Understanding facility, peer data called crucial to better Medicare Advantage negotiations
By
Josh Henreckson
Mar 27, 2024
Nursing homes have historically had little leverage in negotiations with Medicare Advantage plans, even as MA has come to cover an ever-larger number of skilled nursing beneficiaries.
Medicaid daily revenue hits record as skilled nursing occupancy dispute flares
By
James M. Berklan
Apr 03, 2023
Medicaid revenue per patient day in skilled nursing facilities rose to a record level in January, even as similar measures for Medicare retreated.
Providers call for broader antipsychotic exclusions to help reduce schizophrenia diagnoses
By
Kimberly Marselas
Mar 31, 2023
Providers and quality experts are questioning why the agency hasn’t done more to review its quality measure for antipsychotic drug use.
Need more referrals? Expert hones in on the ‘M’ word
By
Kimberly Marselas
Dec 08, 2022
In a skilled nursing environment driven increasingly by data, providers must know which metrics matter most to their stakeholders — and be willing to work hard to improve those that exist beyond the...
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
By
Kimberly Marselas
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics
By
Kimberly Marselas
Nov 10, 2022
Providers still struggling to accurately capture diagnoses that drive federal reimbursement will be doubly left behind as more states start to use Patient Driven Payment Model-like systems to determine...
Nursing homes fire back after CMS warning about ‘exploitative’ debt-collection practices
By
James M. Berklan
Sep 12, 2022
A warning letter sent late last week by federal regulators about nursing home debt collection practices was overblown and obscured another significant problem, nursing home operations experts said over...
‘Sufficient’ will no longer be sufficient as CMS rewrites nursing home staffing rules
Apr 12, 2022
Moderator Kimberly Marselas leads this insightful conversation on practical considerations, providers’ wish-list items and legal concerns that come with such major reform.
Extended survey delays threaten providers
By
Kimberly Marselas
Feb 25, 2022
When a major government watchdog blasted the Centers for Medicare & Medicaid Services in January for a lack of timely survey activity, it detailed extensively what providers on the ground were experiencing...
Uncertainty over realistic nursing home census indicative of ‘ongoing economic crisis’
By
James M. Berklan
Dec 16, 2021
The nursing home sector may be far ahead of where it was at this time last year as far as operational freedoms and safety go, but the continuing instability caused by the COVID-19 pandemic is perhaps no...