by Proactive Medical Review | Dec 2, 2020 | blog, Compliance, Physicians
CMS defines “emergency/disaster” as an event that can affect the facility internally as well as the overall target population or the community at large or community or a geographic area(1). COVID-19 certainly meets that definition. Even if your facility has not...
by Proactive Medical Review | Nov 24, 2020 | blog, Compliance, Physicians
The Department of Health and Human Services (HHS) and The Centers for Medicare and Medicaid Services (CMS) published two final rules last week, targeting the reduction of regulatory barriers to care coordination and increased flexibility for provider participation in...
by Proactive Medical Review | Nov 18, 2020 | blog, Compliance, COVID-19, Medicare
As most providers are aware, the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare fee-for-service medical reviews because of the COVID-19 pandemic on March 30, 2020. This included pre-payment medical reviews conducted by Medicare...
by Proactive Medical Review | Nov 12, 2020 | blog, Compliance, Education, QAPI
Under regulation §483.35 Nursing Services we find the regulatory requirement for sufficient and competent nursing staff at section §483.35(a)(3) which states “The facility must ensure that licensed nurses have the specific competencies and skill sets necessary to care...
by Proactive Medical Review | Oct 19, 2020 | blog, Coding, Compliance, Documentation, MDS, Medical Review, Medicare, PDPM, Reimbursement
Has nursing documentation and internal auditing suffered due to COVID-19 prevention or outbreak efforts? Many facilities have had to prioritize staff and resources in order to meet the challenge of the public health emergency and the many additional responsibilities...
by Proactive Medical Review | Oct 14, 2020 | blog, Compliance, COVID-19
Federal regulations require each facility to conduct and document a facility-wide assessment to determine what resources are necessary to care for its residents competently during both day-to-day operations and emergencies. The intent of the facility assessment is to...
