Unraveling the impact: PDPM Medicaid case-mix index and potential Five-Star Rating challenges
By
Steven Littlehale
Mar 01, 2024
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...
Do the new QMs have you seeing stars?
By
Steven Littlehale
Mar 18, 2016
Actions providers take now will make or break their Five-Star Quality Rating experience in July. That’s because the Centers for Medicare & Medicaid Services has changed quality measures in a way...
Judge facilities on an individual basis
By
Liza Berger
Aug 07, 2009
A significant and perhaps somewhat controversial piece of research was released this week suggesting that not-for-profit nursing homes offer higher quality care overall than for-profits. That’s great...
Increase your occupancy now
By
Steven Littlehale
Aug 02, 2021
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...
Which matters most: Social media or Five-Star?
By
Steven Littlehale
May 27, 2022
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,...
Moon landings and the MDS. What gives?
By
Joel VanEaton
Mar 19, 2024
You may be aware that on Feb. 22, Houston-based Intuitive Machines landed a spacecraft on the moon, making history as the first commercial craft to reach the lunar surface and the first U.S. spacecraft...
Saying ‘yes’ to nursing homes and ‘no’ to healthcare reform
By
Liza Berger
Jun 11, 2010
Some of nursing homes’ heartiest advocates on Capitol Hill are against the healthcare reform law. Three such lawmakers addressed members at the American Health Care Association’s annual briefing...
Five-Star is anything but frozen
By
Steven Littlehale
Dec 13, 2017
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...
Post-acute payment bundling system appears ominous
By
Liza Berger
May 21, 2009
Nursing homes have cause to worry about the prospect of a Medicare post-acute payment bundling system. If it pans out, facilities may end up on the losing side of the equation. That is just one of my takeaways...