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The landscape of Medicaid reimbursement for nursing homes is undergoing significant changes. Presently, eight states have adopted the PDPM case-mix index (CMI) model, and an additional 31 states are set...

In the ever-evolving landscape of nursing home care, the use of agency staff has long been a topic of scrutiny, historically linked to concerns about inferior outcomes. However, as we navigate the aftermath...

The report titled “Uninspected and Neglected” by the majority staff of the US Senate Special Committee on Aging brings attention to a pressing issue: the severe understaffing of inspection agencies...

It’s been a flurry of activity leading up to the implementation of the “new MDS.” For months our industry has been doing what we do best — rising to the occasion.  Countless MDS training sessions,...

On a recent flight, I sat next to an attorney whose principal focus was compliance. It turned out that we were both on our way to speak at events in the same popular Florida conference destination. She...

Recently my colleague Ken Kelley, MS, OTR/L, RAC-CT, a clinical consultant/reimbursement specialist, posited something about Five-Star ratings that I hadn’t considered.  He suggested that, in general,...

The Centers for Medicare & Medicaid Services, through its consumer‐facing website, has made additional nursing home staffing data available. Doing so during a public health emergency, when the industry...

Preparing for a presentation is always fun for me, especially when it involves original research. In anticipation of Reimbur$ement-Con, and my session “The Unexpected Nemesis,” we took a deep dive...

The day after Thanksgiving, CMS further defined its intensions with the Five-Star Quality Rating System; more specifically how the new survey process and derivative data will be used in its calculation...

When it comes to contemplating joining caregiving networks, maybe you have more in common with the hospital than you think. Poor-performing hospitals tend to coexist in the same market as poor-performing...