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…
Ask Proactive – Our facility is triggering the UTI QM, and we have identified that many of these are the result of the hospital diagnosing a UTI that does not meet our infection criteria. Do we have to code those on the MDS if they occur during the look-back period?
Q: Our facility is triggering the UTI QM, and we have identified that many of these are the result of the hospital diagnosing a UTI that does not meet our infection criteria. Do we have to code those on the MDS if they occur during the look-back period? ...
Ask Proactive – What are some effective strategies for improving staff engagement and retention in nursing homes?
Q: What are some effective strategies for improving staff engagement and retention in nursing homes? A: Improving staff engagement and retention is crucial for maintaining high-quality care in nursing homes. Here are some strategies: Offer Competitive...
A Guide to Effective Care Plan Meetings
Effective care plan meetings are crucial for delivering high-quality care in skilled nursing facilities. These meetings ensure that each resident receives personalized and comprehensive care tailored to their unique needs and circumstances. Care plan development...
Ask Proactive – My biller is requesting a HIPPS code for a Medicare resident who admitted to our SNF and then transferred to an assisted living facility on the same day. I didn’t think we could bill for the day of discharge. Please clarify.
Q: My biller is requesting a HIPPS code for a Medicare resident who admitted to our SNF and then transferred to an assisted living facility on the same day. I didn’t think we could bill for the day of discharge. Please clarify. A: Generally, the day of...
Practical Tips to Avoid F695 Respiratory Care Deficiencies
F695 Respiratory Care was the 7th most cited deficiency in standard health surveys so far for the 2024 Fiscal Year, being cited in 21% of surveys. F695 mandates that facilities must ensure residents requiring respiratory care, such as oxygen therapy, respiratory...
Ask Proactive – A new resident was admitted to our facility with an order for Mirtazapine 15mg every evening. There is no information in the admission paperwork regarding its use and the admitting nurse entered the order “for antidepressant.” Should N0415C2: High-Risk Drug Classes: Indication be coded “yes” or “no”?
Q: A new resident was admitted to our facility with an order for Mirtazapine 15mg every evening. There is no information in the admission paperwork regarding its use and the admitting nurse entered the order “for antidepressant.” Should N0415C2: High-Risk Drug...
The Critical Role of Frontline Caregivers in Managing Resident Condition Changes
Frontline caregivers are instrumental to the delivery of optimal care practices for residents. Conversely, when changes in a resident's condition go unnoticed or are not communicated promptly by caregivers, there is a significant risk of deterioration. The timely...
Ask Proactive – What should be the first reference for MDS/NAC or IDT members when searching for a diagnosis code?
Q: What should be the first reference for MDS/NAC or IDT members when searching for a diagnosis code? A: The ICD-10-CM Official Guidelines for Coding and Reporting (Guidelines) for the current fiscal year should always be the first reference consulted....
Enhancing Behavioral Healthcare Through Non-Pharmacological Approaches
Behavioral health conditions, including dementia, depression, and anxiety, are common in and out of skilled nursing and long-term care facilities. While medications are often prescribed to manage these conditions, there is a growing recognition of the importance of...
Nutrition and Hydration Refresher
Maintaining adequate nutrition and hydration status is crucial to promoting quality of life and positive outcomes for each resident. Poor nutritional status can lead to adverse health effects, including decreased strength and functional abilities, depression,...
Ask Proactive – Do you have suggested strategies for integrating QAPI into the daily operations of a nursing home?
Q: Do you have suggested strategies for integrating QAPI into the daily operations of a nursing home? A: Best practices for integrating QAPI into daily operations include embedding QAPI principles into the organizational culture, making quality...
Ask Proactive – Is there a specific assessment for determining a resident’s capacity to consent to sexual activity?
Q: Is there a specific assessment for determining a resident’s capacity to consent to sexual activity? A: While you may find samples of assessments that are identified to be used for determining a resident’s capacity to consent to sexual activity, you...
The Lowdown on DON Oversight of MDS
In the fast day-to-day of managing nursing care and services, it’s easy for a a disconnect to develop between the Director of Nursing (DON) and the Minimum Data Set (MDS) Coordinator. This division is exacerbated when the DON is inexperienced in the MDS role, given...
Fiscal Year 2025 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1802-F)
On July 31, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the final rule updating Medicare payment policies and rates for skilled nursing facilities (SNFs) under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year...
Ask Proactive – How can nursing home leadership effectively use Facility Assessment data to drive strategic planning and resource allocation?
Q: How can nursing home leadership effectively use Facility Assessment data to drive strategic planning and resource allocation? A: Facility leadership can leverage Facility Assessment data to drive strategic planning and resource allocation by...