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…
Ask Proactive – Default or Provider Liable? I mistakenly thought a resident qualified for the interrupted stay when in actuality they readmitted beyond the 3-day interruption window (on day 4). I failed to schedule a new PPS 5-day assessment within the required timeframe. Can I still complete the PPS 5-day for billing?
Q: Default or Provider Liable? I mistakenly thought a resident qualified for the interrupted stay when in actuality they readmitted beyond the 3-day interruption window (on day 4). I failed to schedule a new PPS 5-day assessment within the required timeframe. Can I...
Part 1: Ready, Set, Medical Review Resumes
The MACs officially resumed post-payment medical review of items and services with dates of service prior to March 2020, but may now officially begin conducting post-payment medical reviews for later dates of service. The Targeted Probe and Educate program will...
Ins and Outs of Skilled Maintenance Therapy
Skilled maintenance therapy has long been a service offering available for use in long-term care, yet this programming continues to be the source of confusion for many providers. ”Maintenance Therapy”, is often requested by patients and their representatives/families...
Ask Proactive – Is it a “disability-related inquiry” under the ADA to ask about or request documentation that an employee obtained the COVID-19 vaccine from a third party in the community, such as a pharmacy, primary physician, or public clinic?
Q: Is it a “disability-related inquiry” under the ADA to ask about or request documentation that an employee obtained the COVID-19 vaccine from a third party in the community, such as a pharmacy, primary physician, or public clinic? A: According to the EEOC,...
Ask Proactive – Can a resident be on both restorative and therapy at the same time?
Q: Can a resident be on both restorative and therapy at the same time? A: Yes. Facilities may elect to have licensed rehabilitation professionals perform skilled therapeutic interventions that constitute a high level of complexity, or train aides in...
Pandemic Aftermath: Resident Depression
To manage COVID-19 transmission among residents, nursing facilities had to enforce social distancing between residents, their family and friends, and in certain circumstances, even residents and caregivers. The extended quarantine caused social isolation with adverse...
Ask Proactive – We are implementing the use of Paid Feeding Assistants. Once our staff completes the state-approved training program, do we need to do anything else?
Q: We are implementing the use of Paid Feeding Assistants. Once our staff completes the state-approved training program, do we need to do anything else? A: Training is only 1 of the 3 components of the Paid Feeding Assistants federal regulation. Supervision and...
Driving Excellence Through SNF QAPI
QAPI programs help to solidify strong processes for identifying and prioritizing problems and opportunities, and sustaining progress on quality objectives long term. QAPI work plans target organizational process, functions, and services provided to residents based...
Survive Being Served
Receiving a subpoena requesting medical records or to give deposition or trial testimony, is the last thing on any health care professionals wish list. Carefully assembling medical records or preparing for testimony however, is extremely important. As with most...
Ask Proactive – Now that long term care annual surveys have resumed in most states, what are the most frequently cited F-Tags this year?
Q: Now that long term care annual surveys have resumed in most states, what are the most frequently cited F-Tags this year? A: The top 5 most frequently cited F-Tags in standard surveys conducted from Oct 2020 – present are: F812 Food Procurement,...
Are you meeting the requirements for Respiratory Care and Services? Don’t hold your breath…
As reported by the CDC, chronic lower respiratory disease and respiratory infections are leading causes of morbidity and mortality in the elderly, and perhaps unsurprisingly, provisional data indicates COVID-19 was the third leading cause of death in 2020. Given the...
Ask Proactive – When should I code respiratory failure in Section I of the MDS?
Q: When should I code respiratory failure in Section I of the MDS? A: To code any active diagnose in Section I, RAI manual requirements must be met including MD documented diagnosis in the last 60 days & supporting documentation that the diagnosis is active...
Overcoming the Aftermath of COVID: Weight Loss
The COVID-19 Pandemic has impacted rates of weight loss in long-term care facilities both directly and indirectly. Prior to the onset of the pandemic, the Quality Measure ‘Percent of Residents Who Lose Too Much Weight’ was 5.8% at the national average (QIES Database...
Pressure Ulcer Prevention: What We Need to Know
Pressure ulcers/injuries are significant health issues and one of the biggest challenge’s facilities face on a day-to-day basis. Preventing pressure injuries has always been a challenge, not just in long term care, but for the entire health continuum. The presence of...
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...
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