by Proactive LTC Consulting | Aug 23, 2023 | Blog, ICD.10, Medicare, PDPM, Reimbursement
PDPM has been in place for nearly four years, and with it came the shift from payment based on resource utilization to payment driven by patient characteristics and service provision. PDPM presents with many nuances and complexities that open the door to sinking... by Proactive LTC Consulting | Aug 9, 2023 | Appeals, Medical Review, Medicare, Q&A
Q: My facility is going through a Medicare UPIC review and received a significant number of denials followed by a demand letter requiring repayment. What are our options for appealing the decision and what is the interest rate that will apply if we aren’t able to... by Proactive LTC Consulting | May 31, 2023 | Blog, Compliance, Education, MDS, Medicare, Nursing, PDPM
You’ve likely heard that significant changes are coming to the MDS in October 2023. Here’s what you need to know in a nutshell and our recommended action steps to be prepared. An updated version of the MDS 3.0 (version 1.18.11) will be implemented effective October 1,... by Proactive LTC Consulting | May 9, 2023 | Blog, Compliance, Medical Review, Medicare, PDPM
On May 4th, CMS issued Transmittal 12015 instructing MACs to perform a 5 claim probe and educate medical review on every SNF in their jurisdiction. A 15.1% SNF error rate in 2022 based on the Comprehensive Error Rate Testing (CERT) program is the catalyst for this... by Proactive LTC Consulting | May 9, 2023 | Documentation, Medicare, Q&A
Q: If we have a new admission on or prior to May 11th using the QHS waiver, what happens when they require a hospital stay? A: John Kane addressed this during the Open Door Forum (ODF) on March 2nd. The full transcript for this ODF is located under the Skilled... by Proactive LTC Consulting | May 1, 2023 | Documentation, Medicare, Q&A
Q: Why is daily charting necessary and how do you tackle compliance with Medicare A charting? A: Documentation is an important part of providing resident care, it is a means to facilitate communication among the healthcare team, allowing for collaboration and...