by Proactive Medical Review | Feb 12, 2020 | blog, Compliance, RoP
As you prepare the SNF Compliance and Ethics Program work plan for 2020, consider planning a review of the facility HIPAA privacy and security program and take steps to manage risk. Consider these 12 tips to get started: Designate a privacy officer, security...
by Proactive Medical Review | Feb 4, 2020 | Compliance, IPA, Medicare, PDPM, PDPM Coding Questions, SNF
Q: What would happen if the interrupted stay criteria was met, but the resident came back from the hospital with a new diagnosis? A: In order to utilize Medicare benefits, even if the criteria of the Interrupted Stay Policy have been met, the resident must...
by Proactive Medical Review | Jan 28, 2020 | 5 Star, blog, Compliance, Education
CMS has approved funds for an Ohio Medicaid Grant Project in partnership with Proactive Medical Review & Consulting, LLC to administer a targeted Nursing Home Competency Certification Program that will include access to regional workshops, webinars, support from a...
by Proactive Medical Review | Jan 28, 2020 | 5 Star, blog, Compliance, Education
As we begin a new year, there is benefit in evaluating lessons learned in 2019 to establish improvement goals for 2020. As you know, both annual surveys and complaint surveys can have a significant impact on the overall 5-Star Rating. To help guide action planning,...
by Proactive Medical Review | Jan 23, 2020 | Compliance, Education, MDS, PDPM, PDPM Coding Questions, RAI Manual
Q: I have NPO resident on tube feeding. He coughed during trials of nectar thick liquids per speech therapy. Should the MDS be coded for swallow problems? The RD says directions on the MDS RAI manual say “do not code if interventions are successful in treating...
by Proactive Medical Review | Jan 22, 2020 | Compliance, PDPM, PDPM Coding Questions
Q: With section GG replacing Section G in October, will CNA ADL charting go away? A: CMS posted a new DRAFT version of the 2020 MDS item sets (v1.18.0) on December 20, 2019 in which Section G has been removed from all Federal item sets. This will help eliminate the...
