Healthcare, Senior Living, Economics
Medicare Advantage plans or Medicare Part C and D plans continue to grow in popularity. I’ve written a number of posts on various Medicare Advantage topics, of late, coverage issues and denials, particularly for post-acute care stays. A recent post on that topic is here: https://wp.me/ptUlY-wI Medicare Advantage plans (Part C plans) include Parts A, … Read more
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
Every year, the accounting firm of Clifton Larson Allen (CLA) produces an industry trends report based on accumulated cost report data. The report provides a good snapshot of the nursing home industry, nationwide, with insights on regions and states. The report is available here: 38th-snf-cost-comparison-and-industry-trends-report As I’ve written on numerous posts on this site, the … Read more
Happy Hump Day eve! There is so much going on right now with the economy, government shutdown (whew, avoided that one for a bit) dynamics, election news, and health policy that it is becoming difficult to parse topics into stuff of value. Hopefully, a couple of quick updates will make room for more insightful analysis … Read more
A major concentration within my firm, H2 Healthcare, is compliance work. My wife heads this section of the practice, and she is widely known as one of (if not THE) the foremost post-acute/senior living experts on clinical quality, compliance, and risk mitigation/risk management. Her book on reducing survey risk for SNFs is still available on … Read more
No other segment of senior living/senior care got rocked as much by the pandemic as skilled nursing. Frankly, the industry had challenges from labor shortages and lagging reimbursement entering the pandemic (2020). The pandemic didn’t just accentuate these issues, it blew them up in terms of magnitude (impact) while adding supply chain issues, inflation, and … Read more
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
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
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
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