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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 […]

Respiratory Therapy’s ‘Massive’ Skilled Nursing Opportunity Under PDPM

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 […]

PDPM Countdown: ‘We Are All Crossing Our Fingers and Knocking on Wood’

With the Medicare Part A reimbursement overhaul taking effect in just a few months, skilled nursing providers across the country are in countdown mode. But the clock is moving at different paces for different providers, several experts said. Some SNFs began their analysis and preparations months ago; others are barely getting started. That’s led to […]

As PDPM Looms, Providers Must Balance Desire to Boost Payments with Audit Dangers

Under the Patient-Driven Payment Model (PDPM), reimbursement for Medicare Part A patients in skilled nursing facilities will be driven by patient condition, rather than by therapy minutes provided to that patient. It’s a change that the industry has hailed as an opportunity to receive financial credit for the care that they’re already providing, but they […]

PDPM Could Create Risk-Sharing Opportunities, Headaches for Skilled Nursing

Risk-sharing has loomed large in health care reform efforts over the last decade, and the new Medicare payment model for skilled nursing facilities could open up additional avenues for operators to take control — along with pointed questions from partners along the spectrum. The Patient-Driven Payment Model (PDPM) marks a step toward a long-teased site-neutral […]

Skilled Nursing Dealmakers Could Be Overlooking PDPM’s Potential for ‘Biggest Year’ in Decades

The market will still need to determine whether the new Medicare reimbursement structure for nursing homes will be a net positive or negative for the industry, but at least one insider says buyers and sellers in the space aren’t optimistic enough. Current prices for skilled nursing facilities don’t typically account for the potential of cost […]

Under PDPM, Providers Should Expect Close Scrutiny of Nursing Records

The new Medicare model for skilled nursing facilities more closely links reimbursements with resident conditions — and making sure that facilities completely document those conditions will soon be an essential step for success. But because payment under the current Resource Utilization Group (RUG) system is driven primarily by therapy minutes, capturing those conditions on the […]

Genesis’s PDPM Math: 12% Expense Savings, Shift to Fixed-Cost Therapy Contracts

Once the new Medicare payment model for nursing homes takes effect this fall, skilled nursing giant Genesis HealthCare (NYSE: GEN) expects to see significant expense savings — while also changing the way it negotiates therapy contracts with its third-party clients. The Kennett Square, Pa.-based operator projects that the expanded opportunity for group and concurrent therapy, […]

PDPM Goes Beyond Therapy: Finding the Hidden Value in Skilled Nursing Ancillaries

At surface level, the new Medicare payment model for nursing homes revolves largely around therapy, as the federal government works to realign incentives and prevent what officials claim to be a wave of unnecessary services. Speech, occupational, and physical therapy account for three of the five components of the Patient-Driven Payment Model (PDPM), and providers […]

‘All Systems Are Go’ at CMS for PDPM, But Not All Providers Are Ready

The new Medicare reimbursement model for skilled nursing facilities remains on track for implementation this fall, but not everyone is ready — and operators need to look to the big-picture shifts in value-based care for inspiration as the clock keeps ticking. That’s according to a recent webinar from the Minneapolis-based consulting firm Health Dimensions Group […]

Cheat Sheets and Timely Visits: How SNFs Can Support Doctors’ Larger PDPM Role

Timely physician visits will play a central role in effectively capturing resident conditions — and reimbursements — under the new Medicare payment model. But with doctors seeing relatively few incentive changes amid the shift to the Patient-Driven Payment Model (PDPM), skilled nursing operators must find ways to make physician collaboration as easy as possible. Medical […]

Physician Groups Have Skilled Nursing Opportunity in PDPM — If They Take Action

The clinical condition and medical complexities of skilled nursing patients will drive reimbursement under the new Medicare system — giving physician groups that serve skilled nursing facilities the opportunity to have a major impact on the outcomes and success of both the patients and the facilities they serve. But it’s an opportunity they’ll have to […]

Providers Can’t Lose Sight of ‘Where the Money Is’ Under PDPM

When it comes to the changes coming to Medicare reimbursement methodology, coding figures prominently in the discussion among skilled nursing providers. But while it’s important for SNFs to make sure staff education and training on that topic is up to date, there are several other components of reimbursement under the Patient-Driven Payment Model (PDPM) that […]

PDPM 101: What Skilled Nursing Providers Need to Know Now

With a new Medicare payment model for skilled nursing facilities just months away, operators who haven’t started planning for the changes are already months behind. Skilled Nursing News has been reporting on the new Patient-Driven Payment Model (PDPM) since the day it was announced last July 31, and we’ve spent those eight months speaking to […]

Wave of Anticipated Skilled Nursing M&A Action Still Offshore for Now

Major real estate investment trusts (REITs) with stakes in the skilled nursing world almost universally expressed optimism about the coming change in Medicare Part A reimbursement — and several predicted changes in mergers and acquisitions as a result. But the expected wave of small mom-and-pops exiting the skilled nursing industry because the Patient-Driven Payment Model […]

Cain Bros.: Gap Between Haves and Have-Nots in Skilled Nursing Could Widen

Pressured by already light coffers and razor-thin margins, skilled nursing facilities could see an even wider gulf grow between top and bottom performers under the new Medicare payment model. That’s at least according to Cain Brothers director Taaha Shaikh, who this week wrote a commentary calling the coming Patient-Driven Payment Model (PDPM) “the next great […]