It was supposed to work like this. When people need long-term care, they pay privately until they’re impoverished. Then and only then Medicaid helps. To avoid that outcome, people were urged to save...
Capturing acuity: How MDS accuracy has a critical impact on Medicare/Medicaid payment systems
By
Steven Littlehale
Apr 20, 2012
There’s a familiar saying in the industry that “If it’s not documented, then it’s not done.” But what if it is documented, but just not documented correctly?
Fasten your seatbelts: It MIGHT be a bumpy ride
By
Steven Littlehale
Oct 13, 2023
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,...
Great moments in unintended LTC consequences
By
Stephen A. Moses
Jul 26, 2021
Reason.com publishes a video feature called “Great Moments in Unintended Consequences.” Each episode features three problems, three “solutions,” and comical coverage of the unanticipated results....
A good first step but more to do with MDS 3.0
By
Leah Klusch, RN, BSN, FACHCA
Mar 07, 2012
It was a long first day, but there was tremendous value and everyone who is here has learned what the Centers for Medicare & Medicaid Services’ positions are with the April updates and some of the...
On the road to rationed healthcare
By
C.E. Nash
Apr 14, 2011
The Obama administration has determined that we will be able to supply healthcare to several million additional people without increasing the cost of doing so, and with no plan in place to increase the...
CLASS caveats
By
Steve Moses
Apr 06, 2010
The CLASS Act is being touted as a progressive long-term care insurance solution. I have news for you: It’s not.
The Medicaid LTC snafu
By
Stephen A. Moses
Apr 15, 2024
Long-term care operators were sold a pig in a poke. When Medicaid started paying for nursing home care after 1965, it looked like a pretty good deal. The new revenue stream vastly expanded severely limited...
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...
Could everything be a kickback?
By
Chris Sabis
Dec 15, 2021
The U.S. District Court for the Middle District of Tennessee recently issued a number of rulings interpreting the federal False Claims Act (FCA) and its state law counterparts relevant to long-term care...