Nursing home operators in one of the toughest states for Medicaid reimbursements will receive a $240 million reprieve in the next fiscal year. Illinois lawmakers approved the funding boost as part of the state’s most recent budget, which Democratic Gov. J.B. Pritzker signed into law Wednesday; Capitol News Illinois initially reported the nursing home windfall […]
Plante Moran
The new Medicare model for skilled nursing facilities more closely links reimbursements with resident conditions — and making sure that facilities completely document those conditions will soon be an essential step for success. But because payment under the current Resource Utilization Group (RUG) system is driven primarily by therapy minutes, capturing those conditions on the […]
Industry leaders had reason to cheer the federal government’s decision to boost Medicare rates for skilled nursing facilities, but the gain could end up only papering over the persistent reimbursement problems in the space. The Centers for Medicare & Medicaid Services (CMS) last week proposed a 2.5% increase to the Medicare market basket rate, a […]
The state of Illinois bases its Medicaid reimbursements for nursing homes on calculations that are years out of date, leading to financial pressures that have closed 20 facilities in the state since March 2014. That’s according to a new report commissioned by the nursing home advocacy group Health Care Council of Illinois (HCCI). Capitol News […]
Big-picture thinkers in the skilled nursing space have increasingly talked about the need for operators to band together in the face of reimbursement pressures and new payment models — an urge that goes against the competitive nature of the health care industry, particularly in markets saturated with multiple post-acute options. But according to Plante Moran […]
The 5th episode of our podcast, Rethink, is now available! Earlier this year, Betsy Rust and Plante Moran released a report with a fairly explosive thesis: Margins for skilled nursing facilities had actually been on the rise between 2016 and 2017. But the senior care advisory firm was quick to point out that the report […]
When it comes to the changes coming to Medicare reimbursement methodology, coding figures prominently in the discussion among skilled nursing providers. But while it’s important for SNFs to make sure staff education and training on that topic is up to date, there are several other components of reimbursement under the Patient-Driven Payment Model (PDPM) that […]
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 […]
The changes in Medicare reimbursement taking effect in October will mean upheaval in more places than a skilled nursing facility’s billing department. It will mean changes in the nuts-and-bolts processes of patient care, and SNFs need to be preparing for this reality — with the knowledge that regulators will be watching closely. That’s according to […]
Skilled nursing providers actually saw across-the-board gains in Medicare margins between 2016 and 2017, but the effects were mitigated by a familiar foe: Medicare Advantage plans. The average provider saw a profit of $102 per patient day for residents covered under Medicare Part A in 2017, according to a new analysis from accounting and advisory […]
As skilled nursing providers prepare for a new Medicare reimbursement system, those with solid revenues under the current model may be in for the most severe declines going forward. Operators that have mastered the current Resource Utilization Group (RUG) system tend to be those projected to see reimbursement declines under the new Patient-Driven Payment Model, […]
The Medicare payment model taking effect on October 1 this year represents a sea change for skilled nursing providers in that patient condition, rather than therapy minutes, will drive reimbursement. It also represents a sea change in the mechanics of reimbursement. Under the Patient-Driven Payment Model, ICD-10 codes will form the basis of reimbursements, making […]
Of all the changes coming to the skilled nursing industry when a new payment model takes effect next fall, the most pressing may be one of the most basic: Starting in October 2019, providers will have a single opportunity to set themselves up for financial success with a patient’s initial assessment. The Patient-Driven Payment Model, […]
A recent report puts some hard numbers to the pressures skilled nursing facilities face — and offered a prediction of its own about the much-anticipated “silver tsunami.” Though occupancy has been declining in skilled nursing facilities, falling from 87% in 2015 to 82% in 2016, the report from accounting and consulting firm Plante Moran projected […]
Depending on whose earnings call you happened to catch this season, the predicted surge in demand for skilled nursing services is just around the corner — or it isn’t coming at all. At Omega Healthcare Investors (NYSE: OHI), management enlisted the services of two consulting firms to crunch the numbers on demographic trends over the […]
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