Political Issue: Medicare Solvency

With election season heating-up, I’m going to drop some posts in from time to time on health policy issues that candidates SHOULD be talking about – not that they will. The issues I will put forth are the biggies, not the trivial stuff that campaigns and parties use as talking points (e.g., improving Obama Care, … Read more

Wednesday Feature: It’s the Economy, Stupid

The title may jog memories for some readers. During the 1992 election cycle, advisor to then candidate Bill Clinton, James Carville, (running against George H.W. Bush) used the phrase for campaign workers as a charge to focus on. He wanted people to pay attention to the economic issues (inflation) affecting how people were feeling about … Read more

Outlook for Single Site CCRCs/Life Plan Communities

As economic conditions continue to create headwinds for senior living, I thought this post was timely. Bottom-line: I’m seeing lots of single site and even a number of multi-site, small scale organizations struggling. Depending on their markets and their debt load plus cash position, surviving as independents could be a real challenge over the upcoming … Read more

Friday Feature: Quality and the Revenue Connection (2019 version)

I’ve written a lot over the years about understanding the unique connection between quality care and the systems to support its delivery, and revenue. Arguably, the most successful provider organizations understand that impeccable quality of care (delivery, outcomes, patient satisfaction) begets high occupancy (referrals) and preferential payer mix (quality mix). Of course, the inverse relationship … Read more

Five Quality and Compliance Tips

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

CMS Releases Rule on SNF Staffing Mandate

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

Friday Feature: Buffet on Management and Boards of Directors

I ran across this yesterday in a publication I get called Becker’s Hospital Review. I recall seeing much of the content before and really liking it. It is from famed investor and Chair of Berkshire Hathaway, Warren Buffet. It is content from his letters to Berkshire Hathaway shareholders from years back, 1977 to be exact. … Read more

SNFs (and others), a (not good) Staffing Litigation Trend to Watch

It seems like I have been writing a lot on staffing issues these past few months, and I have. Staffing along with the current economy, are a Hydra today (two headed serpent), negatively impacting provider financial conditions and patient care in many forms (access, outcomes, care coordination, etc.). A few months ago, I wrote a … Read more

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

Friday Feature: CMS Updates RAI Manual for SNFs

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