LTC leaders: News report on 'upcoding' distorts the facts

Share this article:
Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
Alan Rosenbloom, president of the Alliance for Quality Nursing Home Care
The Alliance for Quality Nursing Home Care and American Health Care Association expressed outrage over a news report that alleged widespread use of so-called “upcoding” in nursing homes.

“This article paints a negative, incomplete picture of the growing role and tangible benefits associated with skilled nursing facility (SNF) patient care, and ignores the central fact SNFs are caring for higher acuity patients while also saving tax dollars,” Alan Rosenbloom, president of the Alliance, and Bruce Yarwood, president and CEO of AHCA, wrote in response to the article.

The Washington Post story alleged that nursing homes have been taking improper advantage of the creation of new higher reimbursement categories for therapy and acute care over the last decade.

Most recently, in 2006, officials with the Centers for Medicare & Medicaid Services expanded the number of Resource Utilization Groups (RUGs) to 53 from 44.

Yarwood and Rosenbloom contested the implication that “upcoding” is a standard practice among nursing homes.  
“Facilities must use specific regulatory tools to provide patient assessment, which then reflects the level of reimbursement,” they wrote. “Any suggestion that facilities are able to bill any way that they wish is simply false and misguided.”
Share this article:
close

Next Article in News

More in News

Rape investigation blocked by nursing home's HIPAA concerns, authorities say ...

Florida authorities say a nursing home is citing privacy laws to impede the investigation of a possible resident rape, according to local news reports.

Jury hands down $14 million negligent care verdict to 'send message' to nursing homes

Jury hands down $14 million negligent care verdict ...

A Massachusetts jury has awarded $14 million to the family of a nursing home resident who died due to a pressure ulcer, dehydration and other conditions linked to negligent care, ...

CCRC executive director salaries hold steady, therapy directors get boost

Continuing care retirement community executive director salaries have barely increased in the past year, while therapy and rehabilitation directors received a boost, a new report shows. The average salary for a therapy and rehab director is currently $95,905.