American Jobs and Closing Tax Loopholes Act – HR 4213

Funny title that is rather misleading given the gravity of the health care/post-acute care provisions that are included in this bill.  As is the case in Washington, especially these days, important health care provisions not addressed in the PPACA are coming forward in other bills; particularly bills involving unemployment benefits and COBRA benefits, etc.  Such is … Read more

Five Things Every Administrator Should Focus On

I had a phone conversation earlier today with a friend and colleague (he’s part owner of a rehab consulting and management company) and as we talked, the conversation reminded me about the host of issues facing health care administrators.  Our conversation flowed to long-term care and specifically, SNFs (he spends a lot of his time … Read more

GAO Releases Report on Poor Perfoming Nursing Homes

In 1998, CMS created the Special Focus Facility initiative or program designed to target or focus attention on improving the poorest performing facilities (performance defined by survey/compliance history).  Each state selects up to 15 of the poorest performing facilities until the program reaches its cap or maximum of 136 facilities.  The requirements from CMS to … Read more

Health Care Reform Implications: SNFs

The following is a summary of the major provisions in the recently passed health care reform bill.  Please note: I have not attempted to cover every nuance in detail but to provide a highlight for a point of reference.  If any reader has additional questions or wants additional insight on any particular provision, please let … Read more

Hospital Re-Admissions: Update to an Earlier Post

Last week I wrote about hospitals using “observation stays” as a means of dealing with the potential risk of reimbursement penalties imposed by CMS for certain re-admissions.  The focus of my post was on how the trend of hospitals using observation stays to avoid CMS scrutiny (and penalties) was impacting Medicare admissions at SNFs.  I … Read more

Hospital Observation Stays Impacting Medicare SNF Admissions

An issue that I am fielding a fair number of inquiries about lately involves Medicare patients spending more than three days in a hospital, subsequently ‘discharged’ to a SNF and the SNF learning later that the patient was never technically admitted to the hospital.  Mostly, the inquiries I am getting are along the line of “what’s … Read more

Hospice Contract Reminders for SNFs

On a fairly routine basis, I run across SNF Administrators and Directors of Nursing that continue to have issues with hospice patients in their facilities but not from the standpoint of the patient typically; from the standpoint of dealing with the Hospice and the terms of the contract between the Hospice and the SNF.  In … Read more

Affordable Health Care for America Act: Implications for SNFs

This weekend, the House is reportedly set to vote on their version of healthcare reform – H.R. 3962.  The bill is a “monster”; nearly 2,000 pages long.  The title belies the fact that the Bill doesn’t just attempt to create “affordable health care” – it goes much, much further.  For example, embedded within the hundreds of … Read more

Getting Risks Under Control: Improving Organizational Prosperity

Healthcare is a risky business; particularly in heavily regulated environments such as nursing homes and home health and hospice.  The fact that a certain level of risk is omnipresent means that the opportunity constantly exists for an organization that improperly identifies and manages its risks, to suffer expensive damages ranging from financial loss to loss … Read more

Holding onto Your D.O.N.

In our annual Healthcare Leadership Labor Market Report released in July, we presented some rather alarming trends regarding the long-term care and post-acute care industry’s retention of nursing executives.  For example, we noted that 71% of the Directors of Nursing in nursing homes leave their positions each year.  We also noted that the average tenure … Read more