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...
by Proactive Medical Review | Jul 7, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
Even though SNFs have collectively seen higher reimbursement rates under the Patient-Driven Payment Model compared to the previous RUG IV payment model, data shows that there is still room for improvement for most facilities in terms of ensuring accurate revenue under...
by Proactive Medical Review | Jun 29, 2021 | Abuse, blog, Compliance, Legal, Nursing, Regulatory
When you became a long-term care Administrator or Director of Nursing you probably didn’t envision that you would also wear the hat of a detective. In today’s long-term care environment, being able to conduct a thorough internal investigation is a critical strength...
by Proactive Medical Review | Jun 17, 2021 | Audits, blog, Compliance, Medical Review, Regulatory, Reimbursement
The MACs officially resumed post-payment medical review of items and services with dates of service prior to March 2020 this past August, but according to a June 3, 2021 announcement may now officially begin conducting post-payment medical reviews for later dates of...
