Reimbursement

What administrators need to know about therapy metrics

What administrators need to know about therapy metrics

Administrators have multiple departments to oversee, so it is important that they have a method to determine if their therapy department is running efficiently, meeting its goals and adding to the strategic success of the facility. There are several metrics and indicators of a successful therapy department.

Ask the nursing expert ... about ICD-10's impact on nurses

Ask the nursing expert ... about ICD-10's impact on nurses

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What is ICD-10? What does this mean for nurses?

It's not all bad news coming from MedPAC

It's not all bad news coming from MedPAC

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A funny thing happened on the way to a semi-annual eye-rolling over a MedPAC report. It gave me reason to sit up with interest. Even more unlikely, it contained information that made some long-term care providers happy.

ALOS complex query

ALOS complex query

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What do you get when you ask two academics, one geriatrician, one reimbursement specialist, and an analyst to define average length of stay? Five different answers.

Make long-term care a public utility?

Make long-term care a public utility?

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I recently participated in a roundtable discussion that addressed the field's challenges and opportunities. Several remedies for improving care and payments surfaced during the conversation. But one unique suggestion really stood out: Perhaps long-term care should become a public utility.

Skilled nursing facilities: The triple threat of healthcare

Skilled nursing facilities: The triple threat of healthcare

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To say skilled nursing facilities have come a long way would be, well, surprisingly refreshing. Public opinion polls show there is still a wide-spread misunderstanding of what SNFs do, how they are paid for what they do, and why it is so important to preserve the setting.

Bold legislative proposals could prevent deep reimbursement cuts, AHCA leader says

Bold legislative proposals could prevent deep reimbursement cuts, AHCA leader says

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Long-term care providers are offering lawmakers policy ideas aligned with the changing healthcare landscape in the United States, in an effort to control costs and improve quality while avoiding slashed reimbursements, according to Mark Parkinson, president and CEO of the American Health Care Association. The leader of the nation's largest long-term care provider organization spoke out this week for legislation based on $2 billion in savings through reduced hospital readmissions.

Ask the payment expert ... about quality and reimbursement correlations

Ask the payment expert ... about quality and reimbursement correlations

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How can the Centers for Medicare & Medicaid Services correlate quality of care and reimbursement? You always need to remember that Medicare is an insurance plan. As such, Medicare has rules, just like your insurance company. Two of those rules are that we must provide care according to an individualized care plan for each resident and that we provide appropriate discharge planning.

CMS: Providers may need to reimburse beneficiaries due to inaccurate therapy denial codes

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Therapy providers should review therapy cap denials for 2013 and refund any beneficiary payments for these services, according to a Medicare newsletter released Thursday.

Court ruling opens door for providers to seek reimbursement for Medicare bad debts

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Providers may be reimbursed for Medicare beneficiaries' bad debts even after sending them to a collection agency, a U.S. District Court judge has ruled.

PointRight launches aid for on-the-go providers

PointRight launches aid for on-the-go providers

PointRight recently announced the combined launch of its new iPad app. The new tool gives mobile access to all of the firm's analytics services and reports.

Kindred will trim more SNFs from its portfolio, Diaz says

Kindred will trim more SNFs from its portfolio, Diaz says

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Kindred Healthcare will continue to offload its nursing facility operations leased from Ventas, according to President and CEO Paul J. Diaz.

Senate Democrats poised to introduce package to replace sequester cuts

Senate Democrats poised to introduce package to replace sequester cuts

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Democrats in the Senate could introduce a bill this week to replace the automatic spending cuts known as the sequester, which is scheduled to take effect March 1. Many long-term care stakeholders have opposed the 2% Medicare cuts that are part of the $85 billion sequestration package.

Women who ran nursing homes face charges of $2.75 million Medicaid fraud

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In the latest example of reimbursement fraud in Florida, authorities arrested the leaders of a nursing home management company Tuesday for allegedly defrauding Medicaid of more than $2.75 million.

Former CMS administrator scolds long-term care providers  — but he has it all wrong!

Former CMS administrator scolds long-term care providers — but he has it all wrong!

Former CMS chief Tom Scully is off-base in his chastisement of the long-term care industry.

Accuracy with ADL coding

Accuracy with ADL coding

If there's one overwhelming challenge in a long-term care setting, it's how to code the Activities of Daily Living (ADLs).

Former top Medicare official scalds long-term care leaders

Former top Medicare official scalds long-term care leaders

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Tom Scully wondered privately before his keynote address at a seniors housing and care conference last week why he was being asked to speak. Afterwards, long-term care executives in the audience were probably wondering the same thing.

When CMS turns carrots into sticks

When CMS turns carrots into sticks

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The revised hospital payment system technically hasn't begun yet. But that doesn't mean senior living operators shouldn't find a dark cloud around this silver lining.

Democratic rebuttals to GOP Medicare, Medicaid plans expected at national convention

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Next week it will be the Democrats' turn to offer their visions of the future for the Medicare and Medicaid programs, as well as other issues that would significantly affect long-term care operators. Expected at the Democratic National Convention in North Carolina is at least some degree of chest thumping over actions compelled by the Affordable Care Act, the reform law often referred to as "Obamacare." Republicans this week adopted a platform that would significantly alter the way Medicaid and Medicare funds would be distributed. The stakes could be huge for LTC operators: Together, the programs currently pay about 75% of U.S. long-term care costs.

Democratic rebuttals to GOP Medicare, Medicaid plans expected at national convention

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Next week it will be the Democrats' turn to offer their visions of the future for the Medicare and Medicaid programs, as well as other issues that would significantly affect long-term care operators. Expected at the Democratic National Convention in North Carolina is at least some degree of chest thumping over actions compelled by the Affordable Care Act, the reform law often referred to as "Obamacare." Republicans this week adopted a platform that would significantly alter the way Medicaid and Medicare funds would be distributed. The stakes could be huge for LTC operators: Together, the programs currently pay about 75% of U.S. long-term care costs.

MDI Achieve elects COMS Interactive for clinical decision support

A new agreement will bring the COMS Daylight IQ to MDI Achieve Matrix.

Medicaid providers with unpaid taxes should be barred from federal reimbursement, lawmakers say

Medicaid providers with unpaid taxes should be barred from federal reimbursement, lawmakers say

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The federal government should bar healthcare providers with large amounts of unpaid taxes from receiving Medicaid funds, incensed lawmakers said Thursday following the release of a government report.

Half a pound of long-term care funding cure?

Half a pound of long-term care funding cure?

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There's a great Randy Travis song that includes the line, "Since my phone still ain't ringing, I assume it still ain't you." How fitting for long-term care this week.

Half a pound of long-term care funding cure?

Half a pound of long-term care funding cure?

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There's a great Randy Travis song that includes the line, "Since my phone still ain't ringing, I assume it still ain't you." How fitting for long-term care this week.

A winning strategy for nursing homes

A winning strategy for nursing homes

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Last week, I heard one of the most insightful, no-baloney talks I've heard in a while from a long-term care official.

Take advantage of the changing long-term care marketplace, top execs urge

Take advantage of the changing long-term care marketplace, top execs urge

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Long-term care providers should hone in on the changing needs of their market by embracing what customers want and will pay for, and by working to change the profession's image problem, LTC executives said Monday.

LeadingAge gets a 911 call

LeadingAge gets a 911 call

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You could soak up plenty of what you'd want to hear at a conference Monday at the LeadingAge PEAK Leadership Summit: discussions ranging from leadership and policy to payments.

In limbo with underwhelming pay proposal

In limbo with underwhelming pay proposal

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First, it was the U.S. Supreme Court's turn to leave providers in suspense. Now, it's a group of decision-makers without robes who have operators holding their breath.

Analysts disagree whether death of healthcare reform could mean recoupment of provider funding

Analysts disagree whether death of healthcare reform could mean recoupment of provider funding

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Healthcare analysts are proposing that Medicare providers, including nursing homes, could recoup millions of dollars if the Supreme Court strikes down the Affordable Care Act.

So this is what hope feels like?

So this is what hope feels like?

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I don't know when I've ever heard louder joyful shouts of, "We didn't lose!"

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