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...
Ask the payment expert … about MDS payment implications
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Sep 12, 2023
Q: Are changes to the Patient Driven Payment Model expected with the revised MDS in October?
Pay good providers more to care for dementia patients, researchers urge
By
Kimberly Marselas
Feb 09, 2023
Policymakers should consider incentivizing nursing homes to take patients with Alzheimer’s disease and related dementias, argue the authors of a new study that finds such patients currently are more...
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...
SNFs ‘significantly reduced’ occupational, physical therapy use following PDPM
By
Danielle Brown
Jul 15, 2022
The Patient Driven Payment Model led to a “significant reduction” in occupational and physical therapy minutes in its first few months of implementation, a new study has found. The results reinforce...
Long-term care: a bear or bull market?
By
John O'Connor
Apr 18, 2022
When it comes to the long-term care market, is this a time to view it as bearish or bullish?
The top lessons learned from the AHCA’s 2021 Convention and Expo
By
Tamar Abell
Nov 05, 2021
Attending the American Health Care Association’s (AHCA) 2021 Convention and Expo this year felt like reuniting with friends after spending two years on the frontline of a battlefield. The...
Zimmet warns: PDPM ‘reprieve’ could mean 10 percent cuts next year
By
James M. Berklan
Aug 12, 2021
Providers basking in what appeared to be a major bright spot of the 2022 SNF PPS final pay rule still have plenty to be worried about, one of the industry’s leading payment experts warned Wednesday.
Spring cleaning 2021: Will your rehab team pass the white-glove review?
By
Renee Kinder
Apr 22, 2021
Spring is in the air. Time to open the doors, let some fresh air in, and clean above, under and between every surface in our homes. Spring is a season that allows my obsessive cleaning habits to become...
COVID-19 underscores PDPM advantages
By
Bent Philipson
Jan 27, 2021
The efficacy of the Patient-Driven Payment Model has never been clearer than now, in the middle of the coronavirus pandemic. PDPM enabled skilled nursing facilities to see a 9% increase in Medicare reimbursement...