‘CMS Loves That’: Moderate Therapy Shifts, Bureaucratic Reality Could Slow PDPM Changes

Despite steady reports of increasing reimbursements under the new Medicare payment model for nursing homes, at least one industry leader believes that the federal government will be happy with the early returns — and that any changes are fairly far down the road. Skilled nursing operators have not gone overboard with the strategy changes that […]

With $5M Infusion, Home Health Staffing Startup Sees Skilled Nursing Opportunity Amid PDPM Upheaval

A health care staffing startup that had initially focused on the home setting sees significant opportunity to expand into a skilled nursing space still grappling with the implications of a new Medicare payment model — and it recently pulled down a $5 million funding round to help fuel that growth. The Los Angeles-based Gento, formerly […]

PDPM Layoffs Could Send Some Therapists to Home Health, But Former SNF Workers Not Targets

Both the skilled nursing and home health spaces are in the midst of shifts to new Medicare payment models, and despite widespread reports of therapy layoffs at nursing homes, a leading player in the home care space says it isn’t necessarily targeting the cohort of available therapists. Encompass Health Corporation (NYSE: EHC) has been monitoring […]

Omega to Divest Struggling Daybreak Skilled Nursing Portfolio, Cautiously Upbeat on Medicaid Crackdown

After multiple quarters of struggles with operator Daybreak Venture, Omega Healthcare Investors (NYSE: OHI) on Thursday announced a plan to largely purge the provider’s buildings from its portfolio. “During the course of the next several quarters, Omega anticipates transitioning, either through re-leases or sales, the vast majority of Daybreak’s existing Omega facilities,” chief operating officer […]

Ensign Rides High-Acuity Skilled Nursing Model to 6% Rate Gains Under PDPM

The Ensign Group (Nasdaq: ENSG) on Thursday announced that its skilled nursing facilities have seen rate increases of up to 6% under the new Medicare payment model, in part helping to drive the post-acute leader to another set of record earnings. The company’s established same-store facilities achieved those 6% gains, while Ensign’s transitioning facilities — […]

Winners Still Outnumber Losers in Latest PDPM Analysis, But Length of Stay Trends Could Erase Rate Gains

The latest analysis of the new Medicare payment model for nursing homes again shows more operators scoring gains than suffering losses, but the change from the previous system may not be quite as straightforward — particularly as fee-for-service Medicare continues to lose ground to other payment sources. A little more than 67% of skilled nursing […]

Tips for Early PDPM Success: Demand More Data from Hospitals, Market Higher-Acuity Services

The early returns for the new Medicare nursing home payment model have been positive, but providers aren’t seeing gains by sitting back and watching the changes. Several key strategies for success have emerged in the Patient-Driven Payment Model’s first four months, with a particular focus on data — as well as clearly communicating the availability […]

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 […]