News / Blog
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The latest news, events, blogs and more…
Ask Proactive – Are the resident quarantine requirements the same for residents who are unvaccinated and those who are vaccinated, but have not received a booster?
Q: Are the resident quarantine requirements the same for residents who are unvaccinated and those who are vaccinated, but have not received a booster? A: Yes, Based on updated guidance released by the CDC on Feb. 2, 2022: CDC now recommends quarantining residents who...
Ask Proactive – What happens if a patient receives more than 25% of therapy in a concurrent/group setting?
Q: What happens if a patient receives more than 25% of therapy in a concurrent/group setting? A: The provider will receive a warning edit on the validation report that will inform them that they have exceeded the 25% limit. The edit will state: “The total number of...
Understanding the CMS Vaccine Mandate and Compliance with F888
BACKGROUND On November 5, 2021, CMS published an interim final rule with comment period, entitled “Medicare and Medicaid Programs; Omnibus COVID-19 health Care Staff Vaccination.” This IFC revised the infection control requirements, adding a staff vaccination mandate...
Vaccine Mandate To-Do List with Compliance Dates
With the Supreme Court vaccine mandate decision, state surveyors (and/or CMS) will soon begin enforcing COVID-19 vaccine requirements under F888. The mandate covers all Medicare certified health care facilities under the Medicare & Medicaid requirements of...
The Primary Diagnoses Under PDPM: How to Avoid Common Mistakes
Since the inception of PDPM, selecting the Primary Diagnosis has been a challenge for MDS/RAI coordinators. Under PDPM, the diagnosis coded on the 5-day/Initial Minimum Data Set (MDS) in section I0020B largely determines reimbursement for the entire Medicare stay...
Ask Proactive – Since the Discharge MDS does not have a HIPPS code, do we have to do the BIMS/PHQ-9 interviews at DC?
Q: Since the Discharge MDS does not have a HIPPS code, do we have to do the BIMS/PHQ-9 interviews at DC? A: Although the discharge assessment is not required for reimbursement purposes, it is required for regulatory compliance. RAI guidelines (pp. C-1-2) state that...
A Fresh Look at Fall Prevention
It probably comes as no surprise that falls are the number one cause of injury for seniors, the leading cause of hospital admissions for nursing home residents, and the top issue prompting facility lawsuits. The average facility fall-related cost is $17,000.00. Half...
Ask Proactive – I’ve just received an old findings letter from our recent RAC audit. Unfortunately, it looks like our time for open discussion has expired. What should we do next?
Q: I’ve just received an old findings letter from our recent RAC audit. Unfortunately, it looks like our time for open discussion has expired. What should we do next? A: A phone call to the customer service number listed on the letter may prove successful. If not, the...
Ask Proactive – Should discontinued and/or revised policies still be maintained by the facility?
Q: Should discontinued and/or revised policies still be maintained by the facility? A: It is always best to check with your facility legal counsel for their guidance on what documents, other than resident care records, should be maintained, where to maintain them and...
PDPM Insights: Are You Leaving Money on the Table?
To ensure accurate coding of all PDPM clinical conditions and comorbidities, it is essential to review the medical record prior to the 5-day MDS ARD. This chart review process is important to identify the need for gaps which may require additional supporting...
Essentials of the 12/28/21 CMS Vaccine Mandate Enforcement Memo
On Dec. 28, CMS released QSO-22-07-ALL Guidance for the Interim Final Rule that was released on Nov. 5, 2021 that established requirements regarding COVID-19 vaccine immunization of staff. The guidance and survey procedures included in this memo currently does not...
Updated CDC Guidance: Managing Staff with COVID-19 Infection or Exposure
On Dec. 23, the CDC released updated Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 and Strategies to Mitigate Healthcare Personnel Staffing Shortages. Key points included in the revised guidance include: In...
Ask Proactive – What do I do if a resident is admitted Med A and then has an unplanned discharge or death in facility prior to the 5 Day MDS being opened/created?
Q: What do I do if a resident is admitted Med A and then has an unplanned discharge or death in facility prior to the 5 Day MDS being opened/created? A: This would be considered a Missed PPS Assessment. The facility would be liable and would not be able to...
Day in the Life of the Effective Infection Preventionst
With COVID Cases on the rise again, and now 3 different COVID variants identified, COVID prevention and management is a primary focus of the Infection Preventionist (IP). However, COVID is only one of many infection related issues challenging our IP professionals...
Ask Proactive – I’m confused about the Interrupted Stay. If a Medicare A resident discharges home and then returns to the SNF two days later due to inability to care for themselves at home, is this an interrupted stay? The discharge was planned and their return was not anticipated.
Q: I’m confused about the Interrupted Stay. If a Medicare A resident discharges home and then returns to the SNF two days later due to inability to care for themselves at home, is this an interrupted stay? The discharge was planned and their return was not...