Star Ratings Let’s talk about star ratings. I know a lot of people in skilled nursing tell me they don’t like star ratings. Most say the star ratings are flawed and can be misleading. I agree that star ratings aren’t perfect, but they aren’t designed for skilled nursing insiders; they are designed to help people… Continue reading Star Ratings – Some Stats
Author: Joe Eaton
PDPM Non-Therapy Ancillary Pay
PDPM and Non-Therapy Ancillaries The non-therapy ancillary (NTA) part of the patient driven payment model (PDPM) is considered by most people I’ve talked to as being better than what we’re currently doing. It more accurately accounts for expenses and isn’t overshadowed by therapy. In this post I’m going to take a deeper look at it… Continue reading PDPM Non-Therapy Ancillary Pay
Tennessee Medicaid
Case-Mix In Tennessee Tennessee has announced its intention of moving towards the 48 RUG grouper for Medicaid in skilled nursing facilities. This post is intended to be a reference about the 48 grouper you’ll be using in Tennessee. You are in good company The 48 grouper is used by quite a few states. Its use… Continue reading Tennessee Medicaid
SNF Part A LOS – 2017
Part A Length of Stay – All SNFs Nationwide The PDPM enhanced data set has enough information in it to calculate length of stay at the facility level for Part A for 2017. Naturally we’re interested in length of stay so we did a little analysis which we’ll share here. First, let’s look at the… Continue reading SNF Part A LOS – 2017
PDPM – Section GG Functional Scores By State (& County!)
The enhanced provider specific file for PDPM released by CMS has given us an unusual opportunity to study and understand things going on in our industry in a much more timely manner than we’re accustomed to. Let’s hope this trend continues. In this post we’re going to be looking at the new functional scoring technique… Continue reading PDPM – Section GG Functional Scores By State (& County!)
PDPM – Nursing Categories
CMS has released a provider specific impact analysis for PDPM using 2017 data. There’s a lot to analyze and that takes time. However, one interesting question we can answer with the data is something along the lines of “What would happen if all the therapy minutes disappeared?” (Note: Since CMS still refers to the nursing… Continue reading PDPM – Nursing Categories
PDPM Calculator Available!
We’ve just released the PDPM Calculator! (We’ve also retired the RCS-1 Calculator since that proposal is effectively retired. You can still access that calculator here if you want to compare or you’re feeling nostalgic.) Why build a PDPM calculator when CMS released their own Excel-based grouper tool? We felt like the Excel tool was a… Continue reading PDPM Calculator Available!
Test Your Jimmo v. Sebelius Knowledge
It’s been more than 5 years since the landmark Jimmo V Sebelius case. That case is arguably the most important thing to happen to therapy delivery in skilled nursing during the last decade. However, it seems like no one is talking about it and many aren’t even aware of what it means. Let’s hit some… Continue reading Test Your Jimmo v. Sebelius Knowledge
Latest ADL Scoring By State
The Pepper reports give us a glimpse into trends in Medicaid Part A in skilled nursing facilities. Sometimes you have to do a little summarizing yourself to figure out what you want to know. What I wanted to know was “Which states report the highest ADL scores?” Pepper had the data but it needed a… Continue reading Latest ADL Scoring By State
2 Reasons You Should be More Concerned about Casemix than RCS-1 if You’re In Tennessee
Tennessee is in a unique position right now. Everyone is trying to figure out how RCS-1 will change Medicare Part A. However at the same time Tennessee is also preparing to transition to case-mix for Medicaid. RCS-1 can tend to look more important because a lot more people are talking about it but here are… Continue reading 2 Reasons You Should be More Concerned about Casemix than RCS-1 if You’re In Tennessee