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 […]

Proposed Medicaid Rule Would Mean Billions in Cuts, Waves of Nursing Home Closures

With skilled nursing facilities in multiple states facing significant shortfalls in their Medicaid reimbursement, supplemental payment programs used to bolster rates have become a lifeline. This is especially true for Texas and Indiana, both of which employ programs designed to get SNFs a higher rate for Medicaid services through varying mechanisms. Both states are motivated […]

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 […]

[Upcoming Webinar] PDPM One Month Later: What We Know, and What We Don’t

Register NowTime: 1 p.m. – 2 p.m. CSTDate: Wednesday, November 13th The new Patient-Driven Payment Model (PDPM) is the first major update to the Medicare skilled nursing PPS in two decades, and went live just weeks ago. In this discussion, industry leaders will share what administrators need to know, primarily from a clinical and operational […]

[Upcoming Webinar] PDPM One Month Later: What We Know, and What We Don’t

Register NowTime: 1 p.m. – 2 p.m. CSTDate: Wednesday, November 13th The new Patient-Driven Payment Model (PDPM) is the first major update to the Medicare skilled nursing PPS in two decades, and went live just weeks ago. In this discussion, industry leaders will share what administrators need to know, primarily from a clinical and operational […]

[Upcoming Webinar] PDPM One Month Later: What We Know, and What We Don’t

Register NowTime: 1 p.m. – 2 p.m. CSTDate: Wednesday, November 13th The new Patient-Driven Payment Model (PDPM) is the first major update to the Medicare skilled nursing PPS in two decades, and went live just weeks ago. In this discussion, industry leaders will share what administrators need to know, primarily from a clinical and operational perspective, now […]

‘CMS is Watching’: Changing Therapy Patterns Raise Concerns About Skilled Nursing Audits, Care Quality

The first week of the new Medicare payment model for nursing homes has brought stories of rapidly shifting therapy patterns among some providers, and voices from the consulting and advocacy worlds are warning that any sudden movements could cause adverse effects — both immediately and down the road. The advent of the Patient-Driven Payment Model […]

[Upcoming Webinar] New Medicaid Math — Thriving With Change

Date: Wednesday, May 22Time: 1:00 p.m. CDTRegister Now The new Medicare payment system for nursing homes may be grabbing all of the flashy headlines in the post-acute care world, but Medicaid remains the dominant payer for nursing home services nationwide. Persistent funding shortfalls have caused waves of closures in states across the country, and operators […]

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 finalized last July 31, and we’ve spent those eight months speaking to […]

PDPM’s Effects Could Stretch Far Beyond Medicare for Skilled Nursing Facilities

On paper, the Patient-Driven Payment Model (PDPM) will only affect one pillar of the payment equation for skilled nursing facilities. But as players start to unpack the coming rule changes, PDPM’s reach begins to extend far beyond Medicare. Medicare Advantage and Medicaid frequently base rate calculations on the existing Medicare structure, a pair of experts […]

More Winners Than CMS Expects Could Emerge Under PDPM

The government has predicted a mix of winners and losers under the new Medicare payment model taking effect later this year. But due to the impact of payment changes on provider behavior — both past and future — there could end up being more winners under the new system than regulators expect. Specifically, under the […]

Key Skilled Nursing Metrics to Watch as Providers Struggle to Collect

As skilled nursing operators continue to deal with tight reimbursements and high labor costs, financial performance on the individual facility level has taken on greater and greater importance — and having a defined plan is key to success. “It doesn’t matter how much revenue you generate, or how much census goes up, if you don’t […]