Reimbursement

Whistleblower suit alleges AseraCare Hospice defrauded Medicare

Hospice company is charged with misspending millions of tax dollars intended for Medicare recipients in need of hospice care. Read More »

Provider groups: GOP spending bill would mean more SNF Medicare reductions

AHCA and the Alliance decry bad debt provision within the Middle Class Tax Relief and Job Creation Act of 2011. Read More »

Future cuts may realistically push SNFs over the edge (and into the red)

Provider groups have been saying this for years: Skilled nursing facilities cannot survive another round of cuts. (Actually, it’s usually stated more Read More »

Could reimbursement cuts be the impetus for lawsuit reform?

Long-term care providers are justly lamenting the harsh 11.1 percent Medicare reimbursement cuts that took effect on October 1. But in the Read More »

‘Super committee’ teeters toward stalemate

It’s going to be a long weekend for certain members of Congress. The bi-partisan 12-member “super committee,” tasked with finding $1.2 trillion in Read More »

Update on strategies to increase Medicare length of stay, overcome RUG reductions

You might appreciate an update on a new strategy that I’ve implemented with clients in response to Medicare cuts—and the response from referral Read More »

Feeling the fire of SNF PPS rule

The final SNF PPS rule for FY2012 published in August will cause all operational professionals to stop and think about their implementation plans for Read More »

One year later: Administrators speak out on 3.0

Last August, Long-Term Living gauged the mood and outlook of four administrators as they readied their teams for one of the largest operational Read More »

Final rule cuts deep

Bob Gatty The long-term care industry is now facing an 11.1 percent Medicare payment reduction to SNFs for 2012 in new rates to be implemented Read More »

What your team needs to know about the COT OMRA

At the end of July, the Centers for Medicare & Medicaid Services (CMS) published the “Medicare Program; Prospective Payment System and Consolidated Read More »

ACOs update: Three likely payments

And now we wait. The comment period for the Centers for Medicare & Medicaid Services' proposed rules on Read More »

Resident interviews demystified

The scripted interviews that are integral to the MDS 3.0 are a rich source of information about each nursing home resident that often may not be Read More »

CMS considers $4 billion SNF payment reduction

Bob Gatty Since last October, skilled nursing facilities (SNFs) have been paid by the Centers for Medicare & Medicaid Services (CMS) at an Read More »

Spending cuts loom for Medicare/Medicaid

With the pressure on Washington to slash federal spending, the long-term care community can expect to face its share of the pain, and Read More »

MDS 3.0’s challenging PPS assessments

MDS 3.0 and RUGs-IV hit long-term care with a wave of change on October 1, 2010. Universally, most MDS coordinators struggled with the new Read More »

Feds question SNF billing and payment practices

Two reports by federal health investigators have raised questions about billing practices at skilled nursing facilities (SNFs) for therapy Read More »

Resident Assessment Protocol, Care Area Assessment

AT A GLANCE Instead of Resident Assessment Protocols, MDS 3.0 will be using Care Area Assessments for more in-depth assessment. There are some Read More »

Start Now

Editor's note: This is part one of a two-part series. This month's discussion focuses on how to keep good records to avoid a RAC audit. If you are Read More »

POC documentation benefits care, reimbursement

New technologies to document care at the point of care (POC) and to query results and schedules without leaving the resident's side to use a Read More »

CMS pilot attacks unnecessary rehospitalization

Noting that one in five Medicare patients are rehospitalized after discharge, and three-fourths of these cases could be avoided, the Centers for Read More »

Shielding assets for Medicaid: The note and loan strategy

The Deficit Reduction Act (DRA) of 2005, signed into law by President George W. Bush on February 8, 2006, is a federal law designed to severely Read More »

Softening the assessment process

The culture change movement has taught us so much, causing us to think twice about what we do. We're finding, unfortunately, that many of the Read More »

No real healthcare reform without LTC financing discussion

Organizations representing various sectors of the nursing home and long-term care community have urged Congress to include improvements in long-term Read More »

Six strategies for survival

Recently Ziegler Capital Markets issued six strategies for senior living providers facing economic difficulties due to their faltering marketplace. Read More »

MDS 3.0 implementation strategies

Significant changes in assessment philosophy that reflect current clinical practice standards and a focus on resident-directed care are at the core Read More »

Questions & answers from the American Association of Nurse Assessment Coordinators (AANAC)

Q: Regarding coding of assistance with bathing: According to the RAI User's Manual, you code the highest level of assist given in the past seven Read More »

Benchmarking rehab for better care, more reimbursement

Benchmarking is a management tool used in many industries to answer the never-ending question: “How does my operation compare against those of my Read More »

Questions & answers from the American Association of Nurse Assessment Coordinators (AANAC)

Q: Regarding Significant Change in Status Assessments (SCSA): The RAI User's Manual states that improvement or decline would be in two or more of Read More »

Reimbursement realities: A shaky business environment

Reimbursement methods—whether through Medicare, Medicaid, or private pay—have inherent consequences for business operations. How effective are these Read More »

Medicare 101: Know your documentation

Basic knowledge of Medicare's skilled care criteria has been historically considered a “must-know” for skilled nursing facility (SNF) admission Read More »