: Notification Release Note

Call out box

Online Help: MDS Question Actions

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With this upgrade, MDS Coordinators or System Administrators can control which users are able to set and sign assessment completion dates. Per the RAI manual, data points Z0500, V0200B1 and V0200B2 (for comprehensives only) must be completed by Registered Nurse’s only. This enhancement will make it possible to restrict this permission to those users. New permissions have been added to support this function. These include the following:

6.16.1 -MDS - Signature - Z0500 Completion Date – Allows the user to set the assessment’s Completion Date and Signature.

6.16.2 - Signatures - V0200B CAA Completion Date – Allows the user to set the CAA Completion Date and Signature.

6.16.3 - Signatures - V0200C Care Plan Completion Date – Allows the user to set the Care Plan Completion Date and Signature.

To support this enhancement, the fields have been changed on the Resident Assessment Completion Dates page:

o The Completion Dates section will contain the Completion, CAA Completion, Care Plan Completion, and Submission date fields.

o The Signatures section will contain the corresponding user signatures. o Each signature field will display a Plus icon which a user will click to add their signature

for a completion date. o If a user sets a date, their name will automatically be entered into the corresponding

Signatures field. o Users will no longer be able to select other users for sign off on a date. o The X beside the signature can be clicked to remove the signature.

A user must have MDS Read permission - 6.4.1 set to Yes to be able to access the Completion Dates page.

A user with 6.4.5 - MDS Remove Other Users Signature will still be able to remove a user’s signature from the completion dates, even if they don't have the specific completion date permission. However, they cannot sign the completion date themselves without the necessary

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signature permission.

On existing MDS Assessments, newly assigned permissions will only be enforced if a user attempts to change a completion date.

Upon upgrade, the new permissions will be set to match each user’s permissions on 6.2.2 – MDS Scheduling - Write. Set up: Optional Options

To allow or restrict access to completion dates: o Navigate to Setup > User Setup > Permissions. o Locate the necessary User’s Permissions. o Change permissions 6.16, 6.16.1, 6.16.2, and/or 6.16.3

as needed.

User Education Needed: Notification Release Note

Job Aid: MDS Completion Dates

New York Case Mix Index Report

Previously the Case Mix Index (CMI) report did not include all the information necessary for CMI reporting in the state of New York. With this enhancement, the CMI report now includes the necessary information and has been made available in both PDF and Excel formats. Here are the details of this enhancement:

Several columns of information were added to the PDF format of the New York CMI report. These include:

o MCR (Medicare) o Admit (Admit Date)

If the resident has a target assessment, and the assessment’s question A1700 is 1-Admission, then this date will be the date from A1600 of the same assessment.

If the resident does not have a target assessment or the assessment does not have A1700 answered as 1-Admission, then this will be the admission or readmission date as listed in the census.

o Fed RUG (Federal RUG Score) o BMI o Dementia o Vent

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The Excel document will require the resident’s admission date must be on or prior to the picture date to be included, but the ARD date can be after the picture date.

The Excel format of the report will include all of the above as well as the following demographics:

o Gender o DOB (Date of Birth) o Age o City o State o Zip (Zip Code)

This report will only be available to facilities whose state is indicated as New York on the Facility Setup Page.

From the Case Mix Index Report page, the user can select either PDF (New York) or Excel (New York).

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Set up: None User Education Needed: Notification Tools:

Release Note Online Help: Reports : NY State Case Mix Index

CARE PLAN ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

As part of this release, Care Plan Problems have been renamed Focuses in order to be aligned with industry standards. After the upgrade, the new naming will be viewable on all of the following:

Care Plan Log

Care Plan Reports (both resident and library level)

Resident Summary Care Plan tab

CAA Review A message regarding the naming change will display when the user visits the Care Plan Log or Care Plan tab of the Resident Summary the first time after the 20.6 upgrade. This message will include a link to online Help will more detailed information. Set up: None

User Education Needed: None

In the near future, SigmaCare will launch an updated and enhanced Care Plan Module. The key features of this new module are:

Structured elements will be added to the Care Plans Focus (formerly problem). These elements are As Evidenced By and Etiologies.

If structured care plans are implemented, a few of the benefits your facility can expect:

Increased efficiency when developing and maintaining care plans by: o Providing the user with drop-down options to build the care plan o Eliminating the need to type all the details of the care plan

This provides a framework for future standard care plan library support from SigmaCare.

Care plan data is more easily reportable.

In preparation for the new Care Plan module, with this release SigmaCare has added the ability to begin the conversion of existing care plans into structured care plans. This will prepare your facility to use SigmaCare’s new Care Plan Module when it is released. Remember: This new enhancement will give the facility the ability to begin conversion, but the structured care plan format will not be available to end users until implemented at your facility.

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Here are the details converting existing care plans to the new structured format:

From the Care Plan Library Setup, when the details for an existing care plan are opened these new functions will be available:

o Clicking the new Convert To Structured Focus button will open the existing details on the right panel and the new structured panel on the left.

This will allow for review of the existing details while building the new structured care plan.

o By clicking the Plus icon, Etiologies and As Evidenced By options can be added which will create a pick list menu for end users.

Please note: Users will still be able to manually type additional etiologies and as evidenced by when adding a resident’s care plans.

o All etiologies and as evidenced by entered will replace the previous care plan details in the free text box when a user adds that care plan for a resident. Please refer to the screenshot below:

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o Care Plans that are already part of the resident’s record will not be impacted by any conversions.

When Add New Focus is clicked, there are two new menu options: Add New Unstructured Focus – to add a traditional care plan. Add New Structured Focus – to add a new structured care plan.

Upon the 20.6 upgrade, the structured care plan conversion functionality will be available in Care Plan Library setup. Set up: Required for use

For detailed instructions, please refer to the Job Aid: Setup – Care Plan Conversion to Structured Care Plans

User Education Needed: None

CLINICAL ASSESSMENT ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

When changing a clinical assessment’s status to Suspended or Not Needed, users can now indicate if reoccurring or other triggered clinical assessments should still be scheduled based upon the assessment. This will prevent the creation of unnecessary assessments.

The new Continue scheduling based on this assessment? box will be displayed when the phase of a clinical assessment is changed to Suspended or Not Needed.

o If Suspended is selected, it will default as checked. o If Not Needed is selected, it will default to unchecked.

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When the clinical assessment’s phase is changed: o If the box is checked, other assessments will still be scheduled based on it. o If the box is unchecked, no other assessments will be scheduled based on it.

Upon upgrade, users will see the new checkbox at any facility using SigmaCare’s Clinical Assessment module. Set up: None

User Education Needed: Notification

Release Note Online Help: Scheduling Assessments Job Aid: Managing Clinical Assessments

As part of this release, SigmaCare has added the ability to assign clinical assessment sections to specific disciplines, user groups, and/or users. Previously, assessments could not be assigned. This resulted in an assessment showing up as Due on a user’s Dashboard even if none of the assessments were that user’s responsibility. As part of this functionality, the following updates were made:

A new Assigned Assessment Entry row has been added to the Clinical Assessment box on the Dashboard.

This row will display any clinical assessment that has at least one section assigned to the user’s discipline that is due or overdue.

Assignment of a section does not restrict who can complete the section.

The Clinical Assessments Log now includes an Assigned to: filter, which will allow filtering the list by who the assessments are assigned to.

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Setup configuration changes: o The setup section “Reviewed by” was renamed “Sign Off by” to be consistent with the

corresponding Dashboard notification row. o A new Assignment icon was added to the Actions column for each section of the

assessment, both on the Clinical Assessment Details setup page and on the Resident’s Assessment page.

o Clicking this icon will open the Section Assignment window.

o From this window, a section can be assigned to users, user groups, or disciplines or any combination of those.

o Once assigned, the assignees will be displayed at the top of this window. o Assignees can also be removed by accessing this window and clicking the red X.

Upon upgrade, users will see the new row in the Clinical Assessments box and system administrators will see the new setup options. No assignment changes or additions will be made upon upgrade. Set up: Optional For detailed instructions on how to assign sections,

please refer to Job Aid – Setup Clinical Assessment Library.

User Education Needed: None

NURSE INSTRUCTION & CNA ASSIGNMENT ENHANCEMENTS Note: The following enhancements will be available to facilities that have implemented the Medication Management, Full EMR, or EMR/CNA SigmaCare packages.

With this release, several updates have been made to the CNA Configuration functionality. CNA Configuration Form Page: Previously, clicking the Magnifying Glass icon to the right of the CNA

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Configuration name opened the question configurations. With this upgrade, that icon will open a new page titled CNA Configuration Form page.

From this page, a user with CNA configuration setup permissions can set the following:

Description: Multiple CNA Configurations can be added to your account or facility. Giving the unique descriptions will help to determine which configuration your facility should use.

Schedule Library: Select the Schedule Library that will be used for this configuration.

CNA Document Review: Set the timeframe (in days) in which Nurse Instructions need to be reviewed.

Specific Time Due Notification: Set the number of minutes before a specific scheduled start time that a task will show up as due for documentation.

Time Range Due Notification: Set the number of minutes before a scheduled range of start time that a task will show up as due for documentation.

Specific Time Not Documented Notification: Set the number of minutes after a specific scheduled start time that a task will show up as past due for documentation.

Time Range Not Documented Notification: Set the number of minutes after a scheduled range of start time that a task will show up as past due for documentation.

Enforce ADL Documentation Logic: This is a new option that will enforce ADL Documentation Logic. For details on ADL Documentation Logic, please review the details in the ADL Documentation Logic Release Note.

View Question Configuration: Previously, clicking the Magnifying Glass icon to the right of the CNA Configuration name opened the question configurations. With this upgrade, users will click the View Question Configuration link to view the question configurations.

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Addition of an Action Menu: Clicking anywhere on the row of the CNA Configuration name will open a new Actions Menu. This menu includes the following options:

View Configuration: This will open the CNA Configuration Form page.

View Question Configuration: This will open the Nurse Instruction/CNA Questions to view their setup.

View Not Performed Setup: This will open the list of Not Performed reasons.

Print Configuration: This will print the question configuration details.

Auditing Ability A new View Audit Log link is available at the top of the CNA Configurations page. This will open the System Audit Log with filters set to view CNA configuration changes.

Set up: None User Education Needed: None

In order to prevent invalid CNA documentation on ADL tasks, a new option has been added to the CNA Configuration which will enforce logic on ADL (Activities of Daily Living) Documentation. When enabled, this will prevent a CNA from documenting an invalid or illogical Support Provided for the Self

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Performance entered for a task. Details of this enhancement:

If enabled, the CNA must enter the Self-Performance value prior to entering the Support Provided.

Once the Self-Performance value is entered, only logical Support Provided options will display.

For example, if the CNA selects a Self-Performance value of Independent, then available options in the Support Provided menu will be limited to No setup or physical help from staff or Setup help only.

This logic will apply to documentation on the browser and the CNA application, but will not impact the Nurse Instructions.

The following table outlines acceptable Support Provided responses for each Self-Performance value:

Self-Performance Entered Acceptable Support Provided Response

Independent

No setup or physical help from staff

Setup help only

Supervision

No setup or physical help from staff

Setup help only

Continual Supervision No setup or physical help from staff

Setup help only

Limited assistance One person physical assist

Two+ person physical assist

Extensive assistance One person physical assist

Two+ person physical assist

Total dependence One person physical assist

Two+ person physical assist

Activity did not occur Activity did not occur

This logic will apply to the following Nurse Instruction/CNA Assignment questions: o G0110A – Bed Mobility o G0110B – Transfer o G0110C – Walk In Room o G0110D – Walk In Corridor o G0110E – Locomotion on unit o G0110F – Locomotion off unity o G0110G – Dressing o G0110H – Eating o G0110I – Toilet Use o G0110J – Personal Hygiene o G0120A/B – Bathing

This option can be enabled from a new setup page titled “CNA Configuration Form”. On this page, a new “Enforce ADL Documentation Logic?” check box was added.

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A Question Mark icon was also added for this new option. o It can be clicked to view an explanation of the ADL Documentation Logic function. o A link to online Help was included in the message to provide further detail.

Set up: Required for use 1. Navigate to Setup > CNA Assignment

Setup > CNA Assignments Configuration Setup.

2. Click the Magnifying Glass icon. 3. Check the Enforce ADL Documentation

Logic? Box.

For detailed setup instructions, refer to the Job Aid – Setup – CNA Configuration Form.

User Education Needed: Notification Tools:

Release Note

While the new Nurse Instruction and CNA Assignment options explained below can be used at any facility, they were added to give facilities in Massachusetts the ability to appropriately instruct the CNA and have documentation meet the requirements for surveyors and reimbursement.

Behavior Question – 800, 1000 and 1010 Intrusive Wandering has been added as an option in the Nurse Instructions and CNA Behavioral Symptoms questions.

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Here are the details of this enhancement:

The system administrator must add this option under the CNA Configuration and the Behavioral Symptom questions 800, 1000, or 1010.

For Nurse Instructions, Intrusive Wandering can be enabled as another checkbox.

For CNA Documentation, Intrusive Wandering can be enabled as a drop-down. o On question 800, the drop-down options will include:

Behavior not exhibited Behavior present and was easily altered Behavior was not easily altered Behavior exhibited Not Applicable

o On question 1000, the drop-down options will include: Behavior not exhibited Behavior present and was easily altered Behavior was not easily altered Not Applicable

o On question 1010, the drop-down options will include: Behavior not exhibited Behavior exhibited Not applicable

If your facility enables Intrusive Wandering as an option, it is recommended that your facility inactivate Wandering, so both are not available.

Set up: Required for use

Navigate to Setup > CNA Assignment Configuration Setup

Click the View Question Configuration link to the right of your facility’s CNA Configuration.

Locate and select the Behavior question (1000 or 1010).

Make desired options available Intrusive Wandering.

User Education Needed: None

Skin Check – 6950 With this release, the Skin Check question has been updated with the new name Skin Check/Care and some new data points are now available for Nurse Instructions and CNA Assignments. Here are the details of the updates to Question 6950 Skin Check:

Question 6950 has been renamed Skin Check/Care. Apply House Barrier Cream was added as a new data point to this question.

o This data point will not be available to nurses and CNA’s upon upgrade. CNA Configurations must be updated by your facility’s system administrator to use this data point.

o A Nurse Instruction data point was added for Apply House Barrier Cream. When made available in setup, the nurse can include the locations of Hips,

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Coccyx, and/or Heels as options for CNA documentation. Only options checked off by the nurse when completing Nurse Instructions

will be displayed as options for CNA documentation. o When the CNA documents on this data point, the following options will be available in

the drop-down for each location: Applied Not Applied Not Applicable

New CNA documentation options were added to the Decubitus/Pressure Ulcer Prevention data point.

o Two new options are "Applied per instruction" and "Not applied per instruction". These two options can be used in place of “Applied per order” and “Not

Applied per order” if necessary. o Previous options that were only available in Nurse Instructions can now be made

available for CNA Documentation. These include: Elbow protector Heel protector Routine diabetic foot care Hand roll Application of barrier cream Other

Set up: Optional Navigate to Setup > CNA Assignment

Configuration Setup

Click the View Question Configuration link to the right of your facility’s CNA Configuration.

Locate and select the Skin Check/Care question.

Make desired options available Decubitus/Pressure Ulcer Prevention and/or Apply House Barrier Cream.

User Education Needed: Notification Tools:

Release Note

Bed Mobility – 400 Certified Nursing Assistants can now document Position as part of the Bed Mobility task. Here are the details about this data point:

Position was added as a new CNA data point to the Bed Mobility Question (400).

When enabled, the CNA can document one of the following options on this data point: Ambulated, Back, Left, Not applicable, Other, Prone, Right, Toileted, Wheelchair, Weight shift.

These options can be customized in the CNA Assignment Configuration for this question.

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Configuration details: o From the CNA Data Point on the CNA Assignments Question list, the Position data

point will be available upon upgrade. o It can be made Not Available, Available, or Required. o By clicking the Magnifying Glass for the data point, the necessary options for the

CNA’s drop-down list can be specified.

Upon upgrade, this data point will not be available to CNA’s for documentation. CNA Configurations must be updated by your facility’s system administrator to use the data point.

Set up: Required for use

1. Navigate to Setup > CNA Assignments Setup > CNA Assignments Configuration Setup.

2. Select your facility’s CNA configurations. 3. Locate and select the Bed Mobility question. 4. Click the CNA button for Data Points. 5. Click the Not Available link for the Position

data point until it displays the desired status.

User Education Needed: Notification Release Note

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6. Optional: Click the Magnifying Glass to make certain drop-down option unavailable to the CNA.

7. Click the Save button.

With this release, SigmaCare added an ADL Summary report which will provide a summary of a resident’s ADL performance over a timeframe of up to 31 days. This report will provide an accurate and concise summary of all of the ADL’s documented. It was developed to make scoring a resident for the MMQ efficient and accurate for our Massachusetts users. Here are the details of this report:

The ADL Summary Report can be accessed two ways: o From the Resident Summary by clicking the Print Records icon and selecting the ADL

Summary tab. o From the Reports page by selecting CNA Assignments and selecting ADL Summary.

When running the report from the Reports list, the user can generate the report for multiple residents.

The report can be filtered by the following: o Date From/To (required) – This cannot exceed 31 days. o Facility (required) o Unit o Resident o Insurance o The Unit or the Resident must be specified along with the date range and Facility. o If Insurance is selected as a filter, then Resident will be disabled and vice versa.

The report will provide a summary of specific ADLs that will include any of the following that are activated for your facility’s CNA Assignment Configuration:

o Bed Mobility o Dressing o Transfer o Eating o Walk in Room o Toilet Use o Walk in Corridor o Personal Hygiene o Locomotion on unit o Bathing o Locomotion off unit

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Here is what is included in the report for each of the ADL tasks: o Columns for Independent, Supervision, Limited Assistance, Extensive Assistance, and

Total Dependence. o These columns will display the number of days during the report date range that the

ADL was most frequently documented at that level. o If different levels were documented in the same day, the highest level of assistance is

counted. o If the ADL task has an equal number of different levels documented, that will be

considered a “tie” and the highest level of assistance will be counted. o Any “tie” will display an asterisk beside the number. "*For the date range, there was at

least one day with no clear indication of the most frequent documentation. The highest “Self-Performance” value documented the most number of times that day is counted."

o If the report includes invalid documentation (For example, if Self-Performance is documented as Independent but Support Provided is documented as 2+ person physical assist):

If there are the same number of valid and invalid documentations for an ADL, the valid documentation will be counted.

If there is one valid documentation and two invalid documentations, the day will be counted as invalid documentation and will be displayed in the “Other” column.

The right columns of the report include:

o Total Days Column: The total number of days during the date range that the ADL was documented.

o Activity Did Not Occur Column: The number of days that Activity Did Not Occur was

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documented. (This will not include lack of documentation.) o Other Column: The number of days where data that was documented most frequently

cannot be categorized into any other column.

The bottom of the report includes: o Modes of Locomotion data & Bladder/Bowel data: These rows/columns will display the

number of CNA Documentations for each item and the number of days where each item was documented at least once.

Upon upgrade this report will be available to all facilities using SigmaCare’s CNA Module. Any users that have been granted permission 10.3 will be able to view and run this report.

Set up: None User Education Needed: Notification Tools:

Job Aid - Reports: Generating the ADL Summary Report (MMQ) Online Help – CNA Assignment Report

ELECTRONIC PRESCRIBING ENHANCEMENTS Note: The following enhancements will be available to facilities that are using SigmaCare’s electronic prescribing for controlled

substance scripts.

A facility can now require a user enter the dispensed quantity and refills allowed when ordering a controlled substance. At facilities using ePrescribing, if the nursing staff doesn’t complete these fields, the script is considered incomplete and a physician cannot approve it via the mobile application. By requiring these fields, the controlled substance orders, the scripts generated from the orders should have all necessary information to be ready for physician approval.

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Set up: Required for use 1. Navigate to Setup > Physician Order

Setup>Physician Order Rules 2. Click your facility’s name. 3. Click the Dispense Quantity Field Option drop-

down and select Show, Required for Controlled Substances.

4. Click the Refills Allowed Field Option drop-down and select Show, Required for Controlled Substances.

User Education Needed: None

At a facility using ePrescribing, when initiating a script from the order writer, if a physician other than the attending is selected, the script will go to the selected physician for approval. Previously, the script would go to the attending physician regardless of the physician selected.

Set up: None

User Education Needed: Notification

Release Note

INTERACT© The following enhancement will be available for facilities licensed to use Interact©.

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As part of this upgrade several enhancements were made to the medical record printing functionality, including the ability to print INTERACT© SBARs as part of the record. A facility must be licensed to use INTERACT© to use this functionality.

Here are the details:

The ICD-9 Diagnosis and ICD-10 Diagnosis options have been renamed Diagnosis (ICD-9) and Diagnosis (ICD-10).

The medical record options are now listed in alphabetical order, except for Face Sheet which appears at the top of the list. The documents will be printed in this order as well.

If your facility is using Interact SBAR, these can be included to provide more comprehensive medical record. o A new checkbox for INTERACT© SBAR has been added to the Medical Record options.

o This check box will display whether generating the medical records from the Resident Summary by clicking the Print Records icon or from Reports and selecting Medical Records (as shown in the screen shot above).

o If this box is checked, all SBARs with a Started On date within the date range and that have a status of Entry or Completed will be included.

o Any user with permissions to print medical records will see this option upon upgrade. Set up: None User Education Needed: Notification

Release Note

CARE MANAGEMENT AND CRM SYSTEMS The following enhancement will be available for facilities using SigmaCare’s Care Management and CRM systems.

For customers using both SigmaCare’s Care Management and CRM systems, facilities can require Care Management users to enter a reason for a cancelled admission. This information will feed back to the CRM system, and can be used to better identify areas of improvement and opportunity. This feature must be enabled by a SigmaCare Representative. Here are the details of this enhancement:

From the Care Management Admissions Log, if the user clicks the red X to the right of a pre-admission or incomplete admission, the following window will open:

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The Cancel Admission radio button will be the default selection.

If the admission is being cancelled the user will be required to select a Reason from the drop-down, but if the admission is being deleted, the reason field will not be displayed.

The reason options are preset in the CRM application. They include: o Patient Chose Another Facility o Patient Chose Home Health o Patient Went Home o Inability to Pay o Insurance Not Accepted o No Availability o No Private Room o Not Appropriate for Services o Not Qualified for Services o Denied Medically o Patient Expired

The cancellation reason can be viewed and edited from the ADT details page on the ADT History tab.

The entry or edit of the reason will be recorded to the Resident Audit as part of the cancellation.

Set up: Required for use

If your facility is using SigmaCare Care Management and CRM, this feature will be available upon 20.6 upgrade. Please contact your Customer Success Representative or SigmaCare Support for more information.

User Education Needed: Notification Tools:

Release Note

CARE MANAGEMENT AND REVENUE CYCLE MANAGEMENT SYSTEMS The following enhancement will be available for facilities using SigmaCare’s Care Management and Revenue Cycle Management systems.

Admission Source and Discharge Reason Synchronization This enhancement applies only to facilities using both Revenue Cycle Management and Care Management.

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For facilities using both SigmaCare’s Care Management (CM) and Revenue Cycle Management (RCM) systems, Admission Source and Discharge Reason information will be synchronized. This will eliminate the need for dual entry of this information in both systems. This will impact both configuration options as well as resident information.

Configuration Impacts: This table outlines impacts to your facility’s configuration of the Admission Source and Discharge Reason options:

Configuration of Admission Sources and Discharge Reasons Upon Upgrade:

Data Sharing between systems

Admission Sources Admission Sources from RCM will be added to CM and will default to linked.

Existing Sources in CM will remain, but will be unlinked *Setup is necessary for CM sources to be available after upgrade. Refer to the Admission Source/Discharge Reason Setup Job Aid (linked below).

Discharge Reasons Discharge Reasons from RCM will be added to CM and will default to linked.

Existing Reasons in CM will remain, but will be unlinked *Setup is necessary for CM sources to be available after upgrade. Refer to the Admission Source/Discharge Reason Setup Job Aid (linked below).

After Upgrade:

Admission Source, Discharge Reasons, or Transfer Discharge Reasons

If changes or additions are made to these configurations in one system, they will update in the other.

Configuration necessary for Admission Source/Discharge Reason upon upgrade: * For all setup described below, refer to the 20.6 Admission Source/Discharge Reason Setup Job Aid.

The CM Admission Source and Discharge Reason options will remain but will not be linked to RCM. This will impact the following:

o Unlinked CM Source/Reason options will no longer appear in the drop-down menus. o To make these options available to users after upgrade, they must be linked. o Users will still be able to view and save a previous Admission or Discharge that

includes an unlinked option but that data will not feed to RCM. The Discharge Packet will be disabled on the Discharge page until the Discharge Packet Rules

are updated for the new Discharge Reasons. The new Discharge Reason field on the Transfer to Hospital Page will not have drop-down

options until those options are added from the Discharge Reason setup page. (For example, Psychiatric Hospital should be added as the Hospital Type for that reason.)

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Resident Information Impacts: The following table outlines impacts to existing information for linked residents:

Resident Data

Upon Upgrade: Data Sharing between systems

Notes

Admission Sources No changes will occur

Admitting Facilities Will be sent from RCM to CM for all linked residents if the field is blank in CM

If the RCM Admitting Facility field is blank, then no change will occur

Discharge Reasons (entered on Discharge)

No changes will occur

Discharge Reason (entered during Transfer to Hospital)

Will be sent from RCM to CM for all linked residents

After Upgrade:

Admission Source, Discharge Reasons, or Transfer Discharge Reasons

If changes or additions are made to these configurations in one system, they will update in the other.

Synchronizing Existing Resident Information Please Note: Existing resident Admission Sources and Discharge Reasons will not be updated as part of the 20.6 upgrade. If your facility would like to have this information synchronized between the systems so that all resident information matches, please contact your Customer Success Manager or SigmaCare Support. *This synchronization service will only be available prior to the 20.7 Release.

The following table outlines how information will by synchronized if your facility opts to have SigmaCare run the update:

Syncing Existing Resident Data

Data Sharing Between Systems Resident Data Update

Admission Sources Will be sent from RCM to CM for all linked residents

If the RCM Admission Source field is blank, then no change will occur

Discharge Reasons (entered upon discharge)

Will be sent from RCM to CM for all linked residents

If the RCM Discharge Reason field is blank, then no change will occur

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Set up: Optional Refer to the 20.6 Admission Source/Discharge

Reason Setup Job Aid for setup instructions. If your facility wishes to customize Admission

Sources and/or Discharge Reasons, please refer to the Job Aid: Setup – Admission/Discharge.

Users must have been granted permission 1.33 – ADT Setup to make additions or edits to this configuration.

User Education Needed: Notification Tools:

Release Note

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SYSTEM REQUIREMENTS For a complete list of the technical requirements to use SigmaCare Care Management, visit SigmaCare Customer Connect. SigmaCare Customer Connect System Requirements Release Note Disclaimer The purpose of these Release Notes is to inform customers of the functional changes included in this SigmaCare Release. A brief description of each enhancement is included in this document, as well as the workflow processes and roles that may be impacted. These changes may or may not apply to your organization as processes and policies vary from facility to facility.