Proactive Offers Solutions that Allow Providers to Focus on Care
Post-acute care providers face an ever changing regulatory environment, and are experiencing expanded auditing by governmental agencies and contractors. Publicly reported quality and outcomes data requires a focused approach to compliance and care excellence, in order to meet both referral source and community expectations. The administrative and financial implications of these standards are significant, especially for smaller providers without extensive corporate support. Proactive is the budget-friendly answer to results oriented clinical, regulatory, and reimbursement compliance.
Our team of specialists includes expert geriatric therapist, nurse, administrator, and billing consultants. With therapist consultants on staff, we are uniquely positioned to assist skilled nursing facility providers through Medical Review involving rehabilitation services. Learn more about our leadership team below.
Amie Martin and Shelly Maffia have been exceptional partners to work with on the QAPI in Action webinar series. They have provided needed information during each webinar for our membership, and the attendance for each webinar have exceeded expectations. Their professionalism and expertise is much appreciated as our members focus on building successful QAPI programs in critical performance areas.
Kentucky Association of Health Care Facilities (KAHCF)
Proactive Medical Review and Consulting has been providing a QAPI Webinar Series for our association. Quality Assurance and Performance Improvement is a hot topic and at the forefront of our members’ strategic planning at the community level. Amie and Shelly has been providing insight, guidance, critical thinking skills, and tips and tricks to help our member communities review and analyze data, make process changes and improvements and implement new strategies to enhance and achieve high quality care and QAPI success.
Indiana Health Care Association (IHCA)
We have worked with Proactive Medical Review for the past five years. They have been instrumental in keeping us informed and compliant with the ever changing regulations and requirements related to skilled nursing care. Specifically they have targeted and helped us properly document to capture our Rehab RUGS, guided us successfully through the appeal process and provided exceptional tools and education for our nursing and therapy departments. Additionally, they work closely with our nursing department in all facets of their daily responsibilities including the development and revision of our facility policies and procedures. Thanks to their expertise, we were able to obtain a deficiency free survey in 2016. They have been and continue to be a great addition to our team.
Parkway Rehabilitation and Nursing Center
American Association of Nurse Assessment Coordinators (AANAC) https://www.aanac.org/
American Health Lawyers Association (AHLA) https://www.healthlawyers.org
Indiana Heath Care Association (IHCA) http://www.ihca.org/
Leading Age CA https://www.aging.org/
Leading Age IN http://www.leadingageindiana.org/
Leading Age KY http://leadingageky.org/
Leading Age FL http://www.leadingageflorida.org/
Leading Age WA https://www.leadingagewa.org/
Leading Age VA http://leadingagevirginia.org/
Leading Age CO https://www.leadingagecolorado.org/
Leading Age OR http://www.leadingageoregon.org/
Kentucky Association of Health Care Facilities (KAHCF) https://www.kahcf.org/
Health Care Compliance Association (HCCA) http://www.hcca-info.org/
Hoosier Owners and Providers for the Elderly (HOPE) http://hoosierownersandproviders.org/
National Association of Rehabilitation Providers and Agencies (NARA) https://www.naranet.org/
Ohio Health Care Association (OHCA) https://www.ohca.org/
Illinois Health Care Association (IHCA) http://www.ihca.com/
Missouri Health Care Association (MHCA) http://www.mohealthcare.com/
Tennessee Health Care Association (THCA) https://www.thca.org/
Nebraska Health Care Association (NHCA) https://www.nehca.org/
Health Facilities Association of Maryland (HFAM) http://www.hfam.org/
Ohio Health Care Association (OHCA) https://www.ohca.org/
Amie Martin, OTR/L, CHC, RAC-CT, Principal Consultant & Director of Operations for Proactive Medical Review & Consulting, LLC
Amie is an occupational therapist with over twenty years of experience serving in long term care rehabilitation leadership positions and as a clinical program specialist. She is certified in healthcare compliance through the Health Care Compliance Association. She has successfully partnered with post-acute care and rehabilitation service providers to improve clinical outcomes, compliance programs, medical record documentation, and to reduce error rates under medical review. Working with legal counsel to prepare defensive arguments and provide expert witness testimony, she has defended rehabilitation providers under large volume ZPIC and RAC government audits, recovering reimbursement on denied claims. Amie’s recent publications include articles for the American Occupational Therapy Association, American Association of Nurse Assessment Coordination (AANAC), American College of Health Care Administrators, and the American Health Lawyers Association. She has presented extensively to SNF health care associations and national groups such as NARA (National Association of Rehabilitation Providers and Agencies) and AANAC on documentation and Medical Review related topics.
Shelly Maffia, MSN, MBA, RN, NHA, QCP serves as a Director of Regulatory Services for Proactive Medical Review & Consulting, LLC.
Shelly is a Registered Nurse and Nursing Home Administrator with over ten years of experience serving in long term care leadership and consulting positions, including positions as Director of Nursing, Administrator, and Corporate Nurse Consultant and Training Positions. She earned the QAPI Certified Professional (QCP) credential from the American Association of Nurse Assessment Coordination (AANAC), which was established to promote the highest standards for QAPI program implementation in the long-term care profession.
She is a member of the Association for Professionals in Infection Control and Epidemiology (APIC) and earned a Certificate in Infection Prevention Training in the Long-Term Care Setting. She is an AHIMA approved ICD-10-CM and ICD-10-PCS trainer. Shelly has extensive experience providing consultation and leadership support to skilled nursing centers to ensure quality resident care and regulatory compliance. She is experienced in developing clinical training tools, policies, procedures, protocols, and providing training programs on systems, processes, and best practices for long-term care facilities and corporations.
OTR/L, RAC-CT, Director of Audit Services
Stacy is a graduate of University of Southern Indiana with over ten years of long term care experience as an occupational therapist and multi-site manager. She has served as a mentor and clinical instructor, specializing in geriatric clinical programs, post-acute quality care and reimbursement, and medical review management. She currently serves as Director of Audit Services for Proactive Medical Review & Consultants, LLC providing clinical instruction, quality assurance medical record auditing, and medical review response assistance in approximately 100 mid-west based skilled nursing facilities.
Emily King, OTR, RAC-CT, CADDCT
Emily King has twelve years of occupational therapy and rehabilitation management experience serving the geriatric population through leadership positions such as facility rehabilitation coordinator, regional director of rehabilitation and clinical consultant. She has developed and presented numerous rehab clinical programs to ensure clinical excellence, and has a passion for promoting best practices for dementia care. She is a Certified Alzheimer’s Disease Dementia Care Trainer. She is also a certified resident assessment coordinator with a record of successfully partnering with post-acute care facilities and rehab contractors to improve clinical documentation and reduce claim error rates under medical review. She also has extensive experience consulting with providers undergoing government audits including ZPIC, RAC, manual medical review over therapy threshold, and payer probe reviews.
Christa Roberts, PT, MPT, RAC-CT
Christa is a Physical Therapist with 18 years of experience in long term care, serving as lead physical therapist, rehabilitation coordinator and clinical consultant. She has a passion for working with the geriatric population and has presented educational programs related to geriatric care, specifically to falls prevention, lifting procedures and mobility techniques with the geriatric population. She serves Proactive Medical Review in clinical instruction, quality assurance and medical review response assistance for skilled nursing facilities.
Sheena Mattingly, MS CCC-SLP
Sheena is a Speech-Language Pathologist with extensive experience in long term care. She has a passion for progressive illnesses such as Parkinson’s disease and dementia which has led her to extensive research opportunities with a focus on the geriatric population. Most recently, Sheena has assisted in the development of a device for patients suffering from hypokinetic dysarthria along with several other research projects during her education at Purdue University. Sheena now serves as a clinical consultant for Proactive Medical Review & Consultants, LLC providing clinical instruction, medical review auditing, and denials management.
Eleisha Wilkes is a Registered Nurse with over fifteen years of experience in long term care. She has served as a Director of Nursing, Case Manager and Resident Assessment Coordinator with extensive responsibility and success in driving QA in the areas of person centered assessment and care planning through effective systems, staff development, and interdisciplinary team collaboration. She now serves as an RN Clinical Consultant with Proactive Medical Review & Consulting, LLC.