by Proactive Medical Review | Oct 27, 2021 | blog, COVID-19, Legal
As the COVID-19 pandemic swept through the nation in early 2020, one fact that became clear to us all was that the elderly population, especially those residing in nursing facilities, were disproportionately impacted. Around 140,000 residents and staff of nursing...
by Proactive Medical Review | Oct 18, 2021 | ADR, Appeals, Audits, blog, Medical Review, Medicare
Are your processes achieving accurate CMI reimbursement for the care that your staff delivers? The case mix index is intended to reflect the type of residents being treated and the level of care required. Therefore, it is important to ensure that procedures are in...
by Proactive Medical Review | Oct 13, 2021 | blog
Caring for patients nearing the end of life or in the advanced stage of a serious illness should address needs in the areas of physical comfort and practical life tasks, as well as spiritual and emotional needs. This blog overviews Hospice and Palliative Care services...
by Proactive Medical Review | Oct 6, 2021 | ADR, Appeals, Audits, blog, Medical Review, Medicare
Wrongful death claims pose a significant concern for healthcare facilities. In a 2019 review of claims, roughly half of fall-related claims involved a death and 62% of closed claims involved death related to pressure injury with total payments related to pressure...
by Proactive Medical Review | Sep 29, 2021 | ADR, Appeals, Audits, blog, Medical Review, Medicare
The Centers for Medicare & Medicaid Services (CMS) indicated in an August 2021 MLNConnects newsletter that the targeted probe and educate (TPE) program would resume ending the temporary suspension since in place since March 2020 due to the COVID-19 public health...
by Proactive Medical Review | Sep 22, 2021 | blog, SNF
“Calm seas never made a good sailor” Franklin D. Roosevelt was quoted as saying, and if that’s true, I expect the storms weathered by nursing home leaders over the past two years have seasoned many into veteran skippers. While we certainly would not have chosen this...
