Reimbursement
Making sense out of quality measures in long-term care
May 11, 2018Dan Ciolek has spent some 30 years in long-term care, and though he's become adept at quite a few topics in the field, one thing he's still trying to make sense of is quality measures.
With no promise of therapy caps fix, real pain hitting home
February 02, 2018Long-term care providers who supply therapy weren't invited to the big party Thursday, but they're hoping they'll still have reason to celebrate soon anyway.
Not so fast: Some Republicans reluctant to pursue Medicare cuts in 2018
December 13, 2017Some Senate Republicans are skeptical about cutting spending on social programs — Medicare included — in the months leading up to the 2018 elections.
What if the guy with the flying reindeer were disabled?
December 17, 2015There is something oddly juxtaposed about so many Americans cheerfully reaching out to a jolly, obese man in a red suit at this time of year. Good thing he isn't ill or disabled and in need of skilled nursing care.
ADL coding: The importance of being accurate
January 16, 2015Section G is one of the most inaccurately coded sections of the MDS 3.0. This is primarily due to the inaccuracy of the supporting documentation for Activities of Daily Living (ADLs).
What administrators need to know about therapy metrics
August 08, 2014Administrators 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
April 01, 2014What is ICD-10? What does this mean for nurses?
It's not all bad news coming from MedPAC
March 19, 2014A 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
December 01, 2013What 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?
October 18, 2013I 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
October 16, 2013To 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
July 26, 2013Long-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
June 01, 2013How 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
May 24, 2013Therapy 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
April 05, 2013Providers 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
April 03, 2013PointRight 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
April 01, 2013Kindred 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
February 13, 2013Democrats 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
January 30, 2013In 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!
October 01, 2012Former CMS chief Tom Scully is off-base in his chastisement of the long-term care industry.
Accuracy with ADL coding
September 27, 2012If 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
September 26, 2012Tom 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
September 17, 2012The 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
August 31, 2012Next 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
August 31, 2012Next 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
August 08, 2012A 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
August 03, 2012The 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?
August 01, 2012There'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?
August 01, 2012There'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
June 06, 2012Last week, I heard one of the most insightful, no-baloney talks I've heard in a while from a long-term care official.
