About Us
Proactive is the budget-friendly answer to results oriented clinical, regulatory, and reimbursement compliance. Our talented team offers the support solutions that allow your staff to focus on care.
Proactive Offers Solutions that Allow Providers to Focus on Care
Post-acute care providers are facing many challenges–an ever changing regulatory environment, expanded government auditing, and a growing list of publicly reported quality measures. But your mission is centered on care excellence and consistently satisfying resident, referral source and community expectations. For smaller providers without extensive corporate support, the administrative and financial implications of balancing evolving regulatory compliance obligations and care quality can be difficult.
“Proactive Medical Review and Consulting has been a great resource to our team. Their passion and professionalism show in everything they do. From reimbursement processes to regulatory compliance, PMR keeps us on the leading edge of our industry. We are happy to have them in our corner.” Click here to read more testimonials.
Solutions for providers…
Proactive is the budget-friendly answer to results oriented clinical, regulatory, and reimbursement compliance. Our talented team offers the support solutions that allow your staff to focus on care.
Our Leadership Team
Our clinical and operations specialists include expert PT, OT, and SLP therapists, nurse, administrator, and billing consultants. With experienced therapists 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 OTR/L, CHC, RAC-CT
President
Specialty Areas: PDPM Transition, SNF Rehab Stay Justification, Medical Review/Medicare Appeals, Falls Prevention & Management, Dementia Care, QAPI, SNF Requirements of Participation, and Compliance
Click here to learn more about Amie...
What makes her competent to serve you well?
Amie’s experience as a clinical trainer, quality assurance director, Compliance Officer and multi-facility operations manager culminated in the founding of Proactive Medical Review. She is certified in healthcare compliance and as a Resident Assessment Coordinator, and 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. She has partnered with legal counsel to defend providers under large volume ZPIC, UPIC and RAC reviews, and manages hundreds of appeals each year with a proven track record of 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 presents extensively on clinical, compliance and reimbursement topics including, most recently, a monthly PDPM and Requirements of Participation webinar series offered through AHCA state affiliates in Georgia, Hawaii, Indiana, Illinois, Kansas, Kentucky, Maryland, Mississippi, Missouri, North Dakota, Nebraska, Ohio, Oklahoma, South Carolina, Tennessee, and Wisconsin, as well as LeadingAge state associations in Colorado, Connecticut, Florida, Indiana, Iowa, Michigan, Oregon, Rhode Island, Texas, Virginia, and Washington.
Specialty Areas
PDPM Transition, Medical Review/Medicare Appeals, Falls Prevention & Management, Dementia Care, QAPI, SNF Requirements of Participation, and Compliance
Personal Creed
“Whatever you do, work at it with all your heart, as though working for the Lord and not for people.” Colossians 3:23
5 words clients use to describe Amie
Insightful, Warm, Positive, Decisive and Innovative
Things she loves even more than winning a favorable decision on a Medicare appeal
Her husband and 4 kids, boating at Barkley Lake, Cardinals baseball, a good joke, and gardening
Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC
Director of Regulatory Services
Specialty Areas: PDPM Transition, 5 Star Improvement, Requirements of Participation, ICD.10-CM coding, Quality Assurance & Performance Improvement, Developing Clinical training programs & tools, Developing nursing facility policies/procedures, long term care best practices, survey management
Click here to learn more about Shelly...
What makes her competent to serve you well?
Shelly is a Registered Nurse and Nursing Home Administrator with experience serving as Director of Nursing, Administrator, and as a multi-site Corporate Nurse Consultant. She holds AANAC’s QAPI Certified Professional (QCP) credential. She is a member of the Association for Professionals in Infection Control and Epidemiology (APIC) and earned a Certificate in Infection Prevention in Long-Term Care. She is a skilled coder and an AHIMA approved ICD-10 trainer. Shelly specializes in not only identifying SNF regulatory compliance risks, but in supporting SNF leadership in implementing the practical, real life solutions that drive performance improvement and quality outcomes. Shelly coordinates Proactive’s active Phase 1-3 Requirements of Participation facility partnership project teams and leads 5 Star improvement projects. She has presented extensively on survey preparedness, facility assessment, QAPI, Achieving 5-Star QMs, and implementing effective interdisciplinary systems.
Specialty Areas
PDPM Transition, 5 Star Improvement, Requirements of Participation, ICD.10-CM coding, Quality Assurance & Performance Improvement, Developing Clinical training programs & tools, Developing nursing facility policies/procedures, long term care best practices, survey management
Personal Creed
“Great things in business are never done by one person. They’re done by a team of people” – Steve Jobs
5 words clients use to describe Shelly
Wise, Pragmatic, Intelligent, Helpful, & Thoughtful
Things she loves even more than a deficiency free survey
Family, traveling, IU Basketball, and Golf
Stacy Baker, OTR/L, RAC-CT, CHC
Director of Audit Services
Specialty Areas: PDPM Transition, PPS Scheduling & Management, SNF Rehab Stay Justification, Medicare Compliance, Audit Management, Case Mix Index
Click here to learn more about Stacy...
What makes her competent to serve you well?
Stacy is a skilled geriatric clinician, mentor and clinical instructor, specializing in post-acute quality care, reimbursement, and medical review management. An accomplished coder, auditor and coach, she oversees therapy claim audit services for clients from coast to coast. Stacy is known for her approachable style that makes her clients comfortable asking questions, and this –partnered with her background as a multi-site manager with a broad understanding of the integration between rehab, MDS and the business office make her a go-to resource for accurate answers. She has served the medical review and quality assurance needs of over 400 skilled nursing facilities since joining Proactive in 2013.
Specialty Areas
PDPM Transition, PPS Scheduling & Management, SNF Rehab Stay Justification, Medicare Compliance, Audit Management, Case Mix Index
Personal Creed
Each day we choose what we are filled with and what we pour out. In my daily walk, I choose love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self-control (Galatians 5:22-23).
5 words clients use to describe Stacy
Kind, Organized, Approachable, Patient, Detail-oriented
Things she loves even more than strong, supportive medical records
Faith, husband and 2 children, Church Ministries & Outreach, Vacationing, Cooking, HGTV, Pinterest Failer (depressing, but entertaining)
Emily King, OTR, RAC-CT, CADDCT
Clinical Consultant
Specialty Areas: Dementia Care, Medicare Reimbursement, SNF Quality Measure clinical programs, Auditing, and healthcare leadership
Click here to learn more about Emily...
What makes her competent to serve you well?
Emily King has served the geriatric community in multi-site therapy leadership positions and as a clinical educator. She is skilled in assisting nursing facilities and outpatient therapy clinics to improve clinical documentation for measurable error rate reduction under medical review through training and constructive chart review feedback. Her background includes extensive geriatric clinical program development. Awarded the 2016 IHCA Foundation Scholarship for Dementia Care, she is a Certified Alzheimer’s Disease Dementia Care Trainer. Her passion is educating caregivers on creative techniques to enhance the lives of those living with dementia, and she has presented extensively on person centered care, quality of life, and applications of current dementia research.
Specialty Areas
Dementia Care, Medicare Reimbursement, SNF Quality Measure clinical programs, Auditing, and healthcare leadership
Personal Creed
Live and love each day to the fullest and remember that happiness and peace in every aspect of life begins with demonstrating kindness toward each other.
5 words clients use to describe Emily
Creative, Skilled, Cheerful, Bright, and Optimistic
Things she loves even more than positive feedback on a workshop evaluation
Her 3 sons, and her family also enjoys camping, boating, gardening, and four-wheeling.
Christa Roberts, PT, MPT, RAC-CT
Clinical Consultant
Specialty Areas: Falls, Wound Care, Orthopedic Protocols, Geriatric Therapy, Rehabilitation Coding
Click here to learn more about Christa...
What makes her competent to serve you well?
Christa is a Physical Therapist with 18 years of experience in long term care and rehabilitation management. She has a passion for working with the geriatric population and has presented educational programs related to geriatric falls prevention, restorative nursing, evidence based practice, and maintaining functional mobility. She serves Proactive Medical Review as a clinical instructor, quality assurance leader, auditor and medical review response coordinator.
Specialty Areas
Falls, Wound Care, Orthopedic Protocols, Geriatric Therapy, Rehabilitation Coding
Personal Creed
“If you want to lift yourself up, lift up someone else.” –Booker T. Washington
5 words clients use to describe Christa
Thorough, Easy-going, Practical, Focused, Dependable
Things she loves even more than a well written progress report
Spending time with family, camping, traveling, attending my children’s sports events, church family
Eleisha Wilkes, RN, RAC-CTA
Clinical Consultant
Specialty Areas: PDPM Transition, RAI interpretation and application, MDS accuracy, Emergency Preparedness, Developing clinical training programs and tools, Care Planning
Click here to learn more about Eleisha...
What makes her competent to serve you well?
Eleisha is a Registered Nurse with over 15 years of long term care experience. She has significant experience 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 has presented educational programs related to PDPM transition success, MDS accuracy, effective care planning, Competency Based Staff Development, and Restorative Nursing Programs. Eleisha serves as a clinical consultant providing auditing, clinical training, and project development services.
Specialty Areas
PDPM Transition, RAI interpretation and application, MDS accuracy, Emergency Preparedness, Developing clinical training programs and tools, Care Planning
Personal Creed
“Strive not to be a success, but rather to be of value.” – Albert Einstein
5 words clients use to describe Eleisha
Calm, Organized, Prepared, Practical, Open-minded
Things she loves even more than a validated MDS
Her husband and two sons, reading a good book, Netflix binges, good food, family vacations
Kristen Walden, MSN, RN, RAC-CT
Clinical Consultant
Specialty Areas: PDPM Transition, RAI accuracy, Case Mix, Care Planning, Restorative Implementation, Quality Measures, Quality Assurance Process Improvement and Regulatory Compliance
Click here to learn more about Kristen...
What makes her competent to serve you well?
Kristen is a Registered Nurse with over nineteen years of long term care experience. She has experience as a Regional Clinical Reimbursement and Nurse Consultant, Director of Nursing and Resident Assessment Coordinator.
Specialty Areas
PDPM Transition, RAI accuracy, Case Mix, Care Planning, Restorative Implementation, Quality Measures, Quality Assurance Process Improvement and Regulatory Compliance
Personal Creed
“Each day is a new day. Make it matter.”
5 words clients use to describe Kristen
Committed, Compassionate, Diligent, Decisive, Knowledgeable
Things she loves even more than a validated MDS
Her husband, 2 children and 2 grandchildren, music, non-fiction novels and Pinterest.
Jessica Cairns, RN, RAC-CT, CMAC
Clinical Consultant
Specialty Areas: Medicaid and Medicare Regulations, SNF PPS, PDPM Transitions, QAPI, Clinical Reimbursement, Care Planning, Auditing, and MDS Accuracy
Click here to learn more about Jessica...
What makes her competent to serve you well?
Jessica is a Registered Nurse with 17 years experience in long term care. Her background includes significant experience as a reimbursement specialist for a large long-term care organization, providing education and support to those facilities over multiple states. She has served as a subject matter expert in the areas of Medicare and clinical reimbursement, developing and authoring courses for a major healthcare learning management system/education provider. She has extensive experience with medical auditing and compliance, and has collaborated with leadership teams in the development and implementation of restorative programming, QAPI, and Quality Measure improvement. Jessica has presented extensively on Medicare regulations, RAI process, PPS reimbursement, and Case Management.
Specialty Areas
Medicaid and Medicare Regulations, SNF PPS, PDPM Transitions, QAPI, Clinical Reimbursement, Care Planning, Auditing, and MDS Accuracy
Personal Creed
“Tell me and I forget, teach me and I may remember, involve me and I learn.” Benjamin Franklin
5 words clients use to describe Jessica
Ambitious, Passionate, Loyal, Organized, Optimistic
Things she loves even more than a validated MDS
Her husband and three children, her 2 dogs, hockey, interior decorating, and sweet tea.
Latest News/Blogs
Searching for more blogs, news, resources and more? Click here to read more.
Q & A – What is the #1 ICD.10 coding error that you find in your audits?
Q: What is the #1 ICD.10 coding error that you find in your audits? A: Answer: The coding error seen most often is using acute conditions/diagnoses. The RAI Manual states while certain conditions represent acute diagnoses, SNFs should not use acute diagnosis...
Q & A – Should presumptive positive COVID-19 test results be coded as confirmed?
Q: Should presumptive positive COVID-19 test results be coded as confirmed? A: Yes, Presumptive positive COVID-19 test results should be coded as confirmed. A presumptive positive test result means an individual has tested positive for the virus at a local or...
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