by Proactive LTC Consulting | Dec 10, 2025 | Care Planning, Clinical, Coding, Dietary, Documentation, MDS, Medicaid, Medicare, Nursing, PDPM, Physicians
Q: Can I code Malnutrition (Section I5600) on the MDS based on a dietary assessment that identifies the resident as at risk for malnutrition? A: No. Dietitian assessments alone do not provide sufficient documentation for coding of this item on the MDS. ...
by Proactive LTC Consulting | Nov 19, 2025 | Documentation, MDS, Medicaid, Nursing, PDPM, Quality, Regulatory, Reimbursement
Medicaid Case Mix Index Under PDPM: What LTC Facilities Need to Know As of October 1, 2025, the nationwide transition away from RUG-based Medicaid systems marks a major shift for long-term care. With more states moving to PDPM-based methodologies—and many...
by Proactive LTC Consulting | Oct 15, 2025 | Care Planning, Compliance, MDS, Medicaid, Medicare, PDPM, Quality, Quality Measure, Reimbursement, Survey
Q: Your MDS Coordinator could come to you at any time needing an emergency medical leave, giving notice, or simply deciding that the role is no longer a good fit. What potential challenges could arise if you don’t have an experienced person to fill the position, and...
by Proactive LTC Consulting | Oct 1, 2025 | Coding, Compliance, Depression, MDS, Medicaid, Medicare, Nursing, PDPM, Reimbursement
Q: I have recently been directed, when completing the PHQ-2 to 9, that if a resident acknowledges a symptom, but is unable to give a frequency, I should dash both questions (column 1 and 2). Is this correct? A: No, this is incorrect. If a resident answers “yes”...
by Proactive LTC Consulting | Apr 2, 2025 | Compliance, MDS, Medical Review, Medicare, PDPM, Reimbursement, Therapy
The State of SNF Medical Review in 2025: Trends, Challenges, and Key Findings Medical review of Skilled Nursing Facilities (SNFs) continues to be a focus of Medicare and Medicare Advantage oversight activities in 2025. With increased scrutiny from Medicare...
by Proactive LTC Consulting | Jan 14, 2025 | 5-Star, Abuse, Antipsychotics/Psychotropics, Behavioral Health, CMS, Compliance, Falls, MDS, Nursing, PDPM, QA, Quality, Reimbursement, Therapy
Compliance Risk Assessment Considerations for the New Year As we enter 2025, nursing home providers face many regulatory and administrative challenges. January is a good time to conduct a compliance risk assessment that considers the updated nursing facility...