I have never directly spit into the wind just to test popular wisdom. Some sayings you can take at face value.
If there’s anything you learn in long-term care that doesn’t need testing, it’s that all residents are not the same. Not the same when it comes to condition, needed care plans … nor revenue-generating ability.
That’s what makes Wednesday’s release of the latest NIC Skilled Nursing Data Report troubling. We learn that skilled nursing occupancy may have stabilized during the third quarter. Stabilization is normally a good sign and, in fact, it IS better than another drop.
However, Medicaid beneficiaries appear to be slipping between the sheets more often. That’s not a good sign, of course, because Medicaid typically pays much less than Medicare.
Nursing Home Economics 101, I know. But Wednesday’s numbers really were tarnished by the notation that despite an all-time high for average Medicaid revenue per patient day ($214), providers are still whistling in the wind because labor and other operational costs are outstripping Medicaid funding increases.
Anybody see signs of the tight labor market abating any time soon? Didn’t think so.
So while the positive attention given to Medicaid payments in several states earlier this year has been pleasant, we’re still talking tricycles and locomotive engines, unfortunately.
The train is pulling out of the station and it’s gaining speed.
Skilled Medicare case-mix haven’t been encouraging, either, noted Wednesday’s report from the National Investment Center for Seniors Housing & Care. Average length of stay? Let’s not even go there.
Where this really gets intriguing is NIC’s numbers reflect data gathered only through Sept. 30. Let me remind that the Patient Driven Payment Model kicked in the next day. So there’s no accounting for what the new pay rates are going to do to the numbers once carnage from the previously well-paying therapy front is factored in.
Actually, some early returns have shown that providers are doing far better than the budget-neutral goal envisioned by the Centers for Medicare & Medicaid Services. So maybe fallout from lost therapy bucks will be offset by greater revenue generated by the nursing corps. At least for now.
Enjoy it while you can, providers. All signs are that if PDPM turns out to be picking Uncle Sam’s pocket, he’s going to come looking for restitution, and soon — and sew tighter pockets in the future.
Follow James M. Berklan @JimBerklan.