After delaying cuts last year due to Covid, the Centers for Medicare & Medicaid Services (CMS) announced last week that it is moving forward with proposed cuts to Medicare funding for nursing homes. The CMS proposal includes a 3.9% Medicare rate increase for skilled nursing facilities, but the agency announced cutbacks to PDPM payments by […]
Zimmet Healthcare Services Group
The Biden administration is working toward pushing its value-based care agenda on nursing homes by way of state Medicaid programs, a daunting task with no two programs the same, and reimbursement rates varying widely based on state. As evidenced in reforms announced in February, federal agencies are also focused on tying staffing-related measures to value-based […]
Lenders and operators agree the skilled nursing market continues to largely be a regional affair when it comes to prospective transactions – buildings are often considered within the context of others in a 15- to 20-mile radius, with national statistics oftentimes secondary. State or regional specific operators understand what’s happening with labor in those markets, […]
Nursing homes have long been seen as the place where elderly Medicare and Medicaid patients spend their final years, but as these institutions look to evolve post-COVID, their role in the long-term care continuum continues to expand. Over the course of the year, SNN has seen operators open in-house dialysis units, renovate their facilities for […]
The role of a minimum data set (MDS) coordinator is one that continues to evolve in post-acute care since the launch of PDPM in 2019, and as operators have struggled to bring in nurses across the board, so too have they struggled to keep their MDS coordinators. With multiple coordinator openings at the moment, Rockport […]
With Medicare Advantage revenue “significantly lower” than fee-for-service reimbursement, a new Zimmet Healthcare Services Group analysis says, skilled nursing facilities need to weather today’s “reimbursement storm” in order to make it to the incoming wave of baby boomers that will need facility services. In the meantime, Zimmet suggests operators utilize facility data to improve MA […]
When the U.S. Centers for Medicare & Medicaid Services (CMS) announced it would delay adjustments to the Payment-Driven Payment Model (PDPM) until next year, some in the skilled nursing industry felt they were getting some breathing room. But Marc Zimmet, president of consulting firm Zimmet Healthcare Services Group, said he believes that delaying the inevitable […]
The new Medicare payment model for nursing homes provided $200 more per day than the system it replaced in October 2019, according to a new analysis of claims data — setting up a revenue bump at the time the sector needed it most. During the COVID-19 pandemic, the Patient-Driven Payment Model (PDPM) brought an average […]
In the early months of the pandemic, masks for medical personnel were in such short supply that providers, states, and the federal government were all bidding against each other to secure them. Gowns were so hard to come by that reports surfaced of nursing home workers using trash bags as makeshift coverings. The government attempted […]
While the skilled nursing landscape continues to struggle both operationally and financially during the COVID-19 pandemic, those same negative forces have only served to strengthen private health plans — putting Medicare Advantage in an even better position to continue its growth. Cratering census and sharp declines in elective surgeries, while fiscally devastating for nursing homes, […]
The infectious nature of COVID-19 makes it imperative that skilled nursing facilities take extra precautions around any new admissions that they bring in, as well as any residents that are returning from a hospital stay. According to the Centers for Disease Control and Prevention (CDC), the procedure for SNFs is straightforward: Keep any COVID-19-positive patients […]
Skilled nursing facilities received a 9% Medicare reimbursement boost during the early days of the COVID-19 crisis under the new Patient-Driven Patient Model, a new analysis has determined — providing a crucial fiscal lifeline that may not have existed under the structure that PDPM replaced. “RUG-IV would have been a fiscal disaster for SNFs dealing […]
The federal government took several steps to cut red tape in the health care system to help providers across the continuum battle the COVID-19 pandemic. But while those changes included alterations to reporting requirements for skilled nursing facilities, providers won’t be exempt from the consumer-facing rating system — and they need to be aware of […]
Updated guidelines on the use of personal protective equipment (PPE) are causing major headaches for health care providers across the continuum, as both acute and post-acute care settings grapple with supply shortages and a surge in cases of COVID-19. Those headaches include grappling with significant shortages of equipment in the face of the highly contagious […]
Multiple managed care plans have made changes to their procedures for admissions to the skilled nursing setting amid the ongoing coronavirus pandemic, with several major companies suspending prior authorization requirements for admissions to a skilled nursing facility. The changes, however, are not uniform — and that’s if the managed care organization (MCO) chooses to make […]
The federal government has implemented some key waivers designed to ease health care system burdens, including adopting a waiver of the requirement to have a three-day stay in a hospital to get Medicare coverage of a skilled nursing stay. But some of those waivers have led to confusion among operators — and some of the […]
The early returns for the new Medicare payment model for nursing homes have been broadly positive, with multiple experts and operators pegging the revenue gains at a healthy but modest 5% to 6%. But the actual gains may be higher than those numbers betray, and several experts predict some kind of eventual adjustment from the […]
The new fee-for-service payment model for nursing homes took up most of the oxygen in the industry over the past two years, but the rise of Medicare Advantage in markets across the country could make all of that preparation for naught — sooner than many may think. The Patient-Driven Payment Model (PDPM) for nursing homes […]
Despite steady reports of increasing reimbursements under the new Medicare payment model for nursing homes, at least one industry leader believes that the federal government will be happy with the early returns — and that any changes are fairly far down the road. Skilled nursing operators have not gone overboard with the strategy changes that […]
It’s four months into the Patient-Driven Payment Model (PDPM), and despite some industry analysts pointing to early gains for nursing homes, many occupational, speech, and physical therapy advocates continue to criticize layoffs and changes to resident care patterns. On the operational side, the initial PDPM returns have been positive: For instance, 67% of nursing homes […]
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