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Nursing home group at odds with Pritzker over payment reform

A political battle is shaping up between Gov. J.B. Pritzker’s administration and one segment of the nursing home industry. ....

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CMS keeping 'cards close to their chest' on PDPM pay cuts: expert - News - McKnight's Long Term Care News

CMS keeping 'cards close to their chest' on PDPM pay cuts: expert - News - McKnight's Long Term Care News
mcknights.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from mcknights.com Daily Mail and Mail on Sunday newspapers.

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Form 1024, Individual Status Summary

Medicaid No. Enter the individual’s Medicaid number.
CARE or Unique ID No. If the individual is enrolled in HCS, enter the individual’s Client Assignment and Registration (CARE) Identification number; if CARE has transitioned out of use, enter the Unique ID number assigned to the individual by Texas Medicaid & Healthcare Partnership (TMHP). Enter N/A if no CARE or Unique ID number exists.
Date of Birth Enter the individual’s date of birth using the mm/dd/yyyy format.
Service Area Enter the managed care service area the individual resides in. If the individual is not enrolled in HCBS, enter N/A. Link to service areas: https://hhs.texas.gov/sites/default/files//documents/services/health/medicaid-chip/programs/managed-care-service-areas-map.pdf ....

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COVID-19 prompts a rethinking of long-term care models

The pandemic has thrown the long-term care industry into a tailspin.
Fearful of contracting the virus, patients have stayed away from nursing homes, causing a plunge in census numbers for facilities that rely on long-term care residents, short-term rehabilitation referrals and transfers from hospitals.
“Is the industry going to downsize? Yes,” said Andy Edeburn, a principal at Premier, a group purchasing and consulting organization. “Not all nursing homes are going to come back.”
Nursing home occupancies are at an all-time low and facilities are struggling to stay open. Nursing home occupancy dropped 16.5 percentage points to 68.5% in January 2021 from 85% in January 2020, according to the American Health Care Association/National Center for Assisted Living. In addition, 143 facilities closed or merged with other organizations in 2020 and 1,670 are projected to do so in 2021, AHCA/NCAL estimated. ....

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COVID-19 raises questions on Medicare pay restructuring in SNFs

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Only a few months after CMS massively changed how skilled nursing facilities are reimbursed for therapy services, the pandemic hit and threw long-term care operations into a tailspin.
That makes it difficult to determine exactly how the change affected therapy services and therapists in nursing homes, researchers say.
A report published in Health Affairs on Monday shows that therapist staffing levels were cut in anticipation of and after the change to the patient-driven payment model in October 2019. The new model replaced the long-standing Resource Utilization Group payment system, known as RUG, with general support from the post-acute care industry. But, after the fourth quarter of 2019, there isn t reliable data to further track the changes, the authors said. ....

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