The Landscape of Skilled Service Justification in Skilled Nursing Facilities

by | Nov 5, 2024 | Compliance, Documentation, MDS, Medical Review, Medicare, Nursing, PDPM, Quality, Regulatory, Reimbursement, SNF, Therapy

Skilled Service Justification in SNFs In the ever-evolving landscape of skilled nursing facilities (SNFs), the stakes have never been higher. With constant advancements in data analytics, regulatory bodies are sharpening their focus on compliance and accountability...

Ask Proactive – Can we place the room/bed number for a semi-private room on the Enhanced Barrier Precaution sign located outside the resident’s room to notify staff which resident requires PPE for high contact activities or is this a HIPAA violation?

by | Nov 5, 2024 | CMS, Compliance, HIPAA, Infection Prevention, Nursing, Regulatory

Q: Can we place the room/bed number for a semi-private room on the Enhanced Barrier Precaution sign located outside the resident’s room to notify staff which resident requires PPE for high contact activities or is this a HIPAA violation?     A: CMS addresses...

Ask Proactive – I have a resident that routinely receives an injection of fluphenazine decanoate every 4 weeks. The injection was not administered during the 7-day observation period, but its a long-lasting medication. Should I code it under N0415A?

by | Oct 30, 2024 | Clinical, Coding, Compliance, MDS, Nursing, RAI Manual

Q: I have a resident that routinely receives an injection of fluphenazine decanoate every 4 weeks. The injection was not administered during the 7-day observation period, but its a long-lasting medication. Should I code it under N0415A?     A: Page N-9 of...

Ask Proactive – We have a resident with a chronic stage IV pressure ulcer who recently had flap surgery to close the wound. Do I continue to code the stage IV on the MDS?

by | Oct 22, 2024 | Clinical, MDS, Nursing, Pressure Ulcers

Q: We have a resident with a chronic stage IV pressure ulcer who recently had flap surgery to close the wound. Do I continue to code the stage IV on the MDS?     A: According to the RAI (pg. M-6), if a pressure ulcer is surgically closed with a flap or...