Healthcare, Senior Living, Economics
Yesterday, CMS began posting the first elements from the Quality Reporting Program. There are five elements that contain data, compared to the national average. Percent of residents developing new or worsening pressure injuries Percent of residents experiencing one or more falls with major injury Percent of residents who had a functional assessment on admission and the … Read more
Beginning yesterday, I’ve been following the news regarding CMS’ annual issuance of Final PPS rules for providers. Of greatest interest is the SNF Final Rule as it includes a completely new payment system, departing from the RUGS IV, therapy-centric system currently in-place. I’ve read through the Final Rule (all 424 mind-numbing pages) and summarized what SNFs … Read more
Late this afternoon, I caught news that CMS will release a number of Final Rules impacting post-acute providers over the next few days. Below is a quick summary of what is known for SNFs. I will update this information as I get access to the Final Rule. PPS rates (manual) to adjust by 2.4% (increase). A … Read more
I’m not sure how many of my readers are following the subject and CMS stance/policy on interoperability among providers but the concepts and resultant debate are rather interesting. I am trying to encourage as many clients and readers to tune-in on this subject as the implications are sweeping – positively and negatively. Interoperability in this … Read more
Attached is a link a to a good PBJ (payroll based journal) article. It covers the basic concepts of what is going on today with regard to staffing level reporting and the Five Star system. Recall, staffing as a domain, is one of the stars in this system. The article is posted here (re-published) with permission of … Read more
In a memo set for release today, CMS is proposing to reintroduce pre-payment review (with a twist) for Home Health claims. The memo version is here: HHA Pre Payment Recall, CMS first introduced pre-payment review in August 2016, starting in Illinois. The process required agencies to submit claim-related data BEFORE receiving final payment or face an … Read more
Last Friday, CMS released the contents of its annual proposed rule updating the SNF PPS plus (as always), fine tuning certain related programmatic elements. Final Federal Register Publication is set for May 8. (Anyone wishing the PDF version may download it from the Reports and Other Documents page on this site or access it here … Read more
It is rare that I push or endorse any product on this site. This is an exception worth making. http://hcmarketplace.com/survey-success-for-long-term-care The book is authored by my wife who also heads the Clinical Compliance practice within H2 Healthcare, LLC – the firm that I head. She is our Senior Partner as well as the firm’s Chief … Read more
Late yesterday, a reader (who also happens to be a client from time to time), posed this question to me. “When hospitals discharge to hospice and if the hospice has to readmit to the hospital, the hospital doesn’t get penalized for the readmit? Is this true?” Since this question is not one that I have … Read more
Now into February, its time to take stock of the Post-Acute/SNF landscape, particularly as the same pertains to the evolutionary policy initiatives in-play and moving forward. To start, there is little evidence on the horizon of an all-out retreat on the policy changes begat by the ACA. While some framework is building to “Repeal and Replace” … Read more