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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. ...
F695 Respiratory Care: QA Review of Residents on Oxygen
F695 Respiratory Care: QA Review of Residents on Oxygen Ensuring safe, consistent, and compliant oxygen therapy is a critical responsibility in skilled nursing facilities (SNFs). As of the 2025 survey year, F695 Respiratory Care remains one of the top ten most...
The Power of Purposeful Morning Meetings
The Power of Purposeful Morning Meetings In long-term care (LTC) communities, the first moments of the day set the tone for the team and everything that follows. A well-structured morning meeting is more than a daily huddle-- it should service as an anchor for...
Ask Proactive – What types of services are included in the coding of Respiratory Therapy on the MDS? Can this be done by CMTs? What must be included in the documentation to code Respiratory Therapy?
Q: What types of services are included in the coding of Respiratory Therapy on the MDS? Can this be done by CMTs? What must be included in the documentation to code Respiratory Therapy? A: Appendix A of the RAI manual defines Respiratory Therapy as “Services...
Home Health News: Therapy Goal Writing in Home Health
Therapy Goal Writing in Home Health: A Practical Guide for Better Outcomes In home health, therapy goals serve as a roadmap for meaningful functional progress, Writing clear and measurable PT, OT and/or ST goals that connect to functional outcomes is one of the...
Home Health News: The Role of the Governing Body in Home Health
The Role of the Governing Body in Home Health: Why It Matters More Than Ever Running a successful home health agency requires strong leadership, clear oversight, and a structure that ensures accountability for clinical excellence. At the center of this structure is...
Ask Proactive – Addressing Weight Accuracy Concerns in Skilled Nursing Facilities
Q: Our facility has been flagged on the Weight Loss Quality Measure (QM. Upon reviewing the clinical records of residents identified with unplanned weight loss, we found several cases where a previous monthly weight documented on the prior MDS was likely inaccurate....