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?

by | Mar 22, 2023 | Coding, ICD.10, MDS, PDPM, Q&A

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

by | Mar 21, 2023 | Blog, MDS, Medicare, PDPM, Reimbursement

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....

Ask Proactive – For the Quality Measure “Percent of Residents Who Newly Received an Antipsychotic Medication (SS),” is the initial assessment used in the calculation always an Admission or 5-Day?

by | Mar 15, 2023 | Antipsychotics/Psychotropics, Q&A

Q: For the Quality Measure “Percent of Residents Who Newly Received an Antipsychotic Medication (SS),” is the initial assessment used in the calculation always an Admission or 5-Day?   A: For this measure, the initial assessment is the first assessment completed...

Social Services PDPM Impact

by | Mar 7, 2023 | Blog, MDS, Medicare, PDPM, SNF

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 – We have a resident on Enhanced Barrier Precautions who will be staying at our facility long term. Are there criteria for discontinuing these precautions at some point?

by | Mar 6, 2023 | Infection, Nursing, Q&A

Q: We have a resident on Enhanced Barrier Precautions who will be staying at our facility long-term. Are there criteria for discontinuing these precautions at some point?   A: It depends on why the Enhanced Barrier Precautions (EBP) were implemented. For...

Ask Proactive – We have a physician who has requested that all patients be seen in her office rather than on-site at the facility. Will this satisfy the physician visit requirements?

by | Feb 23, 2023 | Compliance, Physicians, Q&A, Regulatory

Q: We have a physician who has requested that all patients be seen in her office rather than on-site at the facility. Will this satisfy the physician visit requirements?   A: The regulations do not specifically address a location requirement; however, according...