by Proactive LTC Consulting | Jul 16, 2025 | ADR, Appeals, Audits, Documentation, Medical Review, Medicare, Reimbursement, SNF
Q: Do we need to obtain prior authorization for every managed care resident who requires skilled services, even if they clearly meet criteria? A: Unfortunately, yes — at least for now. Most managed care plans (including Medicare Advantage) still require prior... by Proactive LTC Consulting | Jul 9, 2025 | Care Planning, Compliance, Documentation, Pressure Ulcers, Quality, Quality Measure
Q: What is the difference between avoidable and unavoidable pressure injuries? A: The determination of whether a pressure injury is avoidable versus unavoidable depends on the facility meeting the following criteria. The facility must ensure the following:... by Proactive LTC Consulting | Jul 9, 2025 | 5-Star, ADL, Compliance, Documentation, MDS, Medicare, Quality, Quality Measure, Therapy
Discharge Function Score: Getting it Right! Are your Discharge Function Scores working for or against you? If you’re still treating Section GG like “just another MDS task,” you’re missing one of the most influential performance measures in the SNF Quality... by Proactive LTC Consulting | Jun 25, 2025 | Compliance, Documentation, Emergency Preparedness, Survey
Is Your Facility Truly Prepared for an Emergency? The OIG Says “Maybe Not” Nursing homes play a vital role in keeping vulnerable residents safe, but recent emergencies in facilities (e.g., hurricanes, infectious outbreaks, fires) have revealed critical... by Proactive LTC Consulting | May 28, 2025 | Compliance, Documentation, F-Tag, Quality, Regulatory
Documentation To Support Transfer or Discharge for F622 & F623 Compliance The decision to transfer or discharge a resident from the nursing facility is not to be taken lightly. Recent updates to Appendix PP of the State Operations Manual are a reminder to... by Proactive LTC Consulting | May 7, 2025 | Care Planning, Compliance, Documentation, F-Tag, Safety
LTC Smoking/Vaping Safety 101 As the use of tobacco and vaping products continues to evolve, nursing homes must address the unique challenges these habits pose to resident safety, health outcomes, and regulatory compliance. Whether accommodating individuals who...