by Proactive LTC Consulting | Apr 12, 2023 | Blog, Compliance, Medical Review, Medicare, Reimbursement
The Q4FY22 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2022 is now available for download. Follow these steps to access your PEPPER and analyze any outlier billing... by Proactive LTC Consulting | 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.... by Proactive LTC Consulting | Mar 7, 2023 | Blog, Quality, Reimbursement, SNF
The SNF VBP program encourages SNFs to improve the quality of care provided to Medicare beneficiaries by awarding incentive payments to SNFs based on their performance in the area of reducing unplanned hospital readmissions. Currently, the SNF VBP program utilizes the... by Proactive LTC Consulting | Feb 22, 2023 | Blog, F-Tag, Medicaid, Medicare, Regulatory, Reimbursement
Medicare beneficiaries in a SNF have rights and safeguards with regard to financial liability and appeal of the denial of Medicare services. Providers are required to inform beneficiaries of their financial liability and their appeal rights in writing by issuing... by Proactive LTC Consulting | Feb 21, 2023 | Nursing, Pressure Ulcers, Q&A, Reimbursement
Q: We have a patient with a stage IV pressure injury to the ankle that is being treated with a wound vac, which is changed 3x/week. Does this meet the criteria for skilled coverage under Medicare Part A in the SNF? A: The Medicare Benefit Manual Chapter 8... by Proactive LTC Consulting | Jun 8, 2022 | Blog, IPA, MDS, Quality, Reimbursement
With staff pressed on every side, ensuring clinical meetings are an effective use of time and resources is essential. Strong meeting processes can facilitate key objectives are met related to clinical quality, MDS assessment accuracy, risk management, and...