Unraveling the impact: PDPM Medicaid case-mix index and potential Five-Star Rating challenges
By
Steven Littlehale
Mar 01, 2024
The landscape of Medicaid reimbursement for nursing homes is undergoing significant changes. Presently, eight states have adopted the PDPM case-mix index (CMI) model, and an additional 31 states are set...
Redefining the role of agency staff in nursing homes: Unveiling new realities
By
Steven Littlehale
Jan 05, 2024
In the ever-evolving landscape of nursing home care, the use of agency staff has long been a topic of scrutiny, historically linked to concerns about inferior outcomes. However, as we navigate the aftermath...
Revamping CMS survey data integration amid regulatory lag in nursing home oversight
By
Steven Littlehale
Dec 08, 2023
The report titled “Uninspected and Neglected” by the majority staff of the US Senate Special Committee on Aging brings attention to a pressing issue: the severe understaffing of inspection agencies...
Fasten your seatbelts: It MIGHT be a bumpy ride
By
Steven Littlehale
Oct 13, 2023
It’s been a flurry of activity leading up to the implementation of the “new MDS.” For months our industry has been doing what we do best — rising to the occasion. Countless MDS training sessions,...
Data lapses did not affect Five-Star ratings, CMS says as providers call for review of agency’s...
By
Kimberly Marselas
Apr 13, 2023
The Centers for Medicare & Medicaid Services said Wednesday it was taking “seriously” a damning report that questioned the accuracy of information it posted on its Care Compare site, but added that...
The Five-Star Quality Rating System’s impact on insurance premiums — and how to address them
By
Ben Newman
Feb 27, 2023
For nearly 15 years, the Center for Medicare and Medicaid Services’ Five-Star Quality Rating System for long-term care facilities has been a single source of truth for multiple parties. Consumers...
CMS to begin audits for schizophrenia coding, says citations will affect quality ratings
By
Alicia Lasek
Jan 19, 2023
The agency will start auditing nursing homes this month to determine whether residents’ schizophrenia diagnoses are accurate and appropriately coded. A pattern of inaccurate coding may result in a quality...
Need more referrals? Expert hones in on the ‘M’ word
By
Kimberly Marselas
Dec 08, 2022
In a skilled nursing environment driven increasingly by data, providers must know which metrics matter most to their stakeholders — and be willing to work hard to improve those that exist beyond the...
Bill would use CMS’s Five-Star system to punish consistently 1-star nursing homes
By
Joe Bush
Oct 10, 2022
A bill that would use the federal government’s Five-Star ratings system as a means to identify and punish poor quality nursing homes passed a New Jersey senate committee Thursday, drawing criticism in...
Lots to learn with new Five-Star
By
Steven Littlehale
Jul 22, 2022
On a recent flight, I sat next to an attorney whose principal focus was compliance. It turned out that we were both on our way to speak at events in the same popular Florida conference destination. She...