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...
CMS 5-claim audits so far a ‘debacle’
By
Jessica R. Towhey
Aug 22, 2023
A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
Providers tell CMS it’s ‘decidedly’ the wrong time to toy with PDPM rates
By
Kimberly Marselas
Jun 03, 2021
Providers need more time before the Centers for Medicare & Medicaid Services would implement any adjustments to PDPM payment rates, operators and associations have told the agency in official comments.
Guess what’s coming to nursing homes next
By
Kimberly Marselas
Apr 03, 2024
I remember when the Patient Driven Payment Model rule was just a proposal inching its way toward finalization, its concept of assigning points for specific non-therapy ancillary costs a pretty exciting...
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...
Understanding PDPM in value-based purchasing
By
Joel VanEaton
Jul 15, 2019
CMS has been clear that a major aspect to the design of the PDPM is payment that is quality informed. That cannot be overstated.