by Proactive Medical Review | Jan 13, 2021 | IPA, Q&A
Q: During the COVID-19 Pandemic, some states have been allowing facilities to temporarily certify beds during the declared pandemic emergency for Medicare/Medicaid that were not already certified. Do MDS Assessments have to be completed for residents in these beds,...
by Proactive Medical Review | Jan 6, 2021 | IPA, Q&A
Q: What effect does the IPA have on the variable per diem rate? A: The IPA does not affect the variable per diem. When an IPA is completed and payment changes, it continues the variable per diem schedule that was established by the 5-day PPS assessment. The IPA...
by Proactive Medical Review | Dec 29, 2020 | COVID-19, IPA, Q&A
Q: After completing the PPS 5-day assessment, a Medicare resident developed symptoms and tested positive for COVID-19 later in their stay. The resident was subsequently moved to the COVID (RED) unit in single room isolation. Should I complete an IPA? A: Once...
by Proactive Medical Review | May 6, 2020 | CMS, COVID-19, IPA, PDPM
On April 10, 2020 the Occupational Safety and Health Administration released a memorandum detailing enforcement guidance for recording cases of Coronavirus disease 2019 (COVID-19). The memo provides interim guidance to Compliance Safety and Health Officers (CSHOs) for...
by Proactive Medical Review | Apr 28, 2020 | 5 Star, CMS, IPA, PDPM, Quality Measure
On April 24, CMS issued a memo (QSO-20-28-NH) regarding Nursing Home Five Star Rating System updates, staffing data and frequently asked questions. In this memo, they announced that the health inspection domain of the five-star rating system will temporarily be...
by Proactive Medical Review | Apr 15, 2020 | CMS, IPA, PDPM, SNF
CMS issued the FY2021 SNF PPS Proposed Rule (effective October 1, 2020) on 4/10/20 with a 2.3% payment increase yielding an approximate increase of $784 million in payments to SNFS. Other changes to the code mappings for PDPM case-mix classification and updates for...