Five Things Every Administrator Should Focus On

I had a phone conversation earlier today with a friend and colleague (he’s part owner of a rehab consulting and management company) and as we talked, the conversation reminded me about the host of issues facing health care administrators.  Our conversation flowed to long-term care and specifically, SNFs (he spends a lot of his time … Read more

GAO Releases Report on Poor Perfoming Nursing Homes

In 1998, CMS created the Special Focus Facility initiative or program designed to target or focus attention on improving the poorest performing facilities (performance defined by survey/compliance history).  Each state selects up to 15 of the poorest performing facilities until the program reaches its cap or maximum of 136 facilities.  The requirements from CMS to … Read more

Part B Therapy Cuts Delayed to June 1

As a follow-up to a post from last week regarding pending cuts in Part B therapy rates, last evening the House passed a bill that the Senate had passed earlier in the day, included within is a provision to delay the pending cuts to the physician fee schedule until June 1.  The provision is tucked … Read more

Part B Therapy Rate Reductions Return

With Congress on recess, the temporary extension of the Part B therapy rate cuts ended on March 31.  As of today, with Congress still on “holiday”, the Part B therapy rate cuts remain in effect.  Best knowledge has it that Congress is working on another temporary extension that would retro to April 1 and last through April 30.  … Read more

Health Care Reform Implications: SNFs

The following is a summary of the major provisions in the recently passed health care reform bill.  Please note: I have not attempted to cover every nuance in detail but to provide a highlight for a point of reference.  If any reader has additional questions or wants additional insight on any particular provision, please let … Read more

Strategies for Accomplishing New Development or Major Capital Projects

One of the focal areas of my consulting practice/work is assisting health care organizations in accessing sources of funding (securing financing basically) for major projects and/or new development.  Given the state of the economy, most specifically the capital markets over the past eighteen months, getting funding for capital projects and/or development has been challenging, though … Read more

Medpac Report to Congress: 2011

Earlier this week, Medpac (Medicare Payment and Advisory Commission) released its report to Congress.  Primary among Medpac’s duties is its provision of recommendations regarding payment updates under Medicare.  Below, I have broken out and summarized the recommendations. Hospice (the points below the first bullet are continued recommendations from 2009) 2011 rate is the market-basket less a … Read more

Hospital Re-Admissions: Update to an Earlier Post

Last week I wrote about hospitals using “observation stays” as a means of dealing with the potential risk of reimbursement penalties imposed by CMS for certain re-admissions.  The focus of my post was on how the trend of hospitals using observation stays to avoid CMS scrutiny (and penalties) was impacting Medicare admissions at SNFs.  I … Read more

Hospital Observation Stays Impacting Medicare SNF Admissions

An issue that I am fielding a fair number of inquiries about lately involves Medicare patients spending more than three days in a hospital, subsequently ‘discharged’ to a SNF and the SNF learning later that the patient was never technically admitted to the hospital.  Mostly, the inquiries I am getting are along the line of “what’s … Read more

Hospice Contract Reminders for SNFs

On a fairly routine basis, I run across SNF Administrators and Directors of Nursing that continue to have issues with hospice patients in their facilities but not from the standpoint of the patient typically; from the standpoint of dealing with the Hospice and the terms of the contract between the Hospice and the SNF.  In … Read more