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Ask Proactive – Key Expectations, Common Survey Findings, Best Practices, and Steps to Consider to Ensure Survey Readiness
Intravenous therapy in skilled nursing facilities care heightens clinical and regulatory risk. Surveyors frequently review IV therapy practices to evaluate compliance related to federal quality of care regulations, nursing standards, infection prevention requirements,...
Path to Five Star Quality Measures in 2026
The MDS 3.0 Quality Measures User’s Manual v18.0, effective January 1, 2026, includes some notable changes to QM specifications and reporting expectations. In addition, MDS‑driven QMs are becoming increasingly impactful across Care Compare, Five‑Star Ratings, SNF QRP,...
Ask Proactive – It doesn’t appear that we’ve had any significant changes at our facility this past year. Do we still need to review or revise our Facility Assessment?
Q: It doesn’t appear that we’ve had any significant changes at our facility this past year. Do we still need to review or revise our Facility Assessment? A: Yes. Under F838, the Facility Assessment must be reviewed at least annually, even if no significant...
Top 5 Skills of the Successful DON
What does it take to be a successful DON? Is it specific training, is it years of experience, or is effective nurse leadership inherent in the DNA of the person? If you were to review the performance characteristics of the most successful Directors of Nursing, these...
Growing Your Home Health Agency: A Practical, Profitable Approach
Sustainable growth of a home health agency comes from strong operations, smart referral strategy, and disciplined financial oversight. Agencies that grow well do a few things exceptionally consistently. Here’s a practical roadmap to help your home health agency grow...
Home Health News: Creating a Successful Home Health Budget
Creating a Successful Home Health Budget: A Practical Guide for Agency Leaders Running a profitable home health agency requires more than growing census, it requires disciplined financial planning. A well-built budget is one of the most powerful tools agency leaders...
Ask Proactive – One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met to discuss a primary diagnosis. Therapy insists we should use Z47.1 Aftercare following joint replacement surgery, but some of the available hospital documentation uses S72.141A Displaced intertrochanteric fracture of right femur, initial encounter for closed fracture. Which is the correct code?
Q: One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met to discuss a primary diagnosis. Therapy insists we should use Z47.1 Aftercare following joint replacement...
PDPM Precision: Why the Details Matter More Than Ever
PDPM Precision: Why the Details Matter More Than Ever The Patient-Driven Payment Model (PDPM) isn’t new anymore, but the challenges surrounding it continue to evolve. Most facilities don’t go wrong as a result of a lack of effort or commitment. Instead,...
Home Health News: The 2026 Home Health Final Rule: What Agencies Need to Know and Do Now
The 2026 Home Health Final Rule: What Agencies Need to Know and Do Now The CMS Calendar Year (CY) 2026 Home Health Final Rule is official, and while the outcome is better than many agencies feared, it still presents meaningful financial and operational challenges....
Ask Proactive – What are some practice tips to determine if an IPA would increase reimbursement?
Q: What are some practice tips to determine if an IPA would increase reimbursement? A: The IDT should meet regularly to discuss the status of each resident utilizing their Medicare A benefits. The MDS coordinator and other key IDT members should have a...
Top Deficiencies of 2025 & Compliance Trends Heading Into the New Year
Top Deficiencies of 2025 & Compliance Trends Heading Into the New Year As we move into the new year, nursing homes continue to navigate an increasingly complex regulatory environment. While enforcement priorities remain consistent in many areas, how...
Home Health News: Everything Indiana Home Health Providers Need to Know About the July 2026 Medicare Certification Requirement
Everything Indiana Home Health Providers Need to Know About the July 2026 Medicare Certification Requirement Effective July 1, 2026, Indiana will implement a new Medicare certification/enrollment requirement for certain health care providers and it’s critical for home...
Ask Proactive – How often should nursing respiratory competencies be evaluated?
Q: How often should nursing respiratory competencies be evaluated? A: Respiratory competency checks should be performed regularly and anytime there's a specific reason to make sure staff can safely provide respiratory care—such as when new equipment is...
F698 Dialysis: Nursing Home Quality Assurance for ESRD Residents on Dialysis
F698 Dialysis: Nursing Home Quality Assurance for ESRD Residents on Dialysis How effectively is your facility monitoring dialysis services to ensure regulatory compliance? Consider these guidelines as part of your Quality Assurance (QA) process… Appendix...
Ask Proactive – Can I code Malnutrition (Section I5600) on the MDS based on a dietary assessment that identifies the resident as at risk for malnutrition?
Q: Can I code Malnutrition (Section I5600) on the MDS based on a dietary assessment that identifies the resident as at risk for malnutrition? A: No. Dietitian assessments alone do not provide sufficient documentation for coding of this item on the MDS. ...