Compliance is defined as the act of adhering to, and demonstrating adherence to, a standard or regulation.  As you know, in the medical field, there are numerous regulations and they are constantly changing. Functional Pathways is passionate and committed to

Prevent Readmissions by Identifying Causes of Acute Change

Causes of acute change of condition in a resident residing in a skilled nursing facility can be categorized into either reasons that relate primarily to the resident’s current status or condition or reasons less directly related to the resident’s current


This week, we have been notified that phase 2 and phase 3 providers are receiving ADRs for October claims for resident’s who were at or over the $3,700 threshold.  Phase 1 providers who have pre-approval are receiving ADRs as well.


In my previous entry I discussed breaking down communication into three phases. I wrote of the initial phase and the importance of communicating early and often. How establishing clear and open lines of dialogue were essential to establishing a good

Functional Maintenance Programs

Functional maintenance Programs (FMP’s) are clinical programs that can be designed to augment or maintain a residents functional status and wellbeing.  It includes therapy services that seek to prevent disease, promote health, and prolong and enhance quality of life or

Prevent Readmissions by Managing Acute Changes

Facility procedures for ensuring recognition of acute changes in condition become the building block for managing those changes in condition and become the cornerstone for any program designed to prevent hospital readmissions within a skilled nursing facility.   Communication of all


So, we are approaching December 1st.  Do you see light at the end of the tunnel for the Manual Medical Review?  Well, if you were in phase 1, you have been working diligently to obtain pre-approval of therapy visits for

Thank Goodness The Election Is Over!!

Regardless of whether one is happy or not about the outcome, I think we can all agree that we are all glad the election is over.    Now perhaps we can focus attention on important issues facing long term care that

Communicate-Early and Often

How many times in your life, either private or professional, do you look back and wish you had communicated better or differently? I think we all can agree that many times this would be true. If it were not important

Settlement Reached: Medicare’s “Improvement Standard”

Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the “Improvement Standard” case, Jimmo v. Sebelius. A proposed settlement agreement was filed in federal District Court