The SNF 5-Claim Probe & Educate officially ended on June 30, 2025, but for many providers, the scrutiny is just beginning. While CMS guidance indicates that providers with 100% error rates (5/5 claims in error) would be prioritized for Targeted Probe & Educate (TPE), we are finding TPEs initiated for facilities with error rates of 60% or more. Was your SNF stretched thin responding to the 5-claim probe? Get ready—the full TPE process is much more intense.
This 4-session series provides actionable insights and resources to bolster retention of nursing staff and other healthcare professionals. Participants will receive information on evaluating key risk factors for staff exiting employment with strategies to perform root cause analysis and prioritize retention interventions. Learn more and register here.
Ask Proactive!
Q: We’ve been receiving complaints from residents and families about slow call light response times. What are some simple interventions we can put in place to improve this?
OCTOBER: Check out these upcoming October webinars!
Preparing for the Survey Revisit, CMPs and Appeals -Webinar
Review what to expect during the survey revisit and while we discuss tips and strategies for preparing for a successful revisit.Presented by Janine Lehman.Learn More
RAC-CTA -Webinar
Take your experience to a higher level with the RAC-CTA certification!Presented by Christine Twombly.Learn More
Strategies for Successful IDR/IIDR & Administrative Law Hearings -Webinar
This session will review the regulatory requirements and process for an IDR/IIDR and Administrative Law Hearing.Presented by Janine Lehman.Learn More
New! F550 - Resident Rights/Exercise of Rights -Webinar
This session will provide an overview of the regulations, common compliance issues, and strategies to ensure residents can exercise their rights.Presented by Shelly Maffia.Learn More
New! Enforcement Remedies -Webinar
Review the CMS Enforcement Remedies from the Plan of Correction to Denial of Payment for New Admissions (DPNA), and everything in between. Presented by Janine Lehman.Learn More
New! Home Health Leadership Training Program -Webinar
Are you ready to lead your agency with confidence, compliance, and compassion? Presented by Nichole McClain.Learn More
New! Hot Topics in LTC Fraud & Abuse -Webinar
New and seasoned leaders will gain insight into industry risks and potential mitigation strategies with skills developed in identifying and addressing potential vulnerabilities related to recent government payers’ fraud and abuse trends. Presented by Christine Twombly & Stacy Baker. Learn More
Access up-to-date policies & procedures, tools & resources, workshops & NAB approved on-demand training all in one affordable subscription. Learn more here.
In the News
Updated materials for the Skilled Nursing Facility Quality Reporting Program
The revised SNF QRP Overview of Data Elements Used for Reporting Assessment-Based Quality Measures and Standardized Patient Assessment Data Elements Affecting Fiscal Year (FY) 2027 Annual Payment Update (APU) Determination and FY 2028 APU determination are now available for download. The SNF QRP Data Collection and Final Submission Deadlines for the FY 2028 SNF QRP can also be accessed along with the FAQ document. Finally, the SNF QRP Measure Calculations and Reporting User’s Manual V7.0 effective beginning October 1, 2025, and containing detailed specifications for calculating the quality measures included in the SNF QRP along with accompanying files including the Change Table, Risk Adjustment Appendix File, Imputation Appendix File, and HCC ICD-10 Crosswalks can be found in the Downloads section on the SNF Quality Reporting Program (QRP) Measures and Technical Information webpage.
An updated .zip file for the Minimum Data Set (MDS) 3.0 Quality Measures (QM) User's Manual v17.0 is now available. This .zip file package contains the updated 2025 Nursing Home Compare Claims-Based Quality Measure Technical Specifications and associated appendix and the updated Skilled Nursing Facility Quality Reporting Program (SNF QRP) Measure Calculations and Reporting User’s Manual V7.0 and associated risk adjustment and imputation appendix files. The .zip file can be found in the Downloads section on the NHQI Quality Measures webpage.
Proactive’s nurse, MDS, therapist, and operations consultant team includes SNF experts with backgrounds as DON, Operations Director, Clinical Reimbursement Director, Clinical Trainer, Surveyor, and Compliance Officer.
