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Ask Proactive – Our IDT was actively working on a discharge plan for a resident to be discharged home on Friday, but on the previous Saturday the family came and told the nurses they were taking the resident home that afternoon. We were able to obtain a discharge order from the MD for this and set up some expedited services for care in the home setting prior to the resident’s departure that afternoon. Would this discharge be considered a planned or unplanned discharge?

by | Mar 4, 2026 | Care Planning, Coding, Compliance, Discharge, Documentation, MDS

Q: Our IDT was actively working on a discharge plan for a resident to be discharged home on Friday, but on the previous Saturday the family came and told the nurses they were taking the resident home that afternoon. We were able to obtain a discharge order from the MD...

Ask Proactive – What are the necessary components to the plan of care for residents receiving hospice services?

by | Jan 28, 2026 | Care Planning, Compliance, Documentation, Hospice, Nursing Home Consultant, Regulatory

Q: What are the necessary components to the plan of care for residents receiving hospice services?   A: To establish and maintain continuity of care, the facility and hospice must collaborate in the development of the resident’s plan of care and includes the...

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?

by | Dec 10, 2025 | Care Planning, Clinical, Coding, Dietary, Documentation, MDS, Medicaid, Medicare, Nursing, PDPM, Physicians

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.  ...