Healthcare, Senior Living, Economics
It’s that time of year again where CMS begins to drop various rule proposals for updates to provider groups under PPS. From Hospitals, to SNFs, to Home Health and Hospice, each industry segment will see a proposed series of rate and programmatic (rule) updates from CMS. This is normal and it occurs at about the … 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
One quarter (three months and change) down and PDPM appears to be mostly positive for SNFs. CMS is reporting a higher average per diem payment level than under RUGs. Despite some added coding complexity, paperwork burdens are down for providers (two MDS’ during most stays now vs. many under RUGs). Anecdotally, the industry is seeing … Read more
I spend a good (ok, large) amount of time working with non-profit and privately held health care, post-acute and seniors housing organizations. Nearly all of my work is at the C-level and above and frankly, my career as an executive was there as well (25 plus years). Boards/governance bodies play a key role in the success and/or failure of … 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
Yesterday I wrote a quick post regarding the news that CMS was about to issue the SNF Final Rule for Fiscal Year 2019. Today, the text is available. Official publication in the Federal Register is set for August 8th. Readers may access the text here: SNF 2019 Final Rule I will have analysis and more … 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