From Manual Reimbursement Audits to Proactive, Continuous Intelligence
For decades, skilled nursing leaders operated in a reactive cycle. MDS teams submitted assessments, operators waited for the billing cycle to close, and only then could they see whether they had hit their reimbursement marks. By that point, it was
AI Proves to be a Safety Net in Skilled Nursing Reimbursement
In skilled nursing, the line between accurate reimbursement and lost revenue often comes down to the smallest details. A missed ADL, a subtle change in oxygen use, or an overlooked function score fluctuation can translate into thousands of dollars in
PDPM Medicaid Transition Playbook: 5 Best Practices for Long-Term Care Leaders
As several states prepare to transition Medicaid reimbursement toward a version of the Patient‑Driven Payment Model (PDPM), long‑term care executives must be strategic and proactive. Below, we outline the current landscape in numerous states making the switch to Medicaid PDPM,
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