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...
by Proactive LTC Consulting | Dec 30, 2025 | Coding, Compliance, MDS, Medicare, PDPM, Reimbursement
PDPM Precision: Why the Details Matter More Than Ever The Patient-Driven Payment Model (PDPM) isn’t new anymore, but the challenges surrounding it continue to evolve. Most facilities don’t go wrong as a result of a lack of effort or commitment. Instead,...
by Proactive LTC Consulting | Dec 24, 2025 | MDS, Medicare, PDPM, Reimbursement
Q: What are some practice tips to determine if an IPA would increase reimbursement? A: The IDT should meet regularly to discuss the status of each resident utilizing their Medicare A benefits. The MDS coordinator and other key IDT members should have a...
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 22, 2025 | Infection Prevention, Nursing, Quality, Reimbursement, Staffing, VBP
Major Changes to SNF VBP Program: What You Need to Know to be Successful The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program continues to evolve, with CMS expanding the scope of this quality incentive program beyond the hospital readmission measure...
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...