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Monique Ervin, CaringForward
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Mid-week roundup of news and views in post-acute care and LTC: Last week, CMS announced that more than 500 providers are on board to test four new models for payment bundling in 2013. Under the Bundled Payments for Care Improvement (BPCI) initiative, participants will have 48 care episodes to choose from. LeadingAge issues a call to action to prevent looming automatic Medicare cuts from sequestration, reminding us that the cuts would trim $11 billion in Medicare spending, $18 million in Section 202 housing funding and $86.7 million from the Administration on Aging Jacqueline Vance, the "Real Nurse Jackie" over at... Continue reading
Posted Feb 6, 2013 at CaringForward
A few days ago we linked to a McKnight's post about how hospitals and post-acute providers were collaborating to reduce readmissions. The numbers seemed rosy: The "14 communities [studied] saw a 5.7% mean reduction in readmissions within 30 days of discharge per 1,000 Medicare beneficiaries." Alas, those sneaky numbers. When we posted this to our LinkedIn groups, reader Don Ridenour, the owner of Always Best Care in Indiana, commented challenging McKnight's interpretation of the original study from the The Journal of the American Medical Association. And he's right. Here's the conclusion from the abstract posted on JAMA: Among Medicare beneficiaries... Continue reading
Posted Jan 31, 2013 at CaringForward
A bold headline from John O'Conner over at McKnight's: "More evidence that long-term care operators are not simply heartless bottom feeders." He notes the extensive reader interest in recent stories about big clinical issues affecting long-term and senior care, including the flu epidemic, norovirus and aspirin issues for elderly users. We have long observed that the top performing SNF providers focus relentlessly on both clinical care and business performance. Sustained financial success depends on exceptional clinical care, which drives patient experience and satisfaction and builds the quality reputation SNFs depend on to maintain census. And consistent quality care depends on... Continue reading
Posted Jan 29, 2013 at CaringForward
Some news and views of interest this Friday morning: At McKnight's, At McKnight's, Shelly Mesure digs deeper into the recent OIG report of $1.5 billion in Medicare overpayments attributed to incorrect therapy utilization and reporting by providers. She questions OIG's approach, saying it's a mistake to consider coding and documentation errors with fraud all in a single category, which then suggests a misguided single solution to a more complex issue. (We have looked at similar OIG perspectives about the skilled nursing industry several times in the past.) Long-term care industry mergers and acquisitions increase in 2012, but the deal size... Continue reading
Posted Jan 25, 2013 at CaringForward
McKnight's reports about a study in The Journal of the American Medical Association documents how post-acute providers are successfully reducing hospital readmissions by communicating and collaborating more closely with hospitals and other healthcare providers. The research, funded by CMS, studied 14 communities where hospitals collaborated with post-acute providers to improve care transitions, with a 5.7% drop in readmissions withing 30 days. It also noted benefits from nursing homes applying the Interventions to Reduce Acute Care Transfers (INTERACT) model. This coincides with another study by Columbia University Medical Center (also published in The Journal of the American Medical Association) that "long-term... Continue reading
Posted Jan 24, 2013 at CaringForward
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Oct 1, 2012
Lot's of news and analysis this week about Medicare reimbursement penalties for patient readmissions and the implications for SNFs and hospitals. Starting Oct. 1, about 2,000 hospitals will face tiered reimbursement penalties for readmitting too many patients with heart attacks, pneumonia and chronic heart failure. As a reminder of the challenge, we see that the best hospitals readmit 19 percent to 20 percent of heart failure patients within 30 days. As the McKnight's article observes, strong collaborative relationships and communication between SNFs and hospitals are more important than ever. Also, here is some solid analysis regarding variables that can unfairly... Continue reading
Posted Aug 14, 2012 at CaringForward
Last week brought good reimbursement news for SNFs after what seemed like years of Medicare bummers: The federal government raises Medicare payments by 1.8 percent in fiscal year 2013. Even AHCA praised CMS for the news: “After years of reimbursement volatility, today’s update to Medicare payments is welcome news to skilled nursing providers. AHCA appreciates CMS’ balanced approach to this year’s Medicare payment system after recognizing the many rounds of government reductions the profession has already endured. Stable Medicare funding will help ensure America’s seniors continue to have access to high quality, post-acute care.” Rejoice! The tides have turned! After... Continue reading
Posted Aug 9, 2012 at CaringForward
We recently looked at how the 11.1 percent Medicare cuts from October 2011 affected top-3 U.S. SNF provider Kindred Healthcare. The short answer—probably not in the ways, or nearly to the extent, that you've read about in the press. But what about other major providers? At least among big public SNF companies, the sky seems securely in place. Although all providers cite the challenges posed by the Medicare cuts, have most reported positive financial results and outlooks, some quite remarkable. Let's look at a few other financial filings for public SNF companies*: Ensign Group (103 SNFs, based in Mission Viejo,... Continue reading
Posted Jun 22, 2012 at CaringForward
Here are some recent items of interest for skilled nursing facilities: A recent article in McKnight's reports that research has found that more focused treatment of common illnesses among dually eligible Medicare and Medicaid beneficiaries could cut costs and lower hospital readmissions. According to a recent McKnight's article, Medicare panel seeks enhanced payments eligibility for the PACE program Patricia Sheehan with Long-Term Living published an interesting article that discusses key considerations when transitioning to an eMAR system. Pamela Tabat's recent article in Long-Term Living discusses the LTPAC HIT Summitt roadmap for 2012-2014. Continue reading
Posted Jun 19, 2012 at CaringForward
The response from skilled nursing facilies to the RMS Web-based bed management functionaility has been very enthusiastic. We have multi-location providers that have replaced their entire bed management tracking process with the integrated RMS bed management capabilities. The bed management functionality of the Referral Management System meets the demands of skilled nursing providers, improving census management by enabling multi-location SNF facility end users and corporate managers to: Seamlessly link bed assignment with the referral management process—assess bed availability for referrals and assign admitted patients to beds, all in one system with one work flow See updated census and bed availability... Continue reading
Posted May 24, 2012 at CaringForward
We work with SNF prospects everyday that we know struggle to capture meaningful information about census, marketing admissions performance. With the RMS CensusVision™ Executive Dashboards, we've been able to deliver valuable and meaningful information to executives at multi-location skilled nursing facilities. CensusVision includes the following standard executive dashboards available within the Referral Management System: Referral win/loss, which provides a high-level graphical comparison of referrals won and lost during a specified period Admissions by payer, which shows admitted referrals per facility by payer type Decline referrals by payer, which highlights reasons that single, multiple or all facilities are declining referrals Lost... Continue reading
Posted May 24, 2012 at CaringForward
Yesterday we posted an update on Greystone Healthcare Management's big gains in Medicare census through improved marketing, referral management and admissions processes, enabled by the Web-based Referral Management System. Today we look at Royal Health Group, a six-SNF provider in Massachusetts that also has documented significant improvements in operations and census performance since partnering with PPS to use the Referral Management System. Royal Health group previously documented how automation and live census trend and analysis reports have improve conversion rates, dropped response times by 80 percent, and driven overall revenue growth. Royal Health Group recently provided some interesting new data:... Continue reading
Posted May 9, 2012 at CaringForward
Greystone Healthcare Management has long documented significant returns and performance results from using the Web-based PPS Referral Management System. Within the first year of using the system, Greystone HCM reported the following: 73% faster referral response times, from 30 minutes to eight minutes 5% increase in overall census Referral conversion rates increased to 88% from 56% That was in late 2010. Greystone HCM recently reviewed new performance data and documented continued performance gains, specifically related to increased Medicare market share. This data confirms that automated census management and live, accurate reporting help deliver continuous operational and financial results for SNF... Continue reading
Posted May 8, 2012 at CaringForward
Publicly traded Kindred Healthcare in February reported some bleak financial results for Q4 of 2011, with losses of $72.8 million (compared to a profit of $19.7 million in Q4 of 2011). It revised its 2012 earnings forecast down by $0.30 per share, and announced that it would not renew it lease with Ventas for 64 facilities, including 54 skilled nursing facilities. Kindred associated the results and the changes, at least in large part, to the notorious 11.1% Medicare reimbursement cuts that went into effect October 1, 2011. In the announcement Kindred said that the "initial quarter under new RUGs IV... Continue reading
Posted Apr 23, 2012 at CaringForward
We've just published the CensusVision™ Executive Dashboards Overview, a document of census and admissions dashboards for skilled nursing facility (SNF) executives available with the Web-based Referral Management System. The CensusVision Executive Dashboard Overview includes extensive details pertaining to the following standard executive dashboards available within the Referral Management System: Admissions by payer, which shows admitted referrals per facility by payer type Decline referrals by payer, which highlights reasons that single, multiple or all facilities are declining referrals Lost referrals by payer, which highlights reasons facilities are losing referrals Total referrals by payer, which shows the total number of referrals by... Continue reading
Posted Feb 17, 2012 at CaringForward
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New allocations of group therapy for skilled nursing facilities has shifted therapy almost completely to individual therapy provision in 2012 Some thoughts about considering rehab/therapy to return patients to previous levels of function when assessing Medicare Part A length of stay: "It is clinically appropriate to continue the therapy program and further progress the patient to his or her highest functional ability." Reginald Hislop from Reg's Blog uses big words, and lots of them, and his posts deliver thoughtful, comprehensive, expert analysis about issues that affect your SNFs. These two recent posts examine why complex, convoluted Medicare rules make billing... Continue reading
Posted Jan 27, 2012 at CaringForward
Here are some recent items of interest for skilled nursing facilities: Has the Centers for Medicare & Medicaid Services underestimated us again? Shelly Measure with McKnight's seems to think so. An interesting article on how to profit from new CMS regulation changes. A recent article in McKnight's reports HHS: New electronic claims regualtion could save providers time, money. McKnight's article reports that republican presidential hopeful Rick Santorum says he favors privatizing Medicare and says he would like to see the elimination of the Centers for Medicare & Medicaid Services. Patricia Sheehan with Long-Term Living published an interesting profile recently about... Continue reading
Posted Jan 10, 2012 at CaringForward
Some additional items of interest for skilled nursing facilities: CRL Senior Living Communities has introduced two new programs, Seniors In Touch and iBraincercise, that empower community residents to make social networking and tablet computing a part of their daily lives. Health Dimensions Group will host the National Summit: Building the Continuum Essential for Success in Post-Health Care Reform February 1-3, 2012, in Phoenix, Arizona. The NewCourtland School of Practical Nursing celebrated its first graduation recently, marking the successful preparation of 20 students aspiring licensure, employment and service to the community as LPNs. New Software Release Drives Down Medication Cabinet Stock... Continue reading
Posted Dec 30, 2011 at CaringForward
Here are some recent items of interest for skilled nursing facilities: Telemedicine will play a much larger role in healthcare during 2012, according to a recent report from Euro RSCG. Jeron Electronic Systems has announced the release of its Provider 790 line of nurse call systems. This networked solution makes it possible to reach every corner of a facility, according to the firm. The Healthcare Information Management and Systems Society recently unveiled an updated version of its ICD-10 PlayBook. Among its new features: free access to its VitalVendors, which helps providers know which software firms have the resources to support... Continue reading
Posted Dec 29, 2011 at CaringForward
We are pleased to announce the ability to identify and track coverage days remaining for dual-eligible patients within the Bed Management System, part of the 4.0 release of the Referral Management System: Patient Placement Systems (PPS) announced today enhancements to its Web-based bed management system that allows skilled nursing facilities to identify and track coverage days remaining for dual-eligible patients—those eligible for both Medicare and Medicaid coverage. PPS included the dual-eligible functionality as part of the new 4.0 release of the Web-based Referral Management System. Click here to learn more... Continue reading
Posted Dec 28, 2011 at CaringForward
Here are some recent items of interest for skilled nursing facilities: Newly introduced legislation would require Medicaid to reimburse 90% of Medicaid providers, such as skilled nursing facilities, within 30 days, and any leftover claims within 90 days. GOP Bill discounting Medicare bad debt ignites skilled nursing backlash A former nursing home administrator was found guilty of receiving illegal payments for referring residents for fraudulent ambulance transport services. An MRI scan that detects atrophy patterns in the brains of Alzheimer's patients also can detect cognitive decline in Parkinson's patients, a new finds. The Senate Special Committee on Aging is holding... Continue reading
Posted Dec 13, 2011 at CaringForward
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Here is the final excerpt of "The 11.1% Survival Guide for SNFs: 5 Tips for Thriving When Times Are Tough." Tip 5: Outmaneuver Your Competitors While They Stand Still SNF organizations that will survive—or better yet, thrive—in tough times will invest in strategies and resources that build quality census and revenue. They will arm themselves with business intelligence to make smart, nimble decisions that promote performance. And they’ll need to do one more important thing: Whip their competition. Current anxiety and uncertainty in the SNF industry open a tremendous opportunity for savvy providers. While other providers scale back staff and... Continue reading
Posted Nov 29, 2011 at CaringForward
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Tip 4: Capture Business Intelligence to Support Smarter—And Bolder—Strategies So far we’ve given you some sage advice. “Keep investing in growth when times are tough.” “Grow your census.” “Optimize your payer mix.” We’ll forgive you at this point if you’re saying, “Well, yeah, of course we’d like to do those things. But how?” These last two survival tips focus on the “how.” How do you make the business case for maintaining and investing in strategic programs? How do you start building and managing the highest quality census? Your most valuable starting asset is knowledge. If you’re going to champion a... Continue reading
Posted Nov 18, 2011 at CaringForward
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Here is excerpt number three from "The 11.1% Survival Guide for SNFs: 5 Tips for Thriving When Times Are Tough." Tip 3: Optimize Your Payer Mix—It’s More Important Than Ever After CMS issued RUG IV in 2010, many SNFs focused on obtaining high-therapy, high-rehab Medicare patients, which had the highest reimbursement rates. Those RUGs, from RLA to RUX, took the brunt of the October 1 cuts from Medicare, representing a disproportionate percentage of the overall cuts. In fact, Medicare adjusted the reimbursement rates specifically to “correct” rates in those categories which they determined had been oversized with the introduction of... Continue reading
Posted Nov 15, 2011 at CaringForward