Four months into the Patient-Driven Payment Model (PDPM), the first cases of COVID-19 were found in the U.S. – and any chance of the Medicare overhaul going as planned was gone. The new system for Medicare reimbursement for skilled nursing facilities, which took effect in October 2019, was designed to be budget-neutral, meaning that the […]
Category: PDPM
The federal government sent a shockwave through the post-acute and long-term care landscape earlier this month when it disclosed that the new Medicare payment model for nursing homes had increased total spending by 5% — counter to its goal of budget neutrality. But while officials mull the ways that the Patient-Driven Payment Model (PDPM) could […]
The federal government announced it would be taking a look at the Medicare reimbursement system for skilled nursing facilities in the wake of higher-than-expected payments over the course of last year, even allowing for the impact of a global pandemic that had a uniquely deleterious effect on SNF operations. But whatever ends up changing, for […]
As the federal government’s approach toward nursing homes and COVID-19 continues to shift from emergency support to reflection and reform, analysts are increasingly warning that the coronavirus-era gravy train could soon come to an abrupt stop. In particular, the past week has brought three pieces of news that may signal trouble ahead for operators and […]
The federal government is mulling several options to recalibrate the Medicare payment structure for skilled nursing facilities as it seeks to achieve its intended goal of budget neutrality — with the aim of shutting off excess payments sooner rather than later. The Centers for Medicare & Medicaid Services (CMS) this week determined that the Patient-Driven […]
Therapist staffing coverage at nursing homes fell up to 10% after the October 2019 implementation of a new Medicare payment model, a new study has determined — with the cuts coming primarily on the backs of contracted employees and not full-time skilled nursing facility staffers. Physical and occupational therapist staffing was 6% lower in the […]
When the overhaul of Medicare Part A reimbursement for nursing homes took effect in October 2019, predictions of audits and the potential for drastic changes came close on its heels. After all, the Patient-Driven Payment Model (PDPM) was meant to be revenue-neutral, meaning that the Centers for Medicare & Medicaid Services (CMS) would not spend […]
Over the course of 2020, as skilled nursing facilities battled the COVID-19 pandemic, the Patient-Driven Payment Model (PDPM) was one of the bright spots for operators, allowing them to secure payments for caring for the clinical needs of patients at a time when those needs grew markedly more complex. The Centers for Medicare & Medicaid […]
The new Medicare payment model for nursing homes provided $200 more per day than the system it replaced in October 2019, according to a new analysis of claims data — setting up a revenue bump at the time the sector needed it most. During the COVID-19 pandemic, the Patient-Driven Payment Model (PDPM) brought an average […]
When the Patient-Driven Payment Model (PDPM) overhauled the way Medicare reimburses care provided in skilled nursing facilities, the federal government attempted to put the focus on the care needs of patients — and in doing so, incentivized facilities to capture patient conditions more thoroughly and add to their clinical specialties. At least, that was the […]
The Patient-Driven Payment Model (PDPM), the overhaul to Medicare reimbursement for skilled nursing facilities that took effect in October of 2019, has proven its worth as a mechanism for paying for nursing care during a global pandemic. It has, however, been “anything but revenue-neutral,” at least in terms of how much money the government is […]
Even with limited data due to COVID-19, an annual benchmarking report found that the operating margin for skilled nursing facilities remained at zero for 2019. And given the costs of managing operations during the pandemic — to say nothing of the occupancy hit — the picture is bleak for margins in 2020. But for all […]
The federal authorities that regulate skilled nursing facilities issued a slew of changes to the rules governing nursing home care in the early months of spring as part of efforts to curb the spread of COVID-19 in the facilities. Some of those changes, such as the loosening of restrictions around the use of telemedicine, are […]
In the months leading up to the implementation of the Patient-Driven Payment Model, the overhaul of Medicare reimbursement for skilled nursing facilities that was implemented last year, several factors emerged as crucial areas for thriving under the new system. The Medicare rate of each facility is determined by a formula that draws from five care […]
A leading wound care provider sees expansion opportunity in both skilled nursing and the home despite the ongoing strains of COVID-19, with a recent private equity investment to back it up. American Medical Technologies in late August announced its acquisition by private equity firm One Equity Partners and investment management company The Silverfern Group, capping […]
The infectious nature of COVID-19 makes it imperative that skilled nursing facilities take extra precautions around any new admissions that they bring in, as well as any residents that are returning from a hospital stay. According to the Centers for Disease Control and Prevention (CDC), the procedure for SNFs is straightforward: Keep any COVID-19-positive patients […]
The Centers for Medicare & Medicaid Services (CMS) has been slow to make moves on audit demonstrations for the Patient-Driven Payment Model (PDPM), the Medicare reimbursement overhaul for skilled nursing facilities that took effect last year. But that doesn’t mean that the agency has forgotten its promise to closely monitor patient outcomes and scrutinize SNFs’ […]
In the lead-up to the implementation of the Patient-Driven Payment Model (PDPM) on October 1, 2019, consultants, therapists, and the federal government warned operators over and over that therapy minutes would come under intense scrutiny in the months following the start of the new Medicare reimbursement system. The model allowed for patients to receive up […]
The federal government late Friday released its proposed rule for skilled nursing facility payments for the coming fiscal year, which will see the nation’s nursing homes receive a 2.3% Medicare pay bump. “This estimated increase is attributable to a 2.7% market basket increase factor with a 0.4 percentage point reduction for multifactor productivity adjustment,” the […]
The new Medicare payment model for nursing homes was designed to eliminate the temptation to make key care decisions based solely on reimbursements, and not on individual residents’ needs. Though the early results from the Patient-Driven Payment Model (PDPM) have largely been positive for the industry, a group of researchers this week raised concerns about […]