Welcome to the HealthPRO® Heritage Blog

An Industry Gut-Check: What's Your PDPM Confidence Level?

Posted on: October 1, 2019

Now is the time for our industry to over-communicate!  Put your two cents in, and learn more about what your peers are thinking, feeling, and what’s keeping them up at night, too. 

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Tags: snf, Skilled Therapy, Patient-Driven Payment Model, PDPM, CMS Update 2019

LUPA Management: Avoiding the 4 Letter Word

Posted on: September 27, 2019

LUPA (Low Utilization Payment Adjustment), the 4 letter word that we have all been trying to avoid under the current PPS system.  Just when we thought we had it under control, CMS has decided to add a whole other level of complexity with PDGM.  The challenge to managing LUPA’s under PDGM will be two-fold; a “moving LUPA” for each 30-day payment, and the need to meticulously manage visits within each of those 30-day windows to avoid that LUPA. 

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Tags: Home Health, PDGM, CMS Update 2019, Patient-Driven Grouping Model

Achieving Agency Growth Under PDGM

Posted on: September 11, 2019

With PDGM a mere 3 months away, agencies need to focus not only on preparing for the biggest change to Medicare reimbursement in 20 years, but also be diligent in developing their 2020 marketing plan to ensure successful growth. Home care is uniquely positioned as one of the lowest cost options for skilled care and is available to patients who adhere to the home bound status. One aspect that does not change with payment reform is the ongoing need for quality and value based care delivered in the home.

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Tags: Home Health, PDGM, Patient-Driven Grouping Model

How to Choose (and Be) a Good Strategic Partner

Posted on: August 29, 2019

Recent CMS initiatives have created an interesting dynamic in the post-acute care industry:  Providers across the care continuum are being incentivized to form strategic partnerships and hold each other accountable for delivering efficient, enhanced patient care. 

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Tags: CMS, senior living, Home Health, Skilled Therapy, Patient-Driven Payment Model, PDPM

Will You Sink or Swim in PDGM? Care Pathways to Success

Posted on: August 28, 2019

Is your current therapy company or in-house therapy team equipped to help you prepare, execute and succeed under PDGM?

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Tags: CMS, Home Health, PDGM, Patient-Driven Grouping Model

Considering In-House Therapy? The Good, the Bad, and the Ugly

Posted on: August 15, 2019

As one of the first therapy companies to specialize in management services for in-house therapy programs, HealthPRO® Heritage was founded 20+ years ago and has since evolved into one of the most prominent, privately-owned therapy AND consulting firms in the country. This article offers SNF providers the benefit of our years’ experience and insight into how PDPM will certainly pressure-test delivery of rehab services – especially for in-house therapy programs.

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Tags: Skilled Therapy, Patient-Driven Payment Model, PDPM, CMS Update 2019

Intake Isn't Just Intake Anymore: Important Steps in PDGM Referral Processing

Posted on: August 13, 2019

Five, ten, and fifteen years ago, the intake department was just that: Intake. Taking in the information given to them from a referral source and performing the necessary data entry. As we prepare for the new world of PDGM, the Intake Department will be an integral part of the team.

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Tags: Home Health, PDGM, Patient-Driven Grouping Model

No Shortcuts: Process ReDesign for PDPM is a Must!

Posted on: August 8, 2019

The industry agrees:  With the roll out of such a complex new system like PDPM…there are several risks and so much at stake.  As such, here’s a question worth asking:

Does your facility have a proactive PDPM compliance, or verification process in place? If yes…good by you! But even a solid, well-functioning version of today’s process MUST be retooled in preparation for PDPM & Beyond!

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Tags: skilled nursing facility, Compliance, PDPM, QAC

The Only Constant is Change...and Documentation

Posted on: August 7, 2019

The Home Health industry continues to evolve: the updated Conditions of Participation (CoPs) in 2018, then OASIS-D and the Review Choice Demonstration (RCD) in 2019, and now the Patient-Driven Groupings Model scheduled for 2020, just to name a few!  Change can be exhausting, so it is comforting to know that some things aren’t changing...like documentation!

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Tags: Home Health, PDGM, CMS Update 2019

CMS' Final Rule is Here!

Posted on: July 31, 2019

Tuesday was the day! On July 30, CMS released the FY 2020 Final Rule for Medicare payment rates and quality programs. This is the moment we have all been waiting for. PDPM is 9 short weeks away, and the industry finally has clarifications RE: the new payment model.

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Tags: The Final Rule, Patient-Driven Payment Model, PDPM, CMS Update 2019