Under PDPM, Benefits of In-House Medicare Advantage Plans Will Go Beyond Money

Forward-thinking skilled nursing providers have increasingly warmed to the idea of starting a special kind of in-house Medicare Advantage plan in order to take more control over their reimbursements in an uncertain environment. But the strategies that operators must adopt to succeed with Institutional Special Needs Plans (I-SNPs) also fit seamlessly into preparations for the […]

PDPM Countdown: ‘We Are All Crossing Our Fingers and Knocking on Wood’

With the Medicare Part A reimbursement overhaul taking effect in just a few months, skilled nursing providers across the country are in countdown mode. But the clock is moving at different paces for different providers, several experts said. Some SNFs began their analysis and preparations months ago; others are barely getting started. That’s led to […]

Cain Bros.: Gap Between Haves and Have-Nots in Skilled Nursing Could Widen

Pressured by already light coffers and razor-thin margins, skilled nursing facilities could see an even wider gulf grow between top and bottom performers under the new Medicare payment model. That’s at least according to Cain Brothers director Taaha Shaikh, who this week wrote a commentary calling the coming Patient-Driven Payment Model (PDPM) “the next great […]

Shorter Stays Bring Rewards Under PDPM — But Only to a Point

Skilled nursing providers might be able to reap financial gains under the new Medicare payment model taking effect in October of this year if they can cut their average patient length of stay (LOS). But the gains will only hold until a certain point, and providers that already have shorter LOS —- such as short-term […]

Investing in Staffing Doesn’t Necessarily Lead to Skilled Nursing Profits

When it comes to staffing, skilled nursing providers may be caught between a rock and a hard place. Regulators have cracked down on the industry over staffing levels, hitting several facilities with one-star staffing ratings in 2018 after payroll-based journal data showed fluctuating workforce numbers. But a data dive by accounting firm CliftonLarsonAllen (CLA) found […]

Average Skilled Nursing Facility Loses Money on Each Resident, Every Day

The average nursing home in the United States lost four cents per patient day in the year 2017, according to a new analysis from a national accounting firm — down sharply from making $3.80 per resident every day just four years before. While the exact figure varied by region, with some areas seeing per-day net […]

MedPAC Unanimously Calls for $2 Billion in Skilled Nursing Payment Cuts in 2020

After floating a proposed recommendation to slash nursing homes’ Medicare reimbursements for fiscal 2020, a leading legislative voice on health care issues made it final last week. The Medicare Payment Advisory Commission (MedPAC) called on Congress to reduce funding for skilled nursing facilities by up to $2 billion in the next fiscal year, citing sufficient […]

No Room for Error as Providers Update Rehab Contracts Under PDPM

When sitting down at the negotiating table, rehabilitation companies can often have an edge over the skilled nursing facilities where they provide services. This is especially true as providers take stock of their costs and care models in preparation for the new Medicare payment system taking effect next year. But that doesn’t mean that SNFs […]

Providers Must Target Rehab Contracts, Cash Flows Now Ahead of PDPM

As skilled nursing providers start preparing for the new Medicare payment model, they need to zero in on how much money they’re making now on the various services they provide. Specifically, they need to brush up on their ICD-10 codes, which will play a key part in the setting of their reimbursement rate, as well […]

Even Top Providers Face Financial Peril as Median Skilled Nursing Margin Falls to Zero

The financial pressures sweeping the skilled nursing space haven’t discriminated between the best- and worst-performing operators in the business, according to a new report from CliftonLarsonAllen — with the median operating margin dropping to zero across the industry in 2017. That’s a 60-basis-point drop from the previous year, the accounting and consulting firm reported in […]

SNF Occupancy, Operating Margins Continued to Drop in 2016

National occupancy rates and operating margins for skilled nursing facility (SNF) providers trended downward in 2016, according to a new report from health care financial consulting and accounting firm CliftonLarsonAllen — though certain areas of the country fared better than others. The report, which included data from more than 15,000 Medicare-certified SNFs across the U.S., provided […]