Ten things to note about the proposed SNF rule

  A proposed rule, titled Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1718-P), was published in the Federal Register on April 25. Here are ten things you need to know. The proposed rule suggests that SNFs be paid at an increase of $887 million, or 2.5%, for FY2020 compared to FY2019. The increased [...]

10 questions for projecting revenue at admission under PDPM

2019_PDPM_Questionnaire_FINALWhat will your revenue and expenses look like for a Medicare Part A resident admitted under PDPM? The release of this exclusive Patient Driven Model Payment (PDPM) questionnaire will serve as an essential tool for you to estimate the revenue and expenses of a Medicare Part A resident admitted under this new case-mix classification model. [...]

Shorter Stays Bring Rewards Under PDPM — But Only to a Point

Skilled nursing providers might be able to reap financial gains under the new Medicare payment model taking effect in October of this year if they can cut their average patient length of stay (LOS). But the gains will only hold until a certain point, and providers that already have shorter LOS —- such as short-term [...]

Scrutiny About Behavior Changes Under PDPM Will ‘Inevitably’ Come to Skilled Nursing

The changes in Medicare reimbursement taking effect in October will mean upheaval in more places than a skilled nursing facility’s billing department. It will mean changes in the nuts-and-bolts processes of patient care, and SNFs need to be preparing for this reality — with the knowledge that regulators will be watching closely. That’s according to [...]

Doctors, Software, Training: Preparing for ‘Non-Negotiable’ PDPM Coding Pressures

Starting October 1, skilled nursing facility operators will have no choice but to become proficient with a specific type of medical coding that previously had no bearing on reimbursements — and leading industry voices say there are multiple paths to getting there. ICD-10 codes, specific diagnosis identifications long used by hospitals, will play a key [...]

PDPM’s Effects Could Stretch Far Beyond Medicare for Skilled Nursing Facilities

On paper, the Patient-Driven Payment Model (PDPM) will only affect one pillar of the payment equation for skilled nursing facilities. But as players start to unpack the coming rule changes, PDPM’s reach begins to extend far beyond Medicare. Medicare Advantage and Medicaid frequently base rate calculations on the existing Medicare structure, a pair of experts [...]

Dwindling reimbursement, occupancy numbers chipping away at skilled nursing margins, new analysis finds

The decline in nursing home beds has been even worse than previously believed, according to a new analysis. Marcum LLP on Monday issued its inaugural statistical analysis of nursing home trends between 2013 and 2017. The 72-page book is aimed at providing a practical tool for operators to establish baselines and compare themselves against the [...]

FY2019 SNF PPS Proposed Rule Analysis – Part III: PDPM Summary

Part III: Patient-Driven Payment Model In addition to payment and policy updates for fiscal year (FY) 2019, the skilled nursing facility (SNF) proposed rule includes a proposal to revise the payment model from the current Resource Utilization Groups (RUG-IV) case-mix classification to the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019 for FY 2020. [...]

Despite Speech Push, Physical and Occupational Therapy Have Key Role Under PDPM

Speech therapy has taken center stage in discussions about the new Medicare payment system for skilled nursing facilities, but therapists and operators say providers can’t ignore physical and occupational therapy services as they adapt. In the months after the Centers for Medicare & Medicaid Services (CMS) announced the new Patient-Driven Payment Model (PDPM), speech therapy [...]

October 2017 Southeast Region Employee of the Month

Gretchen is the Employee of the Month! Odyssey Rehabilitation would like to take this opportunity to announce the October 2017 Employee of the Month for the Southeast Region, as Gretchen Price, Full-time SLP Elkins Rehabilitation & Care Center. Gretchen Price joined Odyssey and the team at ERCC in Sept 2014. Over the course of the last few months, Gretchen [...]