Ask the Payment Expert about ... Mega-rule expenses

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Ask the payment expert ... about the observation stay loophole
Ask the payment expert ... about the observation stay loophole

I'm concerned with the new mega- rule expenses and that maybe I need to rethink my need for SNF beds. What are your thoughts?

Many providers are rethinking their community structure. With the growth of assisted living, providers are assessing the need for additional AL beds. Remember that AL beds are licensed by each state so you need to know your state AL regulations.

In some cases, you might want to convert some SNF beds to AL if they meet the AL regulations. In other cases, providers are adding on AL beds and/or converting a space to memory care. Secure memory care units have been very popular and most can be licensed as assisted living. 

To be a provider of choice in your community, you really want to develop a robust dementia program, utilizing tools from the Alzheimer's Association and other state dementia initiatives.  Someone really needs to be trained and/or certified in dementia care.

Reimbursement for such programs will vary depending on your state. Many have a waiver program where the state may reimburse the provider for care in assisted living. You need to research that and know those rules, who might qualify and the waiting time for those benefits.  

This is a complex decision to make. As you consider transitioning beds, a market study may need to be completed. You also may need to understand your present level of care for your residents and who might be eligible in your state to transition to another level of care. 

Another area to assess is the financial impact of any changes. Know all your information before you plan any transition. Get expert assistance in areas you do not have the ability to do yourself. Assessing these changes through your strategic planning can help make any transition successful.