Reimbursement Rates CMS announced plans to lower nursing home Patient Driven Payment Model (PDPM) rates by 4.6% to account for unintentional overpayments. PDPM reimbursements were intended to be budget neutral. However, the nursing home industry exploited the new model and total spending increased by 5.3%, or $1.7 billion when compared to the old Resource Utilization
RUG v. PDPM There is hope that CMS will fix reimbursement rates associated with the Patient Drive Payment Model (PDPM). PDPM replaced the Resource Utilization Group – Version IV (RUGS-IV) on Oct. 1, 2019. PDPM is a case-mix model that relies on the accurate assessment and coding of over 150 items on the SNF minimum
Failure to Plan North Carolina Health News had a great report about the problems in North Carolina nursing homes. The same problems exists in South Carolina as well. Unsafe staffing and gross failures to plan are widespread. The report discusses Principle Long Term Care and its facility Pine Ridge Health and Rehabilitation. Principle Long Term
Private equity investors and real estate moguls use nursing home properties. They manipulate the financial health of the operation. The owners borrow against, leverage, and divert tax payer funds via Medicare/Medicaid to shell companies or related entities. We need transparency to follow the money and hold people accountable for abuse and neglect. All Year Holdings will
Skilled nursing facilities will have more time to explain how they spent the bailout money from the Provider Relief Fund. The legislation, dubbed the Provider Relief Fund Improvement Act, delays “complex PRF reporting requirements” until after the public health crisis. The delay will give the industry more time to hide and divert funds. The money
Experts and advocates worry that private equity firms and other for-profit owners are underfunding care in order to line their pockets. Evidence, common sense, and academic studies link for-profit status to poor quality. Researchers and investigative articles spotlighting poor care and safety lapses at national chains. Research has repeatedly linked lower staffing levels to substandard care. To date, CMS
Recent Comments