Baseline proficiency for success with managed care payers
By
Susie Mix
Mar 11, 2024
Setting up a building with proficiencies in working with managed care payers is a key to success at this midpoint of the 2020s. Fifty-one percent of Medicare-eligible Americans are covered by Medicare...
Ask the paymenyt expert … about demand bills
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Feb 01, 2024
Under what circumstances are we required to submit a demand bill for a patient?
Nursing operator must issue back pay after abruptly ending shift-differential perk
By
Josh Henreckson
Jan 09, 2024
The National Labor Relations Board sided with a union’s request to have shift-differential pay reinstated and back pay issued after a nursing home’s new owner unilaterally ended the incentive practice...
The top long-term care stories of 2023
By
James M. Berklan
Dec 18, 2023
Long-term care providers were intent on dismissing undesirable memories of the COVID-19 pandemic as much as possible in 2023, but the year’s top stories revealed there were still remnants of it to...
MedPAC plots policy for SNF payment adequacy next Friday
By
James M. Berklan
Dec 01, 2023
The Medicare Payment Advisory Commission will delve into the adequacy of skilled nursing facility payment levels at the panel’s annual December meeting next Friday morning.
Not much to be thankful for?
By
John O'Connor
Nov 19, 2023
It’s easy to take what we have here for granted. This is a land of unmatched freedom and opportunity. Not that it’s always crimson and clover. For example, consider what skilled care providers are...
Ask the payment expert … about payment reductions
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Oct 10, 2023
Q: How do I know what determines my 2% annual payment reduction? I’ve received a non-compliance letter citing MDS reporting requirements, but it doesn’t provide details.
Skilled nursing care’s cloudy Medicare future
By
Brendan Williams
Aug 18, 2023
A net gain of $1.4 billion for a sector comprised of over 15,000 nursing homes somewhat pales in comparison to a looming CMS staffing mandate estimated to cost nursing homes $11.3 billion a year.
Insurgence of leveled contracts
By
Susie Mix
Jul 14, 2023
By now, we’re all pretty familiar with the fact that managed care is altering the post-acute care payor mix with Medicare Advantage plans. This is a byproduct of national policy, intended to offset our...
MedPAC finds single post-acute payment system feasible but says smaller-scale fix might be better
By
Kimberly Marselas
Jun 16, 2023
An attempt to unify payments for providers across all types of post-acute care is “analytically within reach,” but extensive policy changes that would likely be needed,