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Medicaid Case Mix Index Under PDPM: What LTC Facilities Need to Know
Medicaid Case Mix Index Under PDPM: What LTC Facilities Need to Know As of October 1, 2025, the nationwide transition away from RUG-based Medicaid systems marks a major shift for long-term care. With more states moving to PDPM-based methodologies—and many...
Ask Proactive – A resident tells you a personal item is missing. What steps should be taken?
Q: A resident tells you a personal item is missing. What steps should be taken? A: Start by staying calm and acknowledging their concern. Gather the key details — what’s missing, where was the item last seen, and when did they last have it? Document the report...
Ask Proactive – How are residents and their families involved in the CAA process?
Q: How are residents and their families involved in the CAA process? A: The Care Area Assessment (CAA) process is the foundation for developing each residents individualized care plan. The information gathered during CAAs helps the interdisciplinary team...
Home Health News: The Importance of an Individualized Plan of Care in Home Health
The Importance of an Individualized Plan of Care in Home Health In home health care, every patient’s journey is unique — and their care should be too. That’s where an Individualized Plan of Care (POC) comes into play. The POC serves as the foundation for all care...
F697 Pain Management Updates: What SNFs Need to Know
F697 Pain Management Updates: What SNFs Need to Know Managing pain effectively isn’t just about comfort — it’s a core component of quality care and compliance in post-acute care environments. The Centers for Medicare & Medicaid Services (CMS) recently updated F697...
Ask Proactive – Why is monitoring enteral feedings important in LTC?
Q: Why is monitoring enteral feedings important in LTC? A: Monitoring ensures the resident is receiving the correct nutrition safely and effectively. It helps identify complications early, such as: Tube blockage or displacement Aspiration risk Intolerance...
Capturing Required Transfer/Discharge Documentation
Capturing Required Transfer/Discharge Documentation Significant emphasis is placed on the need for comprehensive documentation to support that resident transfers/discharges are justified and in compliance with the regulations outlined in the April 28, 2025 update to...
Home Health News: Ins & Outs of Medicare Certification for Your Home Health Agency
Ins & Outs of Medicare Certification for Your Home Health Agency Becoming a Medicare-certified home health agency (HHA) opens the door to serving a wider range of patients and securing reimbursement for covered home health services. However, the path to...
Ask Proactive – Coding a Pressure Injury That Worsened During Hospitalization
Q: I have a resident with an in-house acquired Stage 2 pressure injury. He went out to the hospital for three days and upon return, it was documented as Stage 4. How should this be coded on the MDS? A: The RAI User’s Manual (v1.18.11, effective Oct. 1, 2025)...
Unreported Falls in Nursing Homes: OIG Study Findings
Unreported Falls in Nursing Homes: OIG Study Findings In September 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released a concerning report related to a study with findings indicating that falls with major injury were...
Ask Proactive – What are best practices for developing a facility cannabis policy, and can staff administer medical marijuana to residents?
Q: What are best practices for developing a facility cannabis policy, and can staff administer medical marijuana to residents? A: As more states legalize medical and recreational cannabis, long-term care facilities are increasingly faced with questions about...
Major Changes to SNF VBP Program: What You Need to Know to be Successful
Major Changes to SNF VBP Program: What You Need to Know to be Successful The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program continues to evolve, with CMS expanding the scope of this quality incentive program beyond the hospital readmission measure...
Mastering the Home Health Plan of Care: Building the Foundation for Quality and Compliance
Mastering the Home Health Plan of Care: Building the Foundation for Quality and Compliance In home health care, the Plan of Care (POC) is more than just paperwork, it’s the blueprint that guides every aspect of patient care. A well-developed POC ensures that care is...
Ask Proactive – Your MDS Coordinator could come to you at any time needing an emergency medical leave, giving notice, or simply deciding that the role is no longer a good fit. What potential challenges could arise if you don’t have an experienced person to fill the position, and what can you do to prevent issues?
Q: Your MDS Coordinator could come to you at any time needing an emergency medical leave, giving notice, or simply deciding that the role is no longer a good fit. What potential challenges could arise if you don’t have an experienced person to fill the position, and...
5 Minute Staff Retention Strategies for the Busy DON
5 Minute Staff Retention Strategies for the Busy DON Most experts agree that the main reasons for high turnover in all areas of healthcare, especially nurses and nursing assistants, include burnout, aging of the workforce and fierce competition to attract...