COVID-19 Response and Pandemic Preparedness: Redux

As COVID-19 has moved to an endemic phase (constant presence, not spreading out of control or taxing health care resources), I’ve started to look back at what transpired since early-2020 and what was learned, known, and now, embedded (perhaps) in our culture and our health care industry. Suffice to say, the review is somewhat mind … Read more

Value-Based Care: Why it Matters, or Should, for Post-Acute Providers

Value-Based Care is kind of a vogue term, one that I encounter quite often. I also have used it when speaking or writing and know most people have no idea what it means or how it can be developed and/or applied. Value-based care is not a new concept. Medicare tried a foray into it back … Read more

CMS Releases Rule on SNF Staffing Mandate

Surprise! Surprise! Surprise! This morning, CMS dropped a proposed rule for a staffing mandate for SNFs. On Wednesday, I wrote about the delays (staffing mandate) and the information from a CMS contracted study completed by Abt and Associates. That post is here: https://wp.me/ptUlY-LM The consensus around the staffing mandate issue is that CMS was bogged … Read more

Wednesday Feature: CMS SNF Staffing Mandate Stalled? The Abt Report on Feasibility…

Happy Hump Day! Another Wednesday with news too heavy to ignore. I’ll try to return to some levity and light in future Wednesday features. For a number of years, CMS has been playing with developing a staffing level mandate.  The first CMS study from 20 years ago recommended a 4.1 hours per day benchmark.  Recently, … Read more

SNF Final Rule 2024 – Update

Back a few weeks ago I did a post summarizing the 2024 Final PPS Rule for Skilled Nursing Facilities. Recall, these rules come out yearly, updating payment rates and other provisions impacting payment and some, impacting policy. Typically, the initial or proposed rule starts in spring and then after comments, etc., becomes final during the … Read more

Politics and Health Policy

Last week, the 2024 Presidential campaign season kicked into full swing with the first candidate debate. Arguably, momentum has been building ahead of the debate, especially in Iowa, during the State Fair, where candidates roamed, gave speeches, and pressed the flesh. I was there one day and enjoyed seeing Tim Scott and few other notables, … Read more

Friday Feature: CMS Updates RAI Manual for SNFs

As foretold in the SNF PPS Final Rule, CMS was going to fine tune the MDS/RAI manual prior to October 1 when the new 2024 Fiscal Year starts. Generally, data such as this update comes much closer, sometimes even after the October 1 implementation date. Providers get a break for a change.  Initial proposed changes … Read more

SNF Claims Audits so Far – Messy

Back in early June, I wrote a post on how Medicare/CMS was intending to audit 5 claims from every participating SNF in the country. The audits would be staggered and conducted by MACs (Medicare Audit Contractors). That post is available here: https://wp.me/ptUlY-AR As we are now three months into the audit process, details are emerging … Read more

Wednesday Feature: CMS Targeting 400 Hospices for Administrative Action

Usually I try to add some “light and levity” to my Wednesday features as the content on this site is pretty heavy health policy and economics, regulatory in nature, etc. In my work, my usual Wednesday messages internally are “fun” – a bit of Hump Day humor or whimsy. By title of this post, readers … Read more

Tapas Thursday: Small Health Policy News Bites

I like tapas from time to time, especially for a happy hour gathering. Thursday seems to always be a good day to have little bites of something prior to a big weekend; even better if Friday is a short day or a day off into the weekend. In a post earlier this week I mentioned … Read more