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…
Payment for HIV/AIDS- related cost under the PDPM
PDPM includes specific provisions to ensure that it accounts for the increased costs associated with caring for SNF patients with HIV/AIDS. Is your facility prepared to manage complex care plans associated with higher acuity admissions? Historically in accordance with...
CMS releases 2019 RAI
Highlights from the new RAI release Opportunity to Review Assessment Steps and Coding Guidance CMS has released the MDS 3.0 Resident Assessment Instrument (RAI) Manual v1.17 effective for assessments with an ARD of 10/1/2019 and after. PDPM guidance and calculation...
Restorative Considerations for PDPM
It may be time to assess your facility Restorative Nursing Program as part of your PDPM transition preparedness plan. Restorative Basics The fundamental requirements for Restorative nursing will remain the same under PDPM. Per the RAI manual, Restorative Nursing...
Achieve Section GG – PDPM Function Score Accuracy
New! Easy Front-Line Staff Training Tool-Kit for Section GG Is your team up to speed on GG coding for PDPM? Under PDPM, Section GG significantly impacts Medicare reimbursement. Section GG replaces the Section G ADL score coding as the function measure under the new...
Proactive serves on NARA expert Panel in DC
NARA’s Spring Conference in Washington DC I was invited to NARA’s Spring Conference in Washington DC to join as an expert panelist during their Pre-Conference session. The expert topic was related to ICD-10-CM and the shift from a payment model that emphasizes volume...
Does your staff training and competency assessment program measure up?
Protect your facility and residents from adverse events and negative survey outcomes. The Phase 3 SNF §483.95 Training Requirements must be in place by November 28, 2019. As part of the new requirements, nursing facilities will be required to develop, implement, and...
5 Star Rating take a hit in April?
5 Star Rating take a hit in April? We can help! Nearly 40% of SNFs experienced a decline in overall star rating due to the changes in the 5 Star Rating calculation put into effect in April. Proactive partners with providers to drive 5 Star improvement through a...
SNF Proposed Payment Updates for FY 2020
On Friday 4/19, CMS released the pre-publication of the FY 2020 Skilled Nursing Facility Prospective Payment System Proposed Rule. As expected, the Patient-Driven Payment Model is confirmed to go into effect October 1, 2019. SNF Proposed Payment Updates for FY 2020:...
MDS Accuracy Key For PDPM Success
PDPM: MDS Accuracy and QAPI Initiatives With the implementation of the Medicare Patient Driven Payment Model (PDPM) on October 1st, 2019 comes the need for increased MDS accuracy and supportive documentation. Under PDPM, responses to 188 MDS items will be used to...
WEBINAR: PDPM Ready! Supporting Section K for Rehab and Dietary
UPDATE: This webinar is now available to purchase as a RECORDED WEBINAR DOWNLOAD. Click here for details. Register now for our upcoming webinar! Earn CEs! Seminar Details: Seminar Title: PDPM Ready! Supporting Section K for Rehab & Dietary: Identify & Code...
The Impact of Diagnosis Coding Under PDPM Reimbursement
Reimbursement under PDPM Reimbursement under PDPM will require updates to clinical systems, policies and procedures, and operational focus. Diagnosis coding accuracy will be paramount to appropriate payment under PDPM, as ICD-10 Diagnosis codes & other patient...
How will you meet Trauma Informed Care standards?
How will you meet Trauma Informed Care standards required under the Phase 3 Requirements of Participation (ROP)? Trauma-informed care is an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all...
SNF PEPPER Available – Do you have outlier Medicare billing patterns?
PEPPER: Program for Evaluating Payment Patterns Electronic Report Skilled Nursing Facility PEPPER Available The Q4FY18 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September...
CDC/CMS Free Infection Preventionist Training Course
Specialized Infection Prevention and Control Training for Nursing Home Staff On March 11, 2019, CMS announced that the Specialized Infection Prevention and Control Training for Nursing Home Staff in the Long-Term Care Setting is Now Available and can be accessed on...
Five Star Update
Five Star Rating Changes Effective April 2019 This week CMS released upcoming improvements to Nursing Home Compare and the Five Star Rating system that will go into effect in April 2019. Key changes that will take place in April include: Health Inspection...