by Proactive Medical Review | Apr 6, 2022 | blog, Compliance, SNF
The Q4FY21 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2021 is now available for download. Follow these steps to access your PEPPER and analyze any outlier billing...
by Proactive Medical Review | Mar 30, 2022 | blog, Compliance, MDS, Reimbursement
Our office regularly receives urgent calls from providers in crisis. We are in the business of coming alongside nursing facilities to shoulder a portion of the burden, drive corrective actions and assist to remedy problem situations. Given the choice and resources,...
by Proactive Medical Review | Mar 23, 2022 | blog, Compliance, MDS, Reimbursement
Compliance, Accuracy, Quality. These are words we’ve heard over and over in long-term care. They are part of our everyday regulatory landscape and are essential to MDS data integrity. Despite two years under our belts operating under the PDPM payment model, data shows...
by Proactive Medical Review | Sep 13, 2021 | 5 Star, blog, Compliance, Falls, Nursing, QAPI, Quality, Regulatory, SNF, Survey
F689 Free of Accident Hazards/Supervision/Devices has been the third most frequently cited F tag so far in the 2021 fiscal year per Casper data (9/5/21). 3,466 citations have been issued nationally for the 16.6% of providers surveyed. Scope and Severity has ranged...
by Proactive Medical Review | Sep 13, 2021 | blog, Compliance, COVID-19, Documentation, Medical Review, Medicare, SNF
On Sept. 8, 2021, CMS updated SE20011 (see p. 13) regarding Emergency SNF QHS and benefit period requirements under Section 1812(f) of the Social Security Act which were implemented to help restore SNF coverage for patients affected by the emergency. The update...
by Proactive Medical Review | Aug 31, 2021 | blog, Compliance, MDS, Medicare, PDPM, QAPI, Reimbursement
Strategies for timely estimation of potential care needs and costs are essential to SNF success, as well as systems for identifying clinical conditions and services that impact reimbursement under PDPM. Follow these steps to drive payment accuracy. Prior to Admission...
