Welcome to the HealthPRO® Heritage Blog

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.

Read More

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

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!

Read More

Tags: skilled nursing facility, Compliance, PDPM, QAC

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.

Read More

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

The Bright Future of Rehab Includes Student Clinical Affiliations!

Posted on: July 11, 2019

Among the many important decisions related to the PDPM transition is the question of whether SNFs and their rehab partners should accept students for clinical affiliations.  As strategy consultants and leaders in therapy, HealthPRO® Heritage offers this guidance: 

Read More

Tags: PDPM, CMS Update 2019

(Re)Consider the Optimal Therapy Model for PDPM & Beyond!

Posted on: July 1, 2019

Decisions. Decisions. Since the industry began wrapping their heads around RCS-1 two+ years ago, SNFs continue to weigh the pros and cons of retaining in-house therapy vs. an outsourced model. Questions arise: What does payment reform mean for SNFs with their own program? Is there a financial or operational advantage to transitioning from full service to in-house or a “managed” in-house model?

Read More

Tags: PDPM, CMS Update 2019, Therapy Model

HealthPRO Heritage Reports: RAI Manual Updates

Posted on: June 10, 2019

The 2019 RAI Manual is here! The SNF world has been on the edge of their seat in anticipation of how the changes would impact the interdisciplinary team and coding of the MDS assessment.  CMS’ message is clear:  No longer is the manual only for MDS coordinators!  More emphasis on clinical characteristic coding for PDPM case mix group assignment means all disciplines must participate in completion of the MDS. The MDS item sets have been adapted for this shift in the Medicare classification system, requiring significant updates in the go to manual for RAI process.

Read More

Tags: PDPM, CMS Update 2019, RAI

Struggling to Define Success Beyond PDPM? Sustaining QMs is the Solution!

Posted on: May 30, 2019

SNFs have been bombarded with changes to many key performance indicators – such as Quality Measures, Five Star Ratings and the Quality Reporting Program – and will be expected to sustain and even grow quality improvements over time.  Read up on all the new changes here. (And have you heard the latest: CMS recently implemented a process whereby the QM thresholds will increase by 50% of the average rate of improvement in QM scores.)  

Based on these obvious smoke signals from CMS, the industry pundits foresee: Quality Measures just might be CMS’s way of monitoring for appropriate levels of skilled rehabilitation services after the October 1 transition to PDPM.   

In light of this prediction, consider your facility’s QM performance in highly monitored areas – such as skin integrity, falls, ADL performance, weight loss, functional mobility, pain, etc. 

Ask:  Are these areas recurrent concerns for your SNF?  

If so, HealthPRO® Heritage advises:

Read More

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

Restorative Nursing Under PDPM: Looking for Answers?

Posted on: May 16, 2019

We can all agree: the value of a solid, efficient Restorative Nursing Program for SNFs should not be underestimated!

There’s a lot of BUZZ in the industry about increasing restorative programming in preparation for PDPM. Many SNFs have Restorative Nursing programs. Many do not. Some have a program, but it doesn’t function the way it should.

Here’s the stone cold truth…
Restorative Nursing may (or may not) make sense for your organization. Hear us out. 

Read More

Tags: Patient-Driven Payment Model, PDPM, CMI, Case Mix Index, Restorative Nursing, Restorative Nursing Program

PDPM: Outcomes, Outcomes, Outcomes

Posted on: May 2, 2019

Success under PDPM – and beyond!  in large part, boils down to this: A SNF’s ability to build positive, sustainable outcomes. As such, HealthPRO® Heritage advises providers to focus on the strategies, processes, and initiatives that will support consistent delivery on exceptional clinical and performance outcomes.  

Read More

Tags: Rules of Participation, PDPM, CMS Update 2019

SNF Proposed Payment Updates

Posted on: April 25, 2019

Today, CMS published the FY 2020 Skilled Nursing Facility Proposed Payment System (SNF PPS) in the federal register. It contains the SNF PPS payment update is 2.5% for FY 2020, which is an increase in payments of $887 million, compared to FY 2019.  This estimated increase is attributable to a 3.0 percent market basket increase factor with a 0.5 percentage point reduction for multi-factor productivity adjustment.

Read More

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