by Proactive LTC Consulting | May 13, 2026 | Coding, Compliance, Documentation, MDS, Medicaid, Medicare, Nutrition, PDPM, Reimbursement
Q: Can IV fluids be coded in K0520A (Parenteral/IV Feeding) on the MDS? A: Yes — but only when the IV fluids are administered specifically to address a nutrition or hydration need and there is supporting documentation in the medical record. CMS clarifies that...
by Proactive LTC Consulting | Apr 8, 2026 | Audits, Compliance, MDS, Medicare, PDPM, QRP, Quality, Quality Measure, Reimbursement, Staffing, VBP
FY 2027 SNF Proposed Payment Rule: What SNFs Need to Know On April 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for updates to Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing...
by Proactive LTC Consulting | Mar 18, 2026 | 5-Star, Coding, Education, ICD.10, MDS, Medicaid, Medicare, Nursing Home Consultant, Quality, Quality Measure, Reimbursement, SNF
Impact of Primary Diagnosis Selection on the Quality Measures A well‑chosen primary diagnosis and accurate coding of all active diagnoses on the MDS does more than impact reimbursement. It shapes a resident’s clinical category, which in turn determines whether the...
by Proactive LTC Consulting | Mar 11, 2026 | Compliance, Documentation, MDS, Medicare, Nursing Home Consultant, PDPM, SNF, Training
The Nitty Gritty of SNF Skilled Service Criteria Determining whether a resident qualifies for Skilled Nursing Facility (SNF) care is an important, and frequently misunderstood, responsibility in post-acute care. Admission decisions, coverage, documentation, and care...
by Proactive LTC Consulting | Feb 18, 2026 | Coding, Compliance, Documentation, MDS, Medical Review, Medicare, Nursing Home Consultant, PDPM, Reimbursement
Q: Why is nursing documentation one of the biggest risks in medical reviews? A: Nursing documentation is one of the biggest medical review risk areas because it supports Medicare coverage and directly affects the nursing component, Non-Therapy Ancillaries...
by Proactive LTC Consulting | Dec 30, 2025 | Clinical, Coding, MDS, Medicare, PDPM, Reimbursement, SNF
Q: One of our long-term residents fell and fractured their femur requiring a hip replacement. They returned to our facility on a skilled stay. The IDT met to discuss a primary diagnosis. Therapy insists we should use Z47.1 Aftercare following joint replacement...
