In adjusting to new case-mix systems under the Patient Driven Payment Model (PDPM), the changes to reimbursement rates might be more widespread and large-scale than anticipated, posing financing threats to the nursing home sector because lenders are basing loans on rate projections that are expected to be scaled back. The goal of budget neutrality – […]
More guidance is available on how to conduct mood interview changes, with the Centers for Medicare & Medicaid Services (CMS) updating the Resident Assessment Instrument (RAI) manual to reflect key changes in the new Minimum Data Set (MDS). Notably, if a resident refuses or is unwilling to participate in the interview, assessors need to go […]
Ahead of the upcoming Minimum Data Set (MDS) changes on Oct. 1, the preparation of clinicians is mixed and may have a lot to do with company size and regional market, along with resources to stay apprised of reimbursement updates. Many clinicians feel stressed and overwhelmed by the adjustments, with some playing catchup to the […]
A big question that operators must ask themselves when considering involvement in an institutional special needs plan, or I-SNP, is ultimately wrapped up in how much money is being made on the Medicare Part B therapy side, some say. It might not make financial sense to sign up for an I-SNP if a SNF operator […]
Although survey citation rules can vary from state to state, nursing home operators can implement broad steps to avoid deficiencies if they focus on the often overlooked easy fixes as well as the more complicated overlaps between disparate areas of care – ranging from food safety and mental health documentation to infection control. Certain trends […]
Covid cases are beginning to rise again, steadily at first and now with a sharper increase over the past five weeks, especially in large metropolitan areas. Hospitalizations across the country rose by nearly 19% in the last week to 15,067, according to data from the U.S. Centers for Disease Control and Prevention. This is especially […]
Industry leaders continued to have mixed reactions about the fate of the Biden Administration’s nursing home staffing mandate after the accidental online release of a staffing study commissioned by the Centers for Medicare & Medicaid Services (CMS), with some insiders questioning the leaked study’s data. Industry stakeholders doubted the reliability of the study conducted by […]
For skilled nursing facility operators, the most common survey deficiencies might not be the ones always at the top-of-mind. In multiple states, a Zimmet Healthcare Services Group (ZHSG) analysis found that food safety and procurement was the primary deficiency, among other areas, like basic infection control and resident rights. “During interviews, the food quality often […]
As nursing home operators enter the final stretch before Minimum Data Set (MDS) changes take effect on Oct. 1, they are focusing particular attention on items related to capturing resident depression. With a substantial amount of reimbursement being at stake, the effect of the change from the PHQ-9 to the PHQ-2 to 9 is the […]
The issue of formally requiring patient surveys for nursing homes, similar to surveys mandated in other segments of health care, has long been a source of debate – one getting stirred up again after federal policy makers decided to nix patient satisfaction measures from the recently issued final prospective payment rule for 2024. The Centers […]
The skilled nursing sector is under increasing pain due to the growth of Medicare Advantage, with the industry losing hundreds of millions of dollars while operators also are contending with a host of operational burdens. This was a message delivered repeatedly Wednesday at the “Roaring Reimbursement” conference held by Zimmet Healthcare Services Group (ZHSG) in […]
General staffing metrics used to assess quality of care hold less weight these days and need to be updated, experts say, because the entire skilled nursing industry is struggling to build and retain its workforce. These quality measures need to be presented through the lens of the pandemic and the staffing crisis, SNF leaders say. […]
As acuity continues to rise among nursing home residents, providers say reimbursement needs to change too – and not just the dollar amount. Incentives should be based on quality of care, and the industry will need to build out specific reimbursement models to match expanded acuity specialities, especially as value-based care becomes more and more […]
All skilled nursing facilities that participate in Medicare Fee-for-Service (FFS) can expect a letter from the Centers for Medicare & Medicaid Services (CMS) regarding improper payment rates starting June 5. And, as of an updated memo from CMS on Monday, claims could be adjusted or denied if an improper payment is identified. CMS initially posted […]
The Centers for Medicare & Medicaid Services (CMS) took aim at improper skilled nursing payment rates in its latest memo on May 4. This appears to be a reaction from data compiled using the Comprehensive Error Rate Testing (CERT) program, which projected an improper payment rate of 15.1% in 2022 for Medicare Fee-for-Service (FFS), nearly […]
As Medicare Advantage continues to penetrate the nursing home market, leaders say that MA plans are depressing margins amid higher costs to run operations. This might lead some operators to contemplate closing, while others will be wiser to hire staff in designated roles to help them negotiate better rates – and exclusions – for managed […]
Occupancy for post-acute care was flat on a month-over-month basis as of April 9, 2023, according to a data analysis from BMO Capital Markets. The news is dimmer for the real estate investment trusts (REITs) covered by the firm, most of which saw sequential declines, according to a note issued Friday. The analysts mapped REIT […]
Following states like Illinois and New York, Connecticut is the latest state to introduce a bill aimed at transforming staffing and requiring transparency changes among area nursing homes. Proposed changes would apply to the more than 200 nursing homes across the state. One change involves boosting minimum staffing hours from 3 to 4.1 per person […]
The skilled nursing industry is facing a defining moment that could determine the future of Medicaid reimbursement, with a new model emerging that ties increased dollars to facility performance. “I doubt that we’re going to get another chance,” Zimmet Healthcare Services CEO Marc Zimmet said Tuesday at the annual eCap conference in Miami. This as […]
As the skilled nursing industry is beset by crippling staffing shortages, inflation costs, and increased government oversight in an already highly regulated field, operators must be proactive in shielding themselves from litigation risk. Risk is coming from a multitude of different places, according to experts at a Zimmet Healthcare Services Group webinar on Thursday, and […]
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