by Proactive LTC Consulting | May 8, 2024 | ICD.10, MDS, Medicare, PDPM, SNF
CMS issued corrections to the FY 2024 SNF PPS Final Rule PDPM ICD-10 Mapping. The document, which was issued and effective April 10, 2024, makes corrections to technical errors that are applicable beginning 10/1/2023. This correction document can be accessed at the... by Proactive LTC Consulting | May 1, 2024 | Compliance, Documentation, Medical Review, Nursing, SNF, Therapy
Audits are on the rise! Skilled nursing facilities (SNFs) are at an all-time high when it comes to active medical review. From the SNF 5 Claim Probe and Educate and individual Medicare Advantage reviews, to recovery audit contractors (RACs) and Supplemental Medical... by Proactive LTC Consulting | Mar 11, 2024 | Clinical, Nursing, Quality, Regulatory, SNF
As the acuity and complexity of long-term care residents has increased, the responsibilities of the Director of Nursing (DON) have also escalated significantly. The duties of the DON are not just clinical in nature, they also involve regulatory, reimbursement, and... by Proactive LTC Consulting | Feb 6, 2024 | Blog, Compliance, Documentation, ICD.10, MDS, Nursing, PDPM, Reimbursement, SNF
PDPM coding and reimbursement success relies significantly on ICD-10 coding accuracy. In particular, the impact of ICD.10 coding on the clinical category, SLP, Nursing, and NTA comorbid diagnoses cannot be overstated; Medicare reimbursement for SNF services depends on... by Proactive LTC Consulting | Dec 19, 2023 | Blog, MDS, Quality Measure, Reimbursement, SNF
During the December SNF Open Door Forum call, CMS announced their plan to release the MDS 1.19.1, which will be effective October 1, 2024. CMS has indicated the revisions will be minor and impact primarily the following 3 areas of the MDS: Section GG: Self-care and... by Proactive LTC Consulting | Nov 21, 2023 | Blog, Compliance, Documentation, Medical Review, Medicare, Nursing, PDPM, SNF
SNF Meetings– UR & Triple Check Essentials According to a recent Agency Financial Report released by the Department of Health and Human Services (HHS), the primary reasons for SNF payment error include (1) missing or insufficient documentation to support the...