The value-based care payment model, Transforming Episode Accountability Model (TEAM), is confronting challenges related to communication and interoperability across hospitals and nursing homes, including the timely identification of potential TEAM-eligible patients. Moreover, some clinical leaders believe the three-day inpatient stay waiver for TEAM could use a revamp to include additional episodes of care to account […]
Nursing homes are facing greater pressure to prove their value as the Centers for Medicare and Medicaid Services (CMS) holds hospitals and ACOs more accountable for post-discharge costs, readmissions, length of stay and patient outcomes – factors that can influence which facilities hospitals end up choosing as referral partners. The changes mean SNFs should be prepared to demonstrate their ability to control costs and […]
Even though the Centers for Medicare & Medicaid Services (CMS) officially ended its 5-Claim Probe process for nursing homes as of June, many providers still find themselves in limbo with audits. While no new claim requests will be issued – the Skilled Nursing Facility (SNF) 5-Claim Probe process ended on June 30 – some facilities […]
More than a week after updates to the Minimum Data Set (MDS) went into effect, each section change seems to be emphasizing focus on the resident’s voice, which along with substantial coding changes – four years in the making – will require time to incorporate, experts said. Kevin Cezat, director of clinical excellence for Therapy […]
Audits have been trickling in for the 5-claim improper payment probe and educate review led by the Centers for Medicare & Medicaid Services (CMS), which had announced its plans to implement the review for all SNF operators in the country in June. A webinar hosted by Therapy Management Corporation (TMC) on Tuesday delved into how […]
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 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 […]
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’ […]
The Medicare reimbursement overhaul that’s coming in a few short months represents a major change in how skilled nursing facilities are paid for the care that they provide — as well as how officials monitor operators for potential fraud. With the move to the Patient-Driven Payment Model (PDPM), SNFs will be paid based on the […]
With the Medicare reimbursement overhaul taking place in a few short months, skilled nursing facilities — ideally — are moving into the last stages of preparation and training for staff and workflow procedures. But according to post-acute care partnership strategist Mike Wetula of therapy company TMC, SNFs can’t ignore their referral partners in the process. […]
