Tag: PDPM

Nursing home employment rates decline in October

Nursing home employment rates declined in October, according to an update by the Bureau of Labor Statistics (BLS) released November 1. Although the report does not specify what caused the 1.3% dip, earlier reports of therapist layoffs seem a likely culprit for the dip in employment rates. This doesn’t necessarily mean that PDPM is to […]

Post-Acute Wound Management and Patient-Derived Reimbursement Models

By: Roger B. Schechter, MD, Fellow of American College of Wound Specialists; Chief Medical Officer, Synergy Wound Technology Wound care has always been a considerable challenge in the post-acute setting. Patients with skin breakdown usually have a plethora of chronic comorbid conditions. Chronic wounds themselves, including pressure injuries, diabetic foot ulcers, venous leg ulcers, severe […]

Therapist layoffs reported as a result of PDPM

Since the implementation of PDPM on October 1, thousands of therapists have been laid off, reports Modern Healthcare. The payment system prior to PDPM, RUG-IV, allowed SNFs to bill therapy services they deemed necessary, but some took advantage by ordering superfluous therapy services to gain additional reimbursement from Medicare. PDPM seeks to stop this practice. […]

Did you know? 2019 Revenue Integrity Symposium is this October

October 15-16, 2019 | Orlando, FL The Revenue Integrity Symposium is the can’t-miss event for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking for acute and long-term care professionals. Learn from trusted experts with cutting-edge regulatory insight that will arm you with the tools you need to take 2020 by storm. By […]

CMS to hold SNF/LTC Open Door Forum

CMS will hold an open door forum on September 19 for SNFs and LTCs. Discussions will focus on: PDPM updates PBJ updates Policy Questions should be sent to: NHStaffing@cms.hhs.gov Technical Issues/Questions should be sent to: NursingHomePBJTechIssues@cms.hhs.gov PBJ Website MS-6058-FC Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process SNF […]

Home Health and SNF CMS call recording now available

Home Health Call: Audio Recording and Transcript An audio recording, transcript, revised presentation, and clarification are available for the August 21 Medicare Learning Network call on the Home Health Patient-Driven Groupings Model (PDGM): Operational Issues. Learn information to help your agency prepare to implement billing changes for the PDGM on January 1, 2020. SNF Value-Based […]

CMS issues new SNF PPS Final Rule for 2020

On July 30 CMS issued a final rule updating the payment rates under the prospective payment system (PPS) for SNFs. The rule, designed to increase aggregate payments to SNFs by $851 million in 2020 compared to 2019, will go into effect on October 1. This rule includes three main revisions: The rule includes minor changes […]

CMS to hold two-day Quality Reporting training

Registration is open for CMS’ SNF QRP Provider In-Person Training Event, August 13 and 14, 2019. The training is a two-day in-person ‘Train the Trainer’ event for providers at the Four Seasons Hotel, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations. Like the May 2019 […]

PDPM Q&A: Payment overview and billing

CMS has released its FAQ sheet on PDPM: Q. What is PDPM? A. The Patient Driven Payment Model (PDPM) is a new case-mix classification system for classifying skilled nursing facility (SNF) patients in a Medicare Part A covered stay into payment groups under the SNF Prospective Payment System. Effective beginning October 1, 2019, PDPM will […]

What to consider: SNF Proposed Rule for 2020

The following was written by Reg Hislop for Reg’s Blog. Reposted with permission. . The SNF proposed rule is best characterized as mostly good news. The best news is the proposed market-basket (rate inflation) update of 3%. Subtracting the productivity factor of .5% from the update, SNFs will see a rate increase of 2.5% starting […]