Our Team

Proactive Medical Review specializes in providing clinical, regulatory & reimbursement support to post acute care providers.

Our team includes Nurse Consultants, Infection Preventionists, Legal Nurse Consultants, Therapist Consultants, Healthcare Compliance Certified Practitioners, AAPACN certified RAC-CT/RAC-CTA MDS Experts, Certified Coders and Billing Experts to assist your team in managing clinical and operational challenges, so that you can focus on care.  Learn more about our leadership team below.

Amie Martin OTR/L, CHC, RAC-CT, MJ

President

Specialty Areas: PDPM, SNF Rehab Stay Justification, Medical Review/Medicare Appeals, Falls Prevention & Management, Dementia Care, QAPI, SNF Requirements of Participation, Compliance

Learn more about Amie...
What makes her competent to serve you well?

Amie’s experience as a clinical trainer, quality assurance director, Compliance Officer and multi-facility operations manager culminated in the founding of Proactive Medical Review. She is certified in healthcare compliance with a Masters in Jurisprudence Health Law and certifications in Healthcare Compliance and as a Resident Assessment Coordinator, and has successfully partnered with post-acute care and rehabilitation service providers to improve clinical outcomes, compliance programs, medical record documentation, and to reduce error rates under medical review. She has partnered with legal counsel to defend providers under large volume ZPIC, UPIC and RAC reviews, and manages hundreds of appeals each year with a proven track record of recovering reimbursement on denied claims. Amie’s recent publications include articles for the American Occupational Therapy Association, American Association of Post-Acute Care Nursing (AAPACN), American College of Health Care Administrators, and the American Health Lawyers Association. She presents extensively on clinical, compliance and reimbursement topics including, most recently, a monthly PDPM and Requirements of Participation webinar series offered through AHCA state affiliates in Georgia, Hawaii, Indiana, Illinois, Kansas, Kentucky, Maryland, Mississippi, Missouri, North Dakota, Nebraska, Ohio, Oklahoma, South Carolina, Tennessee, and Wisconsin, as well as LeadingAge state associations in Colorado, Connecticut, Florida, Indiana, Iowa, Michigan, Oregon, Rhode Island, Texas, Virginia, and Washington.

Specialty Areas

PDPM, Medical Review/Medicare Appeals, Falls Prevention & Management, Dementia Care, QAPI, SNF Requirements of Participation, Compliance

Personal Creed

“Whatever you do, work at it with all your heart, as though working for the Lord and not for people.” Colossians 3:23

5 words clients use to describe Amie

Insightful, Warm, Positive, Decisive, Innovative

Things she loves even more than winning a favorable decision on a Medicare appeal

Her husband and 4 kids, boating at Barkley Lake, Cardinals baseball, a good joke, and gardening

Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, CPC, CLNC®

Director of Regulatory Services

Specialty Areas: PDPM, 5 Star Improvement, Requirements of Participation, ICD.10-CM coding, Quality Assurance & Performance Improvement, Developing Clinical Training Programs & Tools, Developing Nursing Facility Policies/Procedures, Long Term Care Best Practices, Survey Management, Leads Mock Survey Project Teams, Infection Prevention

Learn more about Shelly...
What makes her competent to serve you well?

Shelly Maffia is a Registered Nurse and licensed Nursing Home Administrator with extensive experience in the long-term care setting. She holds AAPACN’s QAPI Certified Professional (QCP) credential, is certified in healthcare compliance through the Healthcare Compliance Association (HCCA), is an AAPC Certified Professional Coder (CPC), and is a Certified Legal Nurse Consultant. She is a member of the American Association of Legal Nurse Consultants (AALNC), the National Alliance of Certified Legal Nurse Consultants, the American Association of Professional Coders (AAPC), the American Association of Post-Acute Care Nursing (AAPACN), the American Health Information Management Association (AHIMA) and the Healthcare Compliance Association (HCCA). 

Shelly specializes in SNF regulatory compliance and nursing home quality improvement. She provides frequent consultation and training to nursing facilities across the nation on regulatory compliance, reimbursement compliance, and quality improvement. She has presented extensively on survey preparedness, QAPI, Achieving 5-Star QMs, Infection Prevention and Control, PDPM, and ICD-10-CM coding.

Specialty Areas

PDPM, 5 Star Improvement, Requirements of Participation, ICD.10-CM coding, Quality Assurance & Performance Improvement, Developing Clinical Training Programs & Tools, Developing Nursing Facility Policies/Procedures, Long Term Care Best Practices, Survey Management, Leads Mock Survey Project Teams, Infection Prevention

Personal Creed

“Great things in business are never done by one person. They’re done by a team of people” – Steve Jobs

5 words clients use to describe Shelly

Wise, Pragmatic, Intelligent, Helpful, Thoughtful

Things she loves even more than a deficiency free survey

Family, traveling, IU Basketball, and Golf

Stacy Baker, OTR/L, RAC-CT, CHC

Director of Audit Services

Specialty Areas: PDPM, PPS Scheduling & Management, SNF Rehab Stay Justification, Medicare Compliance, Audit Management, Case Mix Index

Learn more about Stacy...
What makes her competent to serve you well?

Stacy is a skilled geriatric clinician, mentor and clinical instructor, specializing in post-acute quality care, reimbursement, and medical review management. An accomplished coder, auditor and coach, she oversees therapy claim audit services for clients from coast to coast. Stacy is known for her approachable style that makes her clients comfortable asking questions, and this –partnered with her background as a multi-site manager with a broad understanding of the integration between rehab, MDS and the business office make her a go-to resource for accurate answers. She has served the medical review and quality assurance needs of over 400 skilled nursing facilities since joining Proactive in 2013.

Specialty Areas

PDPM, PPS Scheduling & Management, SNF Rehab Stay Justification, Medicare Compliance, Audit Management, Case Mix Index

Personal Creed

Each day we choose what we are filled with and what we pour out. In my daily walk, I choose love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self-control (Galatians 5:22-23).

5 words clients use to describe Stacy

Kind, Organized, Approachable, Patient, Detail-oriented

Things she loves even more than strong, supportive medical records

Faith, husband and 2 children, Church Ministries & Outreach, Vacationing, Cooking, HGTV, Pinterest Failer (depressing, but entertaining)

Janine Lehman, RN, RAC-CT, CLNC

Director of Legal Nurse Consulting

Specialty Areas: RAI Process and Care Planning, SNF PPS, Medicaid Case Mix, Regulatory Compliance, Policy Development, Survey Preparedness, Legal Case Review and Trial Testimony, Restorative Nursing Programs, IDR and IIDR Case Preparation, Infection Prevention

Learn more about Janine...
What makes her competent to serve you well?

Janine is a Registered Nurse with over 30 years’ experience in long term care, working in all nursing capacities from Nursing Assistant and Charge Nurse, to MDS Coordinator, Staff Development Coordinator, ADON and DON. She is MDS Certified through AAPACN, and is a Certified Legal Nurse Consultant. Her background includes serving as a Corporate Nurse Consultant, and the Director of Clinical Services for a multi-facility, multi-level of care organization. Janine serves as a founding member of the Kentucky RUG Task Force Committee, and has served on the Case Mix Appeals Panel and IDR Panel as a provider representative, as well as serving on the Kentucky Medicaid Technical Advisory Committee. She has extensive experience in the RAI process, clinical documentation, legal nurse consulting, restorative nursing programs, fall management, QAPI, and infection control, and has provided training on these topics for State and National organizations.

Specialty Areas

RAI Process and Care Planning, SNF PPS, Medicaid Case Mix, Regulatory Compliance, Policy Development, Survey Preparedness, Legal Case Review and Trial Testimony, Infection Prevention, Restorative Nursing Programs, IDR and IIDR Case Preparation, Infection Prevention

Personal Creed

“Success isn’t just about what you accomplish in your life; it’s about what you inspire others to do.” – Zig Ziglar

5 words clients use to describe Janine

Focused, Creative, Determined, Resourceful, Inventive

Things she loves even more than a successful IDR

Her husband, children, and grandchildren, music, Chinese food, ice cream, autumn

Eleisha Wilkes, RN, GERO-BC, RAC-CT, DNS-CT

Clinical Consultant

Specialty Areas: PDPM, RAI Interpretation and Application, MDS Accuracy, Developing Clinical Training Programs and Tools, Care Planning, Infection Prevention, Survey Preparedness

Learn more about Eleisha...
What makes her competent to serve you well?

Eleisha Wilkes is a Board Certified Gerontological Nurse and AANAC certified MDS consultant with over twenty years of experience in long-term care. She has significant experience as a Director of Nursing, Case Manager, and Resident Assessment Coordinator with extensive responsibility and success in driving QA in the areas of person-centered assessment and care planning through effective systems, staff development, and interdisciplinary team collaboration. She has presented educational programs related to PDPM success, MDS accuracy, effective care planning, Competency-Based Staff Development, and Restorative Nursing Programs. Eleisha serves as a clinical consultant providing MDS completion and auditing, clinical training, and project development services. In 2021, Eleisha became the monthly columnist for the Ask the Payment Expert for McKnight’s Long-Term Care News.

Specialty Areas

PDPM, RAI Interpretation and Application, MDS Accuracy, Developing Clinical Training Programs and Tools, Care Planning, Infection Prevention, Survey Preparedness

Personal Creed

“Strive not to be a success, but rather to be of value.” – Albert Einstein

5 words clients use to describe Eleisha

Calm, Organized, Prepared, Practical, Open-minded

Things she loves even more than a validated MDS

Her husband and two sons, reading a good book, Netflix binges, good food, family vacations

Christine Twombly, RN-BC, RAC-MT, RAC-MTA, HCRM, CHC

Clinical Consultant

Specialty Areas: Medicare Part A Coverage Criteria, PDPM, MDS Accuracy, Quality Measures, SNF QRP, Medical Review and Appeals Management, Compliance

Learn more about Christine...
What makes her competent to serve you well?

Christine is a clinical consultant with Proactive Medical Review and Consulting. Ms. Twombly is a certified gerontological nurse, a certified resident assessment coordinator (RAC-CT), a certified AANAC master teacher for both the RAC-CT and RAC-CTA certifications, a health care risk manager (LHRM), and is certified in healthcare compliance (CHC).  Christine has more than 28 years of experience in post-acute care, including many years of hands-on experience with MDS assessments and related care planning. She has worked under Medicare PPS for skilled nursing facilities (SNFs) since its inception and has a strong working knowledge of PDPM for Medicare as well as RUGS for Medicaid CMI. She has extensive experience working with SNFs to conduct Medicare documentation and billing compliance assessments and providing assistance with third-party medical review and the appeals process.

Specialty Areas

Medicare Part A Coverage Criteria, PDPM, MDS Accuracy, Quality Measures, SNF QRP,  Medical Review and Appeals Management, Compliance

Personal Creed

You can’t keep doing the same thing the same way and expect a different outcome. If the goal seems out of reach don’t adjust the goal, change your action plan.

5 words clients use to describe Angie

Knowledgeable, Patient, Positive, Passionate, Approachable

Things she loves more than achieving 5-star quality measures

Spending time with family, my grandsons, traveling, adventures, mountains during the fall, playoff hockey

Brandy Hayes, RN, RAC-CT

Clinical Consultant

Specialty Areas: MDS Accuracy, PDPM, Skilled Documentation, Care Planning, Case Mix, Quality Measures, Survey Management, Clinical Operations, Wound Care, Infection Prevention, Legal Case Review

Learn more about Brandy...
What makes her competent to serve you well?

Brandy is a Registered Nurse and Legal Nurse Consultant with over 22 years of LTC experience including extensive experience in SNF clinical operations as a former Director of Nursing, Staff Development Coordinator, and RAI Coordinator. She is an Infection Preventionist and Wound Care Certified.  Brandy’s expertise in MDS coding, Medicare, Medicaid case mix, driving Quality Measure improvements, as well as long term care litigation support benefit clients seeking a consultant with a well- rounded perspective. 

Specialty Areas

MDS Accuracy, PDPM, Skilled Documentation, Care Planning, Case Mix, Quality Measures, Survey Management, Clinical Operations, Wound Care, Infection Prevention, Legal Case Review

Personal Creed

“Whether you think you can or whether you think you can’t, you’re right.” – Henry Ford

5 words clients use to describe Angie

Calm, Organized, Practical, Dependable, Approachable

Things she loves more than achieving 5-star quality measures

Her husband and three daughters, reading a good book, naps, and beach vacations.

Angie Hamer, RN, RAC-CT

Clinical Consultant

Specialty Areas: PointClickCare®, Infection Prevention, Dementia Care, QAPI, Restorative Nursing Programs, Survey Preparedness and Management, Care Planning, Auditing, MDS Accuracy

Learn more about Angie...
What makes her competent to serve you well?

Angie is a Registered Nurse with 30 years of LTC experience including in Nursing Administration as DON and as Clinical Consultant for over 20 years for multi-facility organizations. Angie’s expertise includes development of policies and procedures, implementing effective staff development programs, QAPI, and Infection control. Angie serves clients as part of Proactive’s mock survey team, and has extensive survey management experience including writing Plans of Correction (CMS 2567) and Allegation of Compliance for IJ’s. Angie promotes clinical and regulatory compliance through services including interim DON, interim MDS coordinator, MDS coding validation and supportive documentation chart audits, and staff education.

Angie is an expert user of PointClickCare™ and assists clients with software implementation/training for clinical modules, CRM, Document Manager, Carequality, eMAR, POC, and IMM (Integrated Medication Management), as well as Relias Learning Software with projects such as creation and implementation of training plans and monitoring reports.

Angie has served on multiple clinical/regulatory committees for KAHCF and held KADONA offices at the district and state level.

Specialty Areas

PointClickCare®, Infection Prevention, Dementia Care, QAPI, Restorative Nursing Programs, Survey Preparedness and Management, Care Planning, Auditing, MDS Accuracy

Personal Creed

“Integrity is doing the right thing even when no one is watching.” – CS Lewis

5 words clients use to describe Angie

Calm, Organized, Practical, Dependable, Approachable

Things she loves more than achieving 5-star quality measures

Porch sitting weather, being a Nana, beach vacations, puzzle books, HGTV

Jessica Cairns, RN, RAC-CT, CMAC

Clinical Consultant

Specialty Areas: Medicaid and Medicare Regulations, SNF PPS, PDPM, QAPI, Clinical Reimbursement, Care Planning, Auditing, MDS Accuracy

Learn more about Jessica...
 What makes her competent to serve you well?

Jessica is a Registered Nurse with almost twenty years of experience in long term care. Her background includes significant experience as a reimbursement specialist for a large long-term care organization, providing education and support to those facilities over multiple states. She has served as a subject matter expert in the areas of Medicare and clinical reimbursement, developing and authoring courses for a major healthcare learning management system/education provider. She has extensive experience with medical auditing and compliance, and has collaborated with leadership teams in the development and implementation of restorative programming, QAPI, and Quality Measure improvement. Jessica has presented extensively on Medicare regulations, RAI process, PPS reimbursement, and Case Management.

Specialty Areas

Medicaid and Medicare Regulations, SNF PPS, PDPM, QAPI, Clinical Reimbursement, Care Planning, Auditing, MDS Accuracy

Personal Creed

“Tell me and I forget, teach me and I may remember, involve me and I learn.” Benjamin Franklin

5 words clients use to describe Jessica

Ambitious, Passionate, Loyal, Organized, Optimistic

Things she loves even more than a validated MDS

Her husband and three children, her 2 dogs, hockey, interior decorating, and sweet tea

Christa Roberts, PT, MPT, RAC-CT

Clinical Consultant

Specialty Areas: Falls, Dementia Care, Wound Care, Orthopedic Protocols, Geriatric Therapy, Rehabilitation Coding

Learn more about Christa...
What makes her competent to serve you well?

Christa is a Physical Therapist with 23 years of experience in long term care and rehabilitation management. She has a passion for working with the geriatric population and has presented educational programs related to geriatric falls prevention, restorative nursing, evidence-based practice, dementia care, and maintaining functional mobility. She serves Proactive Medical Review as a clinical instructor, quality assurance leader, auditor and medical review response coordinator.

Specialty Areas

Falls, Dementia Care, Wound Care, Orthopedic Protocols, Geriatric Therapy, Rehabilitation Coding

Personal Creed

“If you want to lift yourself up, lift up someone else.” –Booker T. Washington

5 words clients use to describe Christa

Thorough, Easy-going, Practical, Focused, Dependable

Things she loves even more than a well written progress report

Spending time with family, camping, traveling, attending my children’s sports events, church family

Emily King, OTR, RAC-CT, CADDCT

Clinical Consultant

Specialty Areas: Dementia Care, Medicare Reimbursement, SNF Quality Measure Clinical Programs, Auditing, Healthcare Leadership

Learn more about Emily...
What makes her competent to serve you well?

Emily King has served the geriatric community in multi-site therapy leadership positions and as a clinical educator. She is skilled in assisting nursing facilities and outpatient therapy clinics to improve clinical documentation for measurable error rate reduction under medical review through training and constructive chart review feedback. Her background includes extensive geriatric clinical program development. Her passion is educating caregivers on creative techniques to enhance the lives of those living with dementia, and she has presented extensively on person centered care, quality of life, and applications of current dementia research.

Specialty Areas

Dementia Care, Medicare Reimbursement, SNF Quality Measure Clinical Programs, Auditing, Healthcare Leadership

Personal Creed

Live and love each day to the fullest and remember that happiness and peace in every aspect of life begins with demonstrating kindness toward each other.

5 words clients use to describe Emily

Creative, Skilled, Cheerful, Bright, Optimistic

Things she loves even more than positive feedback on a workshop evaluation

Her 3 sons, family, camping, boating, gardening, and four-wheeling

Kayla McKenzie

Marketing Communication Manager

Learn more about Kayla...
What makes her competent to serve you well?

After six years of working in non-profit marketing, Kayla began working for Proactive in January of 2020. Her passion is to give life to a company’s brand through the creation of an organized marketing plan. Alongside leading Proactive’s marketing efforts, Kayla serves as the main point of contact for all of Proactive’s education and training opportunities.

Personal Creed

“You can’t use up creativity. The more you use, the more you have.” ― Maya Angelou

5 words clients use to describe Kayla

Organized, Detail-oriented, Creative, Prepared, Loyal

Things she loves even more than a thorough marketing plan

Her son, dog, photography, and spending time on the four-wheeler

Kirby Swails, MHSA, SSD

Data Analyst & Reporting Administrator

Learn more about Kirby...
What makes her competent to serve you well?

After interning with Proactive and earning her master’s degree in Health Services Administration, Kirby joined our team full time in June of 2022. Kirby supports the rest of the Proactive team through backend data work and analysis.

Personal Creed

“Far and away the best prize that life offers is the chance to work hard at work worth doing.” -Theodore Roosevelt

5 words clients use to describe Kirby

Resourceful, Thorough, Detail-Oriented, Practical, and Reliable

Things she loves even more than a clean data set

Her dog, traveling (especially to Disney), crafting, and spending time with friends & family

Proactive Offers Solutions that Allow Providers to Focus on Care

Post-acute care providers are facing many challenges–an ever changing regulatory environment, expanded government auditing, and a growing list of publicly reported quality measures. But your mission is centered on care excellence and consistently satisfying resident, referral source and community expectations. For smaller providers without extensive corporate support, the administrative and financial implications of balancing evolving regulatory compliance obligations and care quality can be difficult.

PROACTIVE REGULATORY COMPLIANCE CONSULTING:
“Proactive Medical Review and Consulting has been a great resource to our team. Their passion and professionalism show in everything they do. From reimbursement processes to regulatory compliance, PMR keeps us on the leading edge of our industry. We are happy to have them in our corner.” Click here to read more testimonials.
Brody O’Niones

Administrator

Contact us for more ways Proactive's services can help you.