Ask Proactive – I know the PHE is set to expire in July. As we continue to admit new patients using the SNF waivers, what will happen if the PHE ends during the patient’s benefit period?

Q: I know the PHE is set to expire in July. As we continue to admit new patients using the SNF waivers, what will happen if the PHE ends during the patient’s benefit period?   A: Effective April 21, 2021, HHS Secretary extended the PHE, the new expiration date...

How Hot is Your SNF PEPPER?

As part of CMS’ goal of preventing Medicare fraud, waste and abuse, PEPPER (Program for Evaluating Payment Patterns Electronic Report) analyzes billing patterns to determine the level of risk for improper payments in key target areas. PEPPER compares your SNF’s...

Ask Proactive – Is this a Fall with Major Injury? A resident had an unwitnessed fall and self-reported that she hit her head. No injuries or concerns were noted upon post-fall evaluations. Three days later, the resident was transferred to the hospital due to chest pain and non-reactive pupils. Diagnostic imaging showed a subdural hematoma. Should this be reported on the MDS as a fall with major injury?

Q: Is this a Fall with Major Injury? A resident had an unwitnessed fall and self-reported that she hit her head. No injuries or concerns were noted upon post-fall evaluations. Three days later, the resident was transferred to the hospital due to chest pain and...