Stay Ahead of Key Changes to the Function Quality Measures
In the skilled nursing industry, function quality measures play a vital role in quantifying facility performance. These measures provide valuable insights for consumers and providers alike into resident outcomes, helping facilities improve care and comply with regulatory requirements. Recently, the two
The Critical Role of Section GG in Nursing Home Medicaid Reimbursement
For skilled nursing facilities (SNFs), precise and comprehensive documentation isn't just a regulatory requirement—it’s a driver of financial stability. One essential piece of this puzzle is Section GG of the Minimum Data Set (MDS). This section directly influences reimbursement rates
Discharge Function Score – A Simple Guide
The Discharge Function Score will be used to assess the functional status of patients at discharge. It is a comparison measure that measures whether a resident’s observed discharge function score meets or exceeds an expected discharge function score. The Discharge
Harnessing AI to Enhance Reimbursement Efficiency
The skilled nursing industry is inherently complex and data-intensive, where accuracy and efficiency are paramount. One area that requires exceptional precision is clinical data capture for reimbursement — the process of gathering and documenting detailed information about a patient's medical
Don’t Slip Up When Coding SLPs – Use These Tips Instead
The Patient-Driven Payment Model (PDPM) presents challenges and opportunities, particularly in coding for the Speech Language Pathology (SLP) component. Since the SLP case-mix index (CMI) multiplier ranges from 0.68 to 4.21, even one MDS coding misstep can be costly. This
October Ushers in a New MDS Era and Impacts State Medicaid
This October SNF/LTC communities implement an updated MDS Item Set, ushering in a new MDS era forreimbursement. The change marks the largest, most significant update to MDS 3.0 since its inception in 2010. 29 new and modified MDS items. Updates
New Clinical Reimbursement Market Report Reveals Coordinator Strain Will Negatively Impact Reimbursement
A lot has been written about the macro trends around shifting payment models, Managed Care growth, turnover and resource strains, which continue to impact reimbursement. But not much attention has been paid to the role and function of Clinical Reimbursement.
Resource Strains Threaten Reimbursement – AI Automation is a Solution
Turnover. Burnout. Staff shortages. Overtime. These are all consistent themes playing out in our nation’s nursing homes and splashed across the industry headlines each and every week. It’s not just impacting front-line staff either
Service Charge Capture is Key to Managed Care Revenue Integrity
Every day, you’re providing the patients that come to your SNF care with meaningful services that maintain or improve their quality of life. Your clinical team members are meeting with them, checking on their condition, and providing treatment for many
End The Reimbursement Scavenger Hunt
Could your SNFs reimbursements use a boost? Combine widespread census pressure with a staffing/resource squeeze from the pandemic and many SNF operators are starved for revenue. Despite making efforts and investments to stay ahead, many operators are finding themselves caught