The new Medicare reimbursement system for skilled nursing facilities (SNFs) – the Patient-Driven Payment Model (PDPM) – fundamentally changes the financial incentives for facilities. With PDPM, Medicare now pays lower rates for residents needing … [Read more...] about Medicare SNF Payment Model Creates Changes in Care and Admissions – What about Facility Assessments?
Skilled Nursing Facility
Accountable Care Organizations and Observation Status
One of the ongoing problems that Medicare beneficiaries face is so-called “outpatient” hospital observation status. When a hospital classifies a patient as an outpatient, rather than as an inpatient, the result is that the patient is ineligible for … [Read more...] about Accountable Care Organizations and Observation Status
Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries?
Skilled nursing facilities (SNFs) do not like the prior authorization requirements, limited lengths of stay for residents, and lower Medicare reimbursement rates that are associated with Medicare Advantage (MA) plans. Some SNFs are responding to … [Read more...] about Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries?
Protect Nursing Home Nurse Aide Training Requirements; Protect Residents’ Right to High Quality Care
Protect Nursing Home Nurse Aide Training Requirements; Protect Residents’ Right to High Quality Care January 6, 2020 - Certified nurse aides provide most of the direct hands-on care to the nation’s 1.3 million nursing home residents. Aides’ central … [Read more...] about Protect Nursing Home Nurse Aide Training Requirements; Protect Residents’ Right to High Quality Care
Skilled Nursing Facilities Lay off Therapists, Change Therapy Services – What Can Residents & Therapists Do?
On October 1, 2019, the Centers for Medicare & Medicaid Services (CMS) implemented a new Medicare reimbursement system for skilled nursing facilities (SNFs) called the Patient-Driven Payment Model (PDPM).[1] The prior system, called Resource … [Read more...] about Skilled Nursing Facilities Lay off Therapists, Change Therapy Services – What Can Residents & Therapists Do?
Patients Need Therapy – Medicare Payment Systems Create Barriers
A unified Medicare payment system that pays all institutional post-acute care providers the same rates, regardless of setting, runs counter to repeated analysis showing that all post-acute providers are not the same, even when they treat patients … [Read more...] about Patients Need Therapy – Medicare Payment Systems Create Barriers
Fairness in Nursing Home Arbitration Act Provides Important Protections
On December 5, 2019, Representatives Linda Sánchez (D-CA) and Jan Schakowsky (D-IL) introduced the Fairness in Nursing Home Arbitration Act (H.R. 5326). The legislation prohibits long-term care facilities from requiring or requesting residents (or … [Read more...] about Fairness in Nursing Home Arbitration Act Provides Important Protections
Center for Medicare Advocacy Submits Statement to Ways & Means Hearing on “Caring for Aging Americans”
The House Ways and Means Committee held a hearing on November 14, 2019 entitled “Caring for Aging Americans.” In a Statement submitted for the record, the Center for Medicare Advocacy expressed concerns about the Patient-Driven Payment Model (PDPM), … [Read more...] about Center for Medicare Advocacy Submits Statement to Ways & Means Hearing on “Caring for Aging Americans”
Quality Care for Nursing Home Residents Act of 2019
Concerns about nursing home quality have increased over the last several years. For instance, a June 2019 report by the Government Accountability Office (GAO) found that the number of cited abuse violations more than doubled between 2013 and 2017. … [Read more...] about Quality Care for Nursing Home Residents Act of 2019
Issue Alert – Medicare Benefit Periods Under PDPM
Benefit Periods. Medicare covers up to a maximum of 100 days of skilled nursing facility (SNF/nursing home) care in each benefit period. A benefit period begins on the first day that a nursing home resident receives services and ends when the … [Read more...] about Issue Alert – Medicare Benefit Periods Under PDPM