CMS recently released updated information on the value-based purchasing program. The data included a facility-level look at how the program is going. CMS also expressed concern during the Open Door forum that the rate of re-hospitalization had increased over the baseline year even with the financial incentive. Let’s take a closer look at the data,… Continue reading Value-Based Purchasing Data
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Minor Changes to PDPM Calculator
We’ve made a couple of minor changes to the PDPM calculator. As CMS releases more information, we will continue to update the calculator to keep it as accurate as possible. For today’s update, we have two minor changes: Under some circumstances, it is possible that the PT/OT category will not be “Acute Neurologic” even though… Continue reading Minor Changes to PDPM Calculator
MACS, RACS, ZPICS…and now TPEs….Oh my!
Over the past few years, we have all, unfortunately, gotten used to many different audits. The latest one, CMS has engaged different MACs in doing the process of the TPE – Targeted Probe and Education. The premise of these audits is related to “The process is only used with those who have high denial rates… Continue reading MACS, RACS, ZPICS…and now TPEs….Oh my!
Part A RUGs by Facility (Yes all of them.)
CMS has released 2016 Part A data for skilled nursing (and others). It’s easy to see from this data why PDPM is on the way. For those who are curious but not so curious to spend much time on it, I’ve taken all the RUGs for every facility in the US and mapped them. See… Continue reading Part A RUGs by Facility (Yes all of them.)
Paying for Rehab Under PDPM
Under PDPM, rehab will become a cost and no longer be a source of revenue. Since outcomes are still job one, you might be wondering just how you’re going to pay for the rehab that is necessary to achieve the best possible patient outcome. Planning is critical to your success. Contrary to what a lot… Continue reading Paying for Rehab Under PDPM
The ADL Difference
Take a look at this: (click to enlarge) View fullsize This is data from 2016. At that time, Broad River Rehab was just getting started. We were serving only 8 facilities. But even at this early stage you can see that our customers had significantly higher ADL scores than national averages. We’d effectively moved more… Continue reading The ADL Difference
ALF Expectations
Recently I had the opportunity to sit down and share a meal with some smart and savvy operators of several assisted living facilities after the NCALA Trade Show. (By the way, the show was awesome! Thanks NCALA!) During that meal, a very smart nurse said the following: (I’m paraphrasing here.) Changes that you might expect… Continue reading ALF Expectations
Part A RUGs – Some Observations
Do you want to see a picture that explains a lot about skilled nursing right now? Take a look at this: (click to enlarge) View fullsize This is from the 2016 Medicare Part A data that CMS released a few days ago. There is a lot to unpack in that data set, but just based… Continue reading Part A RUGs – Some Observations
PDPM, Non-Therapy Ancillaries & MDS Section I
PDPM includes a new pay category, the non-therapy ancillary or NTA. Everyone I’ve talked to agrees the NTA payment is a good idea. But, since it’s new, we’re going to have to work on understanding how it’s supposed to work, and how we can most easily and efficiently complete the assessment with accurate information. View… Continue reading PDPM, Non-Therapy Ancillaries & MDS Section I
Understanding the Value of the MDS Nurse Under PDPM
As the SNF world draws its collective breath and begins to consider the Patient Driven Payment Model (PDPM), the new reimbursement system that will drive payment for Medicare Part A for SNFs starting October 1, 2019, there are many questions and misunderstandings. Because of the major changes to the payment system, compared to RUG IV… Continue reading Understanding the Value of the MDS Nurse Under PDPM