Among the many unknowns of the new Patient-Driven Payment Model (PDPM) is its effect on the types of patients coming into the skilled nursing facility. But one place to watch resident patterns is around the addition of ventilator services and care to facilities — especially if they haven’t offered those options before. Respiratory therapy — along with […]
With intense attention on therapy cuts and reimbursement changes during the transition to the Patient Driven Payment Model (PDPM) on October 1, operators and lead clinicians have focused on continuing education and training to remain financially sustainable amid this historic shift. SNN spoke to four therapy companies to see how operators and clinicians are faring […]
The first round of claims data under the new Medicare payment model for nursing homes shows that the majority of operators are seeing reimbursement boosts — while some are also making key billing mistakes that could result in missed payments for certain services. The average skilled nursing facility saw Medicare reimbursements of $614.96 per patient […]
Some of the private insurance companies that process Medicare claims on behalf of the federal government are holding up claims for skilled nursing facilities after the implementation of the Patient-Driven Payment Model (PDPM) in October. But it’s not clear how widespread that is, BKD director John Harned and senior managing consultant Sherri Robbins said on […]
About a month into the Patient-Driven Payment Model (PDPM) for skilled nursing facilities, operators are taking stock of reimbursement strategies — including how they are tracking clinical outcomes and overall margins. Shifting from a third-party provider to an in-house model, or vice-versa, might also be part of that equation, though the answer isn’t quite straightforward. […]
The first round of earnings calls these past two weeks revealed few firm outcomes related to the new Medicare payment model for nursing homes, but one provider was identified as potentially ahead of the curve: Signature HealthCARE. Omega Healthcare Investors (NYSE: OHI) chief investment officer Robert Stephenson on Wednesday praised Signature, one of its tenants, […]
The nursing home industry saw a slight drop in employment in its first full month under the new Medicare payment model, but the reason for the dip might not be as simple as cause and effect. The nation’s nursing facilities lost 1,300 workers between September and October, according to a Friday update from the Bureau […]
Though it’s too soon to tell what effect the new Medicare payment model for nursing homes will have on resident outcomes, the head of a leading industry trade group says operators will deserve everything regulators can dream up if changing treatment patterns lead to worse care. “If we don’t do better, we should be crushed […]
Reports of therapist layoffs and cuts in therapy hours hit the news within days of the implementation of the new Medicare reimbursement system for skilled nursing facilities, sending shock waves throughout the rehab provider community. But according to one major skilled nursing trade group, the cuts to therapy were baked into the system of the […]
With the federal overhaul of Medicare reimbursement to skilled nursing facilities comes a new focus on patient characteristics and clinical needs. And to thrive in a world where payment for care is based on such information, SNFs have to have that information readily at hand — in a format that they can understand. To that […]
Skilled nursing providers looking for a simple answer to how managed care plans will react to the new Medicare payment model will likely have to face an inconvenient truth: It’s complicated. Private Medicare Advantage insurers didn’t have to follow the old Resource Utilization Group (RUG) model when deciding how to reimburse for skilled nursing services, […]
The long wait is over: The new Medicare payment system for nursing homes has arrived. October 1 marks the official start of the Patient-Driven Payment Model (PDPM), just about 18 months after the federal government first announced the change in April 2018. Since then, the skilled nursing industry has trained a laser focus on preparations […]
Skilled nursing operators will be facing a complete overhaul of Medicare reimbursement from one day to the next when September ends. And to be ready, they need to examine their data collection practices now — from admission strategies to coding accuracy. Providers still rushing to prepare for the coming sea change need to have a […]
With less than a month to go before the implementation of the new Medicare payment system for nursing homes, most providers should have a firm plan in place to effectively capture reimbursements on October 1. But as the Patient-Driven Payment Model (PDPM) transitions from a proposal to a reality, operators need to prepare for the […]
Under the new Patient-Driven Payment Model taking effect October 1, skilled nursing facilities across the country will have to demonstrate their value to patients under a brand-new set of incentives. With therapy minutes no longer driving reimbursement, providers have to be able to offer the best care to a sicker population in order to thrive […]
Faced with a sea change in the Medicare reimbursement system for nursing homes, operators have spent the last year asking a key question about their therapy offerings: outsource or in-house? And if the answer is outsource, what will that relationship look like moving forward in unfamiliar payment landscape? There’s no one correct answer for contract […]
The Medicare reimbursement overhaul that’s coming in a few short months represents a major change in how skilled nursing facilities are paid for the care that they provide — as well as how officials monitor operators for potential fraud. With the move to the Patient-Driven Payment Model (PDPM), SNFs will be paid based on the […]
Accurately diagnosing and treating depression could bring significant rewards for operators under the new Medicare payment model for nursing homes — both financially and clinically. Training frontline caregivers to notice the signs of depression among residents of skilled nursing facilities will be vital to success under the coming Patient-Driven Payment Model (PDPM), according to Zimmet […]
Forward-thinking skilled nursing providers have increasingly warmed to the idea of starting a special kind of in-house Medicare Advantage plan in order to take more control over their reimbursements in an uncertain environment. But the strategies that operators must adopt to succeed with Institutional Special Needs Plans (I-SNPs) also fit seamlessly into preparations for the […]
As providers continue to stare down the October 1 implementation of a new Medicare payment model for nursing homes, specialization remains at the top of many operators’ to-do lists — with respiratory therapy potentially emerging as a key revenue source. Because the Patient-Driven Payment Model (PDPM) matches reimbursements with resident acuity, operators have looked to […]