by Proactive Medical Review | Apr 6, 2022 | CMS, Q&A
Q: My facility considers October through March as “flu season.” Does this mean flu season is officially over for MDS Section O coding purposes? A: It’s best not to restrict yourself to specific date ranges for influenza vaccination seasons and reporting...
by Proactive Medical Review | Mar 30, 2022 | CMS, Q&A
Q: A resident went out to the ER, and while he was there, he received IV medication. Can I count that as ‘IV Medication while a resident’ under O0100H2? A: If the resident was not admitted to the hospital, then he would be considered a resident of the facility...
by Proactive Medical Review | Mar 22, 2022 | CMS, Q&A
Q: What are some best practices for residents who refuse care? A: In the CMS State Operations Manual – Appendix PP in F 578 §483.10(c)(6), (c)(8), (g)(12) CMS has provided guidance regarding resident refusals: While the resident also has the right to refuse any...
by Proactive Medical Review | Mar 16, 2022 | CMS, Medicare, Q&A, SNF
Q: What should be done if a PPS 5-Day assessment completed for Managed Care is submitted to CMS? A: Assessments that are completed for purposes other than OBRA and SNF PPS reasons are not to be submitted, e.g., private insurance, including but not limited to...
by Proactive Medical Review | Mar 2, 2022 | CMS
Biden’s March 1st State of the Union speech included a promise to bring Nursing Home Industry Reforms including minimum staffing requirements, enhanced nursing home oversight, and greater transparency of facility ownership with a focus on private equity firms. The...
by Proactive Medical Review | Aug 31, 2021 | blog, CMS, Medical Review
CMS announced on August 12, 2021 that the MAC’s Targeted Probe and Educate (TPE) Program is restarting after a temporary pause during the Public Health Emergency. TPE involves a process of selecting providers identified based on data analysis as being at high risk for...
