CMS has been clear that a major aspect to the design of the PDPM is payment that is quality informed. That cannot be overstated.
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...
MDS meets VBP: I love a good value, don’t you?
By
Joel VanEaton
Oct 10, 2022
I love a good value, don’t you? It’s hard to find one these days in this economy. Recently a friend of mine purchased a used vehicle from a reputable local dealership. Within a week, the engine...
COVID-19 dealt a devastating blow to nursing homes — don’t let looming cuts make it worse
By
Cynthia Morton
Jul 12, 2021
In late June, the U.S. Department of Health and Human Services Office of Inspector General released a report stating that approximately 42% of Medicare beneficiaries in nursing homes were diagnosed with...
Ready, set, review!
By
Renee Kinder
May 11, 2023
We’ve all been waiting for this. We knew it was coming! What am I speaking of? The May 4, 2023, notice of Skilled Nursing Facility (SNF) 5-Claim Probe and Educate Review, of course! Since the initiation...
Final pay rule and rates: A primer for rehab professionals
By
Renee Kinder
Sep 01, 2022
The October 2019 industry shift to the Patient Driven Payment Model allowed all rehabilitation professionals the opportunity to document specific clinical characteristics about the patients we serve and...
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...
Ball girl, stand down!
By
Steven Littlehale
Aug 24, 2018
There is something you and your team must do immediately, the success of which will make or break your transition to the government’s new payment model. Relax. Refresh. Recharge. Only with a clear...
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...