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While 2025 remains a bit uncertain due to the federal staffing mandate and a new White House administration, leaders in the nursing home industry plan to continue working toward improving quality of care, addressing workforce challenges and advocating for fair regulation and reimbursements. Clif Porter, president and CEO of the American Health Care Association/National Center […]
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Former president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) Mark Parkinson will be joining Comprehensive Rehab Consultants’ (CRC) board of directors as of Nov. 4. There was a “powerful alignment” in goals and values between Parkinson and leadership for CRC when they first connected, the company said […]
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For some nursing homes, quality assurance and performance improvement (QAPI) meetings serve merely as a checkbox for requirements, but they haven’t driven changes to improve care quality outcomes. On the flip side, however, other nursing homes are effectively using QAPI meetings to push for success in quality of care. Executives at these facilities emphasize that […]
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Nursing homes and hospitals are developing closer ties and improving communication, and with this trend, admissions into nursing homes are expected to increase as rehospitalizations and excessive lengths of stay are also seen as declining. With rising acuity and staffing shortages of recent years, nursing homes have often been reluctant in admitting challenging cases that […]
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Longevity Health and Infinity Healthcare Consulting on Wednesday announced a joint venture for institutional special needs plans (I-SNPs), marking Longevity’s entry into three new states, along with the expansion of its existing business into an additional state. Longevity and Infinity’s clients will collaborate to assist I-SNP members living in Infinity nursing facilities across Indiana, Kentucky […]
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In weathering the rise of managed care penetration – which has often meant lost profits – nursing homes are turning to centralized processes for handling claims, beefing up teams to handle additional documentation requests (ADRs), and closely tracking contract renewals. Rates for managed care plans like Medicare Advantage are often lower than traditional fee-for-service Medicare […]
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Coming off of his first year as CEO of American Senior Communities Steve Van Camp is busy planning an Institutional Special Needs Plan (I-SNP) joint venture with five other providers in Indiana, while also devoting time and resources to meeting quality measures and outcomes among ASC facilities. Important considerations to forge ahead with these efforts […]
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Of an estimated 36 million Americans with a family member or friend in a nursing home, only 37% say their loved one is receiving high-quality care. And political affiliation aside, older adults want public policies that support and improve quality care. That’s according to a study issued by The John A. Hartford Foundation. Based on […]
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Customer service, staff wellbeing, and tackling low reimbursement rates are some of the top priorities for nursing home operators as they prepare for the future. And educating and supporting care teams is especially important in order to strategize with the quality measures that will be implemented in the coming years, as these will have an […]
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TEAM Model Gives Nursing Homes Another Lever for Medicare Advantage Negotiations
By Amy Stulick| September 6, 2024Negotiating power with Medicare Advantage (MA) plans may become easier as nursing homes explore participation in bundled payment options such as the Transforming Episode Accountability Model (TEAM), which enables following patients through an entire episode of care. It’s a lever available to participants and collaborators to forge new contracting strategies with their MA plan and […]
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Meticulous documentation is the name of the game for nursing home operators looking to keep up with Minimum Data Set (MDS) changes and maintaining a good rating in the Five-Star Quality Rating System. This is especially because inaccurate or insufficient data could affect a facility for at least a year in the future. Leaders in […]
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Reimbursement issues at nursing homes are pushing operators to adapt their payment models to increase reliance on Institutional Special Needs Plans (I-SNPs) and Accountable Care Organizations (ACOs). But while these models aim to enhance care quality even as they control costs, they also bring on unique challenges, including requiring extra oversight with discharges and related […]
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Despite operational and financial headwinds affecting the nursing home sector currently, a transitional care program and physiatry partnership has been able to cut readmission rates from 29% to 9% among a group of facilities. OSF HealthCare, a 17-hospital system in Illinois and Michigan, partnered with physiatry and care coordination management group Puzzle Healthcare to deliver […]
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Amid plans to launch the largest provider-owned institutional special needs plan (I-SNP) in the U.S., Brickyard Healthcare is also making sure it surpasses certain other challenges facing the sector. Along with this endeavor, eliminating agency use, preparing for managed Medicaid in Indiana, and being ready to face the staffing mandate, have all been top of […]
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Texas-based Touchstone Communities hasn’t been slowing down this year, with the operator busy acquiring and building properties. On top of brick-and-mortar updates, Touchstone also partnered with Longevity Health in January to offer institutional special needs plans (I-SNPs) to its residents. It’s very thoughtful, controlled growth aimed at diversification of assets, said Leslie Cunningham Campbell, COO […]
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Managed care’s growth across all health care settings, including nursing homes, has pushed reimbursement rates lower, and operators are implementing strategies to counter the situation. For starters, operators expressed the need to be well equipped for negotiating better rates with managed care organizations (MAOs). And, coming armed with cost of care data to the negotiating […]
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Operational and financial challenges can make it difficult for nursing homes and other health care facilities to transition to the federal government’s Value-Based Program (VBP), which ties payment to quality and outcomes. An editorial published in JAMA Internal Medicine Monday expresses the need for more data and improved measurement of outcomes, better methods of financial […]
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The Centers for Medicare & Medicaid Services’ (CMS) in April released a bundled payment model that is the culmination of the best aspects from such past models, all to align with the agency’s efforts to get all Medicare Fee-for-Service beneficiaries involved in value-based care by 2030. The Transforming Episode Accountability Model, or TEAM, is considered […]
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If there’s no additional funding for the minimum staffing rule, well over 5% of existing facilities will close, depending on how successfully operators can pivot to meet the standard. The rates of closure may even reach 10% to 15%, depending on the market, cautioned sector leaders attending the LTC100 conference this week. Steve Nee, CEO […]
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The Centers for Medicare & Medicaid Services (CMS) is testing out a payment model that would cover all costs associated with an episode of care, including a skilled nursing stay, but it appears that select hospitals would be in the driver’s seat if approved. Certain surgical procedures will fall under the new model and include […]