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

High Acuity Assisted Living and Home Health Becoming a Trend?

With a push to find increasing value in care delivery on the part of payers, providers in assisted living and home health are seeking to carve out a niche in what can best be described as “hospital or acute care” alternative locations. The most forward trend is occurring in home health, known as hospital-at-home care. … Read more

Not Just Senior Living…Hospitals Too

Lately I’ve written a fair amount (multiple articles) regarding the economic conditions in senior living/post-acute care. The current economic headwinds of rising capital costs/interest rates, labor scarcity, rising costs due to labor scarcity and commodity inflation have caused providers to rethink many operating assumptions. Margins have eroded and often, decisions about additional volume via admissions, … Read more

Friday Feature: Home Health Proposed Rule Implications

Last month, CMS dropped the 2024 PPS Proposed Rule for Home Health. Like all other provider segments, Proposed Rules function to address primarily payment, then other programmatic issues/rules such as quality measures, data reporting, etc. The proposals generally mirror the final rules, but tweaks do occur. The payment end, however, rarely changes much as often, … Read more

Jobs Data and Staffing Status Update

With reports from the Bureau of Labor Statistics out this past week, the job market remains relatively strong and healthcare within the market, similarly strong. Unemployment remained at 3.6% and labor participation remained at 62.6% (same for last four months) and the percent of the population employed remained at 60%. For the month of June, … Read more

Friday Feature: MedPAC, Single Payment, and the IMPACT Act

The Medicare Payment Advisory Commission (MedPAC) via a report submitted to Congress on Thursday (yesterday) indicated that a single post-acute payment under Medicare is feasible but extensive policy procedural changes would be required to make it workable. The concept is that one uniform payment would apply to post-acute care delivered in home health, skilled nursing, … Read more

Friday Feature: SNFs Still Make Sense

For some recent years, enhanced by the pandemic, the role of SNFs in the post-acute/senior living industry has tarnished. Residents and families often view the SNF as a “negative place” to reside, even if for short-term recuperation. Clinical staff take a dim view of the care complexity such that the SNF is a downgraded clinical … Read more

Follow-Up: Real Impacts of Poor Quality and Lax Compliance

About ten days ago, I wrote a piece regarding the negative impacts providers can expect (and receive) when quality of care and service combined with vigilance on compliance are not primary in and across their organizations.  All too often, I hear companies and organizations that I work with, say they are committed to quality but by deeds, the evidence is … Read more

Home Health Final Rule: Rate Increases plus PDGM

While I was in Philadelphia speaking at LeadingAge’s annual conference, CMS released its 2019 Home Health Final Rule.  As I wrote in an earlier post regarding the proposed rule, the topic of interest was/is a new payment model – PDGM.  As has been the case across the post-acute industry, CMS is advancing case-mix models crafted around … Read more

Post-Acute, Site Neutral Payment Upcoming?

In the 2019 OPPS (outpatient PPS) proposed rule, CMS included a site neutral payment provision.  With the comment period closed, the lobbying (against) fierce, it will be interesting to see where CMS lands in terms of the final OPPS rule – maintain, change, or abate.  The one thing that is for certain, regardless of the … Read more