Ask Proactive – We have a resident who we are skilling related to a recent femur fracture. The principal diagnosis is S72.22XD, which maps to the Non-Surgical Orthopedic/Musculoskeletal Clinical Category, but it states “May be Eligible for One of the Two Orthopedic Surgery Categories”. How do we determine if it is eligible for one of the Orthopedic Surgery categories?

Q: We have a resident who we are skilling related to a recent femur fracture. The principal diagnosis is S72.22XD, which maps to the Non-Surgical Orthopedic/Musculoskeletal Clinical Category, but it states “May be Eligible for One of the Two Orthopedic Surgery...

Winning at PDPM

Resident conditions and resource needs drive reimbursement under the Patient-Driven Payment Model (PDPM). Successful facilities have developed systems to effectively recognize and capture the differences among residents, particularly in the utilization of resources....

Social Services PDPM Impact

The Social Service department plays a significant role in daily nursing facility operations. From patient care planning, patient adjustment to facility admission, discharge planning, engaging with family/representatives, and beyond, social service staff members wear...

Ask Proactive – Is it appropriate to skill every resident that tests positive for COVID-19? Does the waiver allow us to skill “in place” any resident who tests positive?

Q: Is it appropriate to skill every resident that tests positive for COVID-19? Does the waiver allow us to skill any resident who tests positive?   A: There has been quite a bit of confusion surrounding the use of the waivers, especially when it comes to current...

Ask Proactive – I understand that CMS will be conducting audits of schizophrenia coding in the MDS data and potentially adjusting the long-stay residents who are receiving antipsychotic drugs QM ratings when inaccurate coding is found. What are the criteria for diagnosing Schizophrenia?

Q: I understand that CMS will be conducting audits of schizophrenia coding in the MDS data and potentially adjusting the long-stay residents who are receiving antipsychotic drugs QM ratings when inaccurate coding is found. What are the criteria for diagnosing...