by Proactive Medical Review | Jul 21, 2021 | blog, COVID-19, Quality Measure
Nationally, telehealth appears to have had a positive impact on the CMS Quality Measures regarding Emergency Department (ED) Visits—has your facility shown improvement in this area? In March 2020, following the declaration of the COVID-19 public health emergency, CMS...
by Proactive Medical Review | Jul 14, 2021 | 5 Star, blog, Regulatory, Survey
Wondering when surveyors will be at your facility for your annual survey? You’re not alone. This past year has been anything but normal in terms of survey activities. Let’s take a look at the current state of recertification surveys occurring across the nation and...
by Proactive Medical Review | Jul 7, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
Even though SNFs have collectively seen higher reimbursement rates under the Patient-Driven Payment Model compared to the previous RUG IV payment model, data shows that there is still room for improvement for most facilities in terms of ensuring accurate revenue under...
by Proactive Medical Review | Jun 29, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
When you became a long-term care Administrator or Director of Nursing you probably didn’t envision that you would also wear the hat of a detective. In today’s long-term care environment, being able to conduct a thorough internal investigation is a critical strength...
by Proactive Medical Review | Jun 17, 2021 | Audits, blog, Compliance, Medical Review, Regulatory, Reimbursement
The MACs officially resumed post-payment medical review of items and services with dates of service prior to March 2020 this past August, but according to a June 3, 2021 announcement may now officially begin conducting post-payment medical reviews for later dates of...
by Proactive Medical Review | Jun 17, 2021 | 5 Star, blog, Falls, Nursing, Quality Measure
While often preventable, falls continue to be the leading cause of both fatal and nonfatal injuries in older adults. Per the Centers for Disease Control and Prevention, each year, a typical nursing home with 100 beds reports 100 to 200 falls, with even more falls...
