The draft version of a unified Medicare payment model for post-acute care contains “numerous fundamental flaws.” That’s according to a statement issued late last week by the American Hospital Association (AHA). Among those flaws, AHA cited the lack of a workable risk adjustment approach and missing reforms outlined by the Centers for Medicare & Medicaid […]
Category: PDPM
The skilled nursing industry is staring down a triple threat. Providers are being challenged operationally, clinically and financially — at least in part due to rising labor and care costs, among other factors. Not-for-profit senior care giant Evangelical Lutheran Good Samaritan Society has had to close or sell nine facilities in just the last eight […]
The nurse practitioner (NP) role has evolved to be much more involved in the day-to-day operations of a nursing home, especially given the higher acuity that the care setting has adopted. Institutional special needs plans (I-SNPs), which are designed to care for residents that need a higher level of clinical care, has led to more […]
As many in the nursing home sector pursue opportunities to add additional service lines to diversify their offerings, and potentially build new revenue streams, Ignite Medical Resorts has stuck to doing one thing well — and so far it’s paid off. The short-term rehabilitation and nursing care provider has turned the traditional post-acute experience on […]
Despite the arduous operating challenges facing skilled nursing providers in 2022 — workforce shortages, inflation, occupancy and looming federal regulations just to name a few — the future of the sector may not be as dark and stormy as one might anticipate. The obstacles nursing home operators have already and will continue to face over […]
The Ensign Group (Nasdaq: ENSG) is in a position to grow in select markets, while its newly-formed real estate investment trust (REIT) Standard Bearer allows the skilled nursing giant to finance other promising operators in the sector. Ensign executives discussed future M&A plans and what it looks to accomplish through its REIT during a virtual […]
Persistent staffing shortages combined with regulatory headwinds have put even more pressure on nursing home MDS coordinators, a specialty position that itself has not been immune to the job turnover felt across the sector. And their role to ensure that facilities get the reimbursement they earn and the right care is provided may be more […]
It will be three years this October since the Patient-Driven Payment Model (PDPM) was first implemented, and some nursing homes are still struggling to adjust. While a global pandemic and unprecedented staffing shortages are partly to blame for problems in PDPM-related processes, so too is widespread staff agency use. And now, with a potential $320 […]
Leaders with National Health Investors Inc. (NYSE: NHI) said the company’s skilled nursing assets continue to be resilient in the face of financial challenges, including the proposed 4.6% cut to the Patient-Driven Payment Model (PDPM). While executives with the real estate investment trust (REIT) hope the Centers for Medicare & Medicaid Services (CMS) final rule is […]
While the skilled nursing industry faces unprecedented staffing challenges, The Ensign Group (Nasdaq: ENSG) has been able to increase its frontline workforce by 3% – a feat achieved thanks to local recruiting and retention efforts supported by the company’s regional market strategy. Ensign’s reliance on agency has also decreased — a trend CEO Barry Port […]
The value-based purchasing program (VBP) available to skilled nursing facilities, while garnering the attention of the Biden administration in its sweeping reform initiatives, was already under the microscope with federal agencies. The Centers for Medicare & Medicaid Services (CMS) already has been authorized to apply nine measures to the program in adherence with the Consolidated […]
The Medicare Payment Advisory Commission (MedPAC)’s value incentive program (VIP) seeks to standardize the many value-based purchasing programs that are available to different care settings, including skilled nursing. In its most recent report on Medicare payment policy, MedPAC devoted a chapter to the design of a VIP for post-acute care (PAC) in order to highlight […]
The value-based purchasing program (VBP) may not be offering sufficient incentives for nursing homes to improve, particularly for low-performing facilities in areas with underserved populations. Only 0.7% of poor-performing skilled nursing facilities were able to improve enough to avoid a financial penalty under VBP, a JAMA study found – the program didn’t “offer a viable […]
As the Centers for Medicare and Medicaid Services (CMS) continues to evaluate the “true” budget neutrality of the Patient-Driven Payment Model (PDPM), it’s clear COVID-19 has impacted usage of the new payment model. A report from professional services firm CliftonLarsonAllen (CLA) found the median Medicare revenue per patient day (RPPD) increased 7% in 2020 under […]
Nursing homes have long been seen as the place where elderly Medicare and Medicaid patients spend their final years, but as these institutions look to evolve post-COVID, their role in the long-term care continuum continues to expand. Over the course of the year, SNN has seen operators open in-house dialysis units, renovate their facilities for […]
For an industry where slim profit margins are a widely discussed concern, a federal advisory board found 2020’s robust 25% margin in Medicare payments justification for a suggested cut to base payment rates in fiscal year 2023. The Medicare Payment Advisory Commission (MedPAC) said “rebounded” industry transactions informed its recommended 5% cut as well, thanks […]
The Centers for Medicare and Medicaid Services (CMS) has made headway separating metrics changes in the past year-and-a-half, tying some to the pandemic and others to implementation of the Patient-Driven Payment Model (PDPM). John Kane, technical advisor and SNF payment team lead for CMS, helped the skilled nursing industry better understand the impacts of PDPM […]
The Centers for Medicare & Medicaid Services (CMS) late Thursday issued a final rule updating Medicare payment policies — namely a delay to Patient-Driven Payment Model (PDPM) pay rate changes until next year and adjustment of provider pay by 1.2%. This was a decrease for fiscal 2022 compared to the agency’s proposed 1.3% boost in […]
The nursing home industry has been through the wringer over the past 24 months, first with the implementation of a new Medicare payment model, the Patient-Driven Payment Model (PDPM), and then the COVID-19 pandemic. Coming out of the pandemic, operators across the country need to start thinking about their future in the post-acute care continuum. […]
In a wide-ranging conversation about value-based care, skilled nursing industry leaders said operators and owners need to be more willing to take on risk to benefit from such models. Integrated Care Solutions CEO Brian Fuller and Eric Tanner, chief executive of SNF operator OnPointe, said during a fireside chat at the Synergy Summit that providers […]
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