PDPM Success Rests on Taking Credit for Existing Skilled Nursing Services

As skilled nursing operators scramble to adapt to a new Medicare reimbursement model ahead of its implementation next fall, the secret to success could lie in taking credit for the services most SNFs already provide. At Zimmet Healthcare Services Group’s annual conference in Atlantic City, N.J. last week, multiple speakers emphasized the importance of identifying […]

CMS Sends Message with Quick PDPM Approval: Change Is Coming Fast

By quickly finalizing the new payment system for skilled nursing facilities, the Centers for Medicare & Medicaid Services (CMS) sent a strong message that the model is final and that the industry will move forward with it. That’s according to a webinar from Minneapolis-based consulting firm Health Dimensions Group (HDG), which last week gave an […]

Looking Locally at Skilled Nursing Industry Could Show Brighter Future

If there’s been one recurring theme in the skilled nursing industry over the last few years, it’s distress, with dropping national occupancy stats and new payment models changing the way providers deliver post-acute care. But one leading industry voice says it isn’t productive to ask about the future of the skilled space as a national, […]

Skilled Nursing Stuck in Awkward Middle Between Old and New Payment Models

Narrowing networks of referral providers have been a top concern for skilled nursing facilities over the last two years, with industry leaders preaching the importance of improving certain metrics in order to impress hospitals and home health agencies. Under models such as Bundled Payments for Care Improvement (BPCI) and other shared-savings plans, the thinking goes, […]

Skilled Nursing Outcomes Don’t Always Improve Along with Star Rating Gains

Hospitalization rates play into the all-important five-star rating for nursing homes, but a new study finds that the two metrics aren’t necessarily correlated. Improvements in nursing home star ratings were not matched by improvements in potentially preventable hospitalizations, according to a study recently published in The Journal of Health Care Organization, Provision, and Financing. Researchers […]

Skilled Nursing Admissions Dropping in Tandem with Lower Hospital Use

Admissions to skilled nursing facilities have declined in a manner consistent with a drop in inpatient hospital usage, according to the Medicare Payment Advisory Commission’s (MedPAC) most recent data book. That’s just one of the conclusions from the statistics, released last month by MedPAC — a non-partisan agency that advises Congress on Medicare issues.  For […]

Uncertainty Surrounds New ‘Arbitrary’ Skilled Nursing Payment Rules

Early reactions to the finalized skilled nursing payment rules from the Centers for Medicare & Medicaid Services (CMS) are in, with one leading provider group issuing a stark warning about the days ahead. “While the skilled nursing profession welcomes a new payment model, we are concerned with the language in this rule about the Patient-Driven […]

CMS Finalizes New Skilled Nursing Payment Rules, Predicts $820M Funding Boost

The Centers for Medicare & Medicaid Services (CMS) on Tuesday finalized its skilled nursing payment updates for fiscal 2019, formally enshrining the Patient-Driven Payment Model (PDPM) and other changes in a final rule. Under the finalized proposal, the PDPM — which will see therapy payments based increasingly on the complexity of patients’ clinical needs, and […]

CMS Hits 1,400 Nursing Homes with One-Star Reviews Over Staffing Concerns

Less than a month after a New York Times story revealed concerns about insufficient nursing home staffing levels, the Centers for Medicare & Medicaid Services (CMS) handed out nearly 1,400 one-star reviews. Last week, when CMS updated its Five-Star Quality Rating System for nursing homes, 1,387 facilities received one-star ratings for staffing coverage, according to […]

Iowa Nursing Home Lobbyists Praise Lowered Fines Under Trump

Nursing home lobbyists in Iowa thanked federal regulators for lowering fines on facilities and asked them to “pursue a more collaborative — and less punitive — role” in nursing home regulation, the Des Moines Register reported Wednesday. In a July 7 phone call arranged by U.S. Sen. Charles Grassley, R-Iowa, Iowa Health Care Association (HCA) President Brent […]

Skilled Nursing Facilities Rank Low on Operators’ Investment Wish Lists

Skilled nursing facilities lag far behind home health and other long-term care settings among providers’ investment outlooks, according to a new survey of major health care providers. Just 12% of organizations surveyed by consulting and advisory firm BDO said they were making investments in skilled nursing care as part of their two-year plan to 2020 […]

Having an In-House Insurance Plan Could Signal PDPM Success

Some skilled nursing providers have turned to in-house insurance plans to take more control of the care process, and the move could pay off if the government’s new proposed reimbursement model is finalized. The Patient Driven Payment Model (PDPM), which the Centers for Medicare & Medicaid Services (CMS) proposed in April, would overhaul skilled nursing reimbursements […]