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SNN Poll: 43% of Operators, Vendors Have Laid Off Therapy Staff Post-PDPM

News of therapy layoffs swept through the skilled nursing industry in the weeks after the implementation of the Patient-Driven Payment Model (PDPM), and a new poll from Skilled Nursing News finds that more than 40% of operators and therapy vendors have made some kind of staffing reductions post-October 1. A little more than 43% of […]

Weighing the Promise and Perils of Skilled Nursing Ventilator Care Under PDPM

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 […]

Early PDPM Reactions: Therapy Companies’ Reimbursement Optimism, Continued Coding Challenges

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 […]

Early PDPM Claims Data Reveals Far More Winners Than Losers, ‘Impossible Combinations’ of Conditions

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 Medicare Contractors Holding Up Claim Payments Amid the Shift to PDPM

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 […]

A Month into PDPM, Breaking Down the Pros and Cons of Third-Party, In-House Therapy

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.  […]

Why Signature Believes 18 Months of PDPM Prep Will Pay Off

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, […]

Therapy Cuts Were ‘Inevitable’ Under PDPM — and Providers Must Prepare for Possible Payment Drops

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 […]

Each Medicare Advantage Plan Can Treat PDPM Differently — and SNFs’ Mileage Will Vary

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, […]

It’s Here: Skilled Nursing Providers, Investors Weigh in on PDPM Opportunities, ‘Stumbling Blocks’

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 […]

Unpacking the New Therapy Contract Math for Skilled Nursing Providers Under PDPM

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 […]

Treating Depression Could Emerge as a PDPM ‘Linchpin’ — Both for Payments and Better Outcomes

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 […]

Under PDPM, Benefits of In-House Medicare Advantage Plans Will Go Beyond Money

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 […]