News

Skilled Nursing Facilities are experiencing the necessity of a positive Payer relationship.
Medicare Advantage plans are focusing on strategies that will have the greatest impact, affecting the most lives.
To succeed, SNFs must learn to identify a Payer’s top priorities and build a solid foundation of communication, ensuring both parties are on the same page with data as this is often a source of conflict.

For more on this please see the article below.

Payments have increased to the two Iowa managed care companies being paid to run the program this year. However, Iowa’s Medicaid Director notes that this should not be referred to as a raise, but as necessary due to rising costs the companies face as well as reflecting the increased payments legislator’s have determined for nursing homes and rural hospitals.

The Medicaid Director believes that taxpayers are actually saving money with the program being run by private companies rather than the state.

For more on this, see the @DMRegister article below.

A national survey on healthcare markets revealed that skilled nursing facility properties demand may increase this year. This as opposed to 2018’s forecast which showed a steady or shrinking demand.

For more on this please see the @mcknightsltcn article below.

Skilled Nursing News sat down with the CEO of Dycora Transitional Health and Living to describe how the industry has changed through the years, to provide pointers for new SNFs and to elaborate on how a SNF can perform to its full potential.

Focusing on your communities needs, telling your story, and being proactive rather than reactive, are suggested to be of the utmost importance.

For more on this, see the full article from @skilled_nursing.

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Two senators recently released a CMS list of nearly 400 nursing facilities nationwide with a “persistent record of poor care” whose names were not released publicly by the government.

On this list, eighteen different Ohio facilities appear as Special Focus Facility (SFF) candidates, with an additional five already marked as SFF.

For more on this, see this article from @ChiTribBiz.
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The Trump Administration has finalized adjustments to Medicare Advantage and Medicare Part D to ensure patients have greater transparency in the cost of prescription drugs, along with improved visibility to their options.

Under this new rule, the Explanation of Benefits document that Part D enrollees receive should now include notice of drug price increases as well as lower-cost alternatives.

For more on this, please see the CMS press release below.

Skilled Nursing Facilities are discovering that investing in their Staffing Star rating doesn’t necessarily lead to profitability.

Rather, SNFs would serve better by focusing their attention on their survey and quality ratings, which show the biggest impact to their CMS five-star rating.

This Star rating is indicative of the operating margin a SNF should expect to see. For example, a five-star facility’s operating margin is around 1.3%, but a four-star facility would see a drop by nearly half to 0.7%.

For more on this, see this article from @skilled_nursing.

Through CMS’s proposed update to the prospective payment system (PPS) for the federal fiscal year 2020, SNF’s would see an increase in Medicare payments of $887 million.
2020 marks the implementation of the Patient-Driven Payment Model (PDPM), which focuses on clinical conditions as opposed to the volume of care provided.

Under this model, CMS placed a limit that no more than 25% of therapy services provided to a SNF resident during a covered Medicare Part A stay may be in a group setting. Group is currently defined as four residents performing similar activities. However, with the proposed update, the definition would change to be two to six residents.

For more on this, see the @ReedSmithHealth article below.