News / Blog
Need to brush up on the latest industry news? Look no further! Proactive Medical Review consultants provide up-to-date blog postings to keep you in the know.
The latest news, events, blogs and more…
Proactive to Partner with McKnight’s LTC News
Proactive Medical Review (PMR) is proud to announce that Eleisha Wilkes, RN, RAC-CTA, DNS-CT will join McKnight’s Long-Term Care News (McKnight’s) as the new monthly columnist for the Ask the Payment Expert News Column. This column features responses to frequently...
Ask Proactive – Is it required that the SNF primary diagnosis and the primary diagnosis for the qualifying hospital stay match?
Q: Is it required that the SNF primary diagnosis and the primary diagnosis for the qualifying hospital stay match? A: No, the SNF primary diagnosis and the primary diagnosis from the qualifying hospital stay do not need to match. We want to be sure we are...
FY 2022 SNF PPS Proposed Rule Released
On April 8, 2021, the Centers for Medicare and Medicaid Services (CMS) released the FY 2022 SNF PPS Proposed Rule which will take effect October 1, 2021. As anticipated, changes to the Patient Driven Payment Model (PDPM) rates and Case Mix Indexes (CMI) are proposed....
Care of the SNF Dialysis Recipient
Per the CDC, the prevalence of CKD in adults aged 30 years or older is expected to increase from 14.4% in 2020 to 16.7% in 2030. For those progressing to End-Stage Renal Disease (ESRD), dialysis is a crucial intervention to prolong life. While you may already be...
Ask Proactive – We had a resident that was discharged home with family, return not anticipated. He suffered a fall after returning home, the family decided they could not care for him and readmitted him to our facility 8 hours after discharge. Since he wasn’t out after midnight, do we have to complete discharge/entry MDS assessments?
Q: We had a resident that was discharged home with family, return not anticipated. He suffered a fall after returning home, the family decided they could not care for him and readmitted him to our facility 8 hours after discharge. Since he wasn’t out after midnight,...
COVID-19 Litigation
Nursing homes have seen a wave of complaints alleging negligence and wrongful death as a result of purportedly failing to protect residents from contracting the COVID-19 virus. As of March 23, 2021, over 9,500 complaints related to COVID-19 have already been filed in...
Medication Management: Best Practices for Regulatory Compliance
Are you ready for the annual survey and the Unnecessary Medications, Psychotropic Medications, and Medication Regimen Review task that is part of that process? Surveyors select 5 residents to conduct this review on following the Critical Element Pathway. Consider...
Ask Proactive – Now that standard surveys are beginning to resume, will surveyors still conduct the annual survey if we have active COVID-19 cases in the facility and will it trigger them to combine a Focused Infection Control (FIC) Survey with the annual survey?
Q: Now that standard surveys are beginning to resume, will surveyors still conduct the annual survey if we have active COVID-19 cases in the facility and will it trigger them to combine a Focused Infection Control (FIC) Survey with the annual survey? A: Yes,...
Ask Proactive – If we have a resident who has a bed that is lowered very close to the floor, and we have a mat beside the bed, and the resident rolls or moves off of the bed onto the mat, is that considered a fall?
Q: If we have a resident who has a bed that is lowered very close to the floor, and we have a mat beside the bed, and the resident rolls or moves off of the bed onto the mat, is that considered a fall? A: Unfortunately, as you will see in this section from the...
Setting Priorities for 5-Star Improvement
2020 was anything but normal in terms of survey processes and 5-Star rating system updates. All three of the 5-Star rating system domains were temporarily held constant at some point during 2020. On Jan. 27, 2021, CMS resumed calculating nursing home 5-Star ratings...
Taking Your Nursing Documentation to Court
“No matter how skilled or experienced you are, inaccurate or incomplete nursing documentation can mean serious trouble for your patients – and for you if you’re ever involved in a lawsuit.” Austin, Nursing2021. Many nurses who have had to testify in a deposition or...
Ask Proactive – How are reviewers determining PDPM payment accuracy from Section GG coding?
Q: How are reviewers determining PDPM payment accuracy from Section GG coding? A: The Function Score calculated from coding responses to certain Section GG items impacts your PDPM rate in the nursing component and the OT/PT component. Not surprisingly,...
Post-Pandemic Considerations – Moving Forward Instead of Just ‘Back to Normal’
There’s nothing quite like a National Public Health Emergency to shake things up and force an altered perspective. Most providers are doing well to keep up with near-daily changes relative to managing the pandemic in its current form and, in a whirlwind of Infection...
Ask Proactive – I am seeking assistance for accurate coding of CVA at item I4500 of the MDS. The physician acknowledges history of stroke in his progress note during the look-back period. The patient also receives daily aspirin and requires ongoing medication management for stroke prevention, nurses monitor for potential side effects from medication including signs & symptoms of bleeding and bruising. Would this meet the criteria to code active condition CVA at I4500?
Q: I am seeking assistance for accurate coding of CVA at item I4500 of the MDS. The physician acknowledges history of stroke in his progress note during the look-back period. The patient also receives daily aspirin and requires ongoing medication management for stroke...
Restorative Nursing Program-Overcoming the Barriers and Obstacles
Last week we reviewed Restorative Nursing and its relationship with COVID in part 1 of this 2-part series. It’s been a tumultuous time in long-term care and restorative programs may have had to be put on the back burner temporarily. How do we rebuild and possibly even...
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