Skilled Nursing reimbursement is like a classic film that has not aged well. Rooted in a 50-year-old timeline, with countless reboots, sequels, and spinoffs, the SNF revenue-cycle is a muddled patchwork of confusing storylines and misdirected plot twists set against the backdrop of healthcare reform. Inadequate Medicaid payment is the industry’s primary antagonist, but as a new chapter begins, a more complex story line is revealed.
This “point-counterpoint” retrospective examines the duality of post-acute care’s economic model where funding and payment policy collide. Will SNFs live happily ever after or are we headed for another cliffhanger!
While the Wolf of Wall Street is based a true story of corruption, SNFStreet is not. Medicare reimbursement system changes don’t just happen in a vacuum. PDPM now has implications that extend far beyond the ever dwindling Medicare FFS, including managed care, Medicaid, innovative payment models, quality and eventually a unified post-acute care payment system. This session will explore your “true story” and these dependencies and help position you for long-term reimbursement success, the right way!
Vincent Fedele, Michael Sciacca
The lights dim, as the ominous music starts to play. The beleaguered actors take their place. Why do they appear so defeated? Then you realize….they are nursing home operators from a highly penetrated Medicare Advantage state. But does this dystopic state need to be your reality? This session provides a data-driven approach to turning the tables on managed care and making them an authentic partner in the post-acute care process.
Vincent Fedele, Jay Gormley
Now that the Creature has been tamed, the plot thickens … It seems the terrain is much deeper and cavernous than we once thought. Rodents of Unusual Size? Fire Swamps? Fred Savage and Columbo in weird cut scenes? No! Instead we are confronted with managed care like entities all with different motivations, reimbursement triggers, and needs. We will look at the rising role of IPA, other provider sponsored risk organizations (like I-SNP and IE-SNP), enhanced care & coordination providers” (ECCPs) and the new REACH ACO model. No need to retreat into the shadows. SNFs can have a leading role in this saga as long as you don’t “choose poorly”.
Jay Gormley, Heidi Wold
Meet me at the corner of financial and clinical integrity, but first you must transverse a myriad of potholes, hollow shoulders and road construction. However you must get to your destination to remain viable. This session brings together new quality outcome measurement and all of its reimbursement repercussions.
Steven Littlehale, Heidi Wold
You’ve been cast in the role of the nefarious nursing home provider. The script was written years ago from every MDS, staffing and cost report that you ever submitted. The courtroom lighting is impossible to bring out your best features…Data Avengers to the rescue! Learn how a better writer can turn your problematic script into a Pulitzer prize screenplay.
Drew Graham, Marc Zimmet, Steven Littlehale
ICD-10 and Skilled Documentation
You don’t have to have won an Oscar to code an MDS assessments, but sometimes it feels it! Is ICD-10 Coding a mystery to you? Join our resident star, Robert Gross and ask your most perplexing questions that will get turn you into an award-winning assessor.
Speech-Language Pathology Case-Mix Factors
Under the PDPM, payment for patients with speech-language pathology needs will be determined by five case-mix factors – and they are not lighting, composition, camera angles, lens, and exposure. Come talk with superstar Tracey Weiss to find out everything you need to know to code the SLP component items.
Medicare Part A Skilled Service
SAG-AFTRA is the union that covers media professionals worldwide, but Medicare Part A covers people aged 65 years or older. The coverage requirements haven’t changed much but still many of us have a hard time remembering our lines. Bring your most challenging questions to Karen Lightner, a true mega-star, to remove the fog of confusion.
Seeing your name in stars is one thing, but Five-Star is entirely different! This consumer rating system is on everyone’s mind and continuously dominates the headlines. Do you struggle to understand Five-Star and how it affects your facility? Do you need help understanding what makes up Five-Star and how to improve them? Amy Greer, hot off of the movie set, will answer your questions and help you get your facility’s name in lights!
Tracey Weiss, Robert Gross, Karen Lightner, Amy Greer
In July 2022, the CT Department of Social Services (DSS) will be transitioning Medicaid nursing facility reimbursement from a cost-based methodology to a case mix payment system. This modernization of Medicaid reimbursement will better align payment with the acuity of residents and ultimately include a value-based purchasing element. Join us for this CT specific breakfast roundtable where we’ll review the phase in plan, anticipated VBP and early lessons learned from CT providers. Facility specific strategies gleaned from other states with similar systems will also be shared.
Sally Fecto, Margaret Kirby
Day Two Key Note
Staff attraction and retention strategies
While we are caring for our nation’s elderly, 43% of us are also caring for a family/friend at home. Caregiving intensity is impacting you and your employees in measurable ways, from increasing staff turnover to creating real barriers to filling vacant positions. ARCHANGELS leverages 25 years of experience in its mission of supporting caregivers as an invaluable resource for your staff. Attracting and retaining an all-star cast goes well beyond a ticket to the movies and a pizza party. ARCHANGELS can help address caregiver intensity in your organization by strategically designing and implementing engagement and support strategies to have a measurable top and bottom-line impact. Hear from ARCHANGELS’ founder Alexandra Drane, a fresh voice on this movie set.
Audience members “clamor for your drama” but it’s hard to put on a show with no actors or crew. Actors, like caregivers, need support and creative directors who are sympathetic to the many challenges outside of the movie set. This session share some never-seen-before strategies to attract and retain staff (and increase occupancy) (add staffing minimums).
Alexandra Drane, Tara Gregorio, Bernie McGuinness, Steven Littlehale
You think that you’re “ready for your close-up” but the casting agency decided to go in a different direction. “Something different, something fresh” but what are they really saying? Do you need to get a “Clinical Transformation” to appear more appealing to your referral network? This session knows all the right doctors.
Melanie Tribe-Scott, Alicia Cantinieri