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Not So Fast: The Truth About Those Initial PDPM Payment Boosts

By Prime Care Tech Marketing on Thu, Feb 13, 2020 @ 04:17 PM

Traditionally, additional revenue is a good thing. However, things aren’t always what they seem. Shortly after the Patient Driven Payment Model was implemented, skilled nursing facilities and nursing homes started reporting boosts in reimbursement. But many analysts are urging providers not to get used to the increased payments.

“The illusion of PDPM budget-neutrality is already over,” writes Michael Zimmet, President and CEO of Zimmet Healthcare Services Group. Zimmet contributed his thoughts on the future of skilled nursing for a January 2020 article in Skilled Nursing News. “We should enjoy the largesse while it lasts,” he continues, “but [we should] prepare for the inevitable correction long before 2020’s back-to-school sales are over.”

But why is PDPM leading to payment boosts in the first place? And what does that mean for future reimbursements?

When New Patients Aren’t New Patients

When the Patient Driven Payment Model was rolled out, most skilled nursing facilities and nursing homes saw an immediate boost in reimbursements. This was due to CMS counting all residents of a care community as new admissions, regardless of how long they had been already been there. Understandably, this rate boost won’t be replicated in the future.

Be Prepared for Inevitable Rate Adjustments

It seems that 9 is a magic number. According to Zimmet Healthcare Services Group, nine out of ten skilled nursing facilities saw a reimbursement boost after PDPM went into effect. On average, SNFs saw an increase of 9 percent or more in Medicare reimbursement. Because the model was designed to be revenue-neutral, industry experts expect that reimbursement rates will be recalculated soon.

The failed attempt at revenue-neutrality has many concerned that CMS could claw back reimbursements or adjust future payments to recoup losses. After all, the goal of model was to cut back on what it saw as inappropriate spending on therapy services that may not be needed.

Length of Stay Issues: When More Can Still Be Less

While per-diem rates are on the rise, the average length of stay is on the decline. This effectively erases any potential boost from per-day payment increases. In fact, CMS data shows that fee-for-service days have decreased by over 17 percent since 2010. Covered days per skilled nursing admission have also dropped by just over 7 percent.

As patient care and outcomes improve, lengths of stay are going to naturally decrease. Unfortunately, this also means that reimbursement will, as well.

What You Can Do to Protect Your Community

The best way to optimize your Medicare reimbursements is to check and double-check your data. Make sure that every diagnosis is captured and reported accurately so you don’t leave money on the table. Inaccurate recording can lead to missed Medicare payment opportunities.


PDPM was designed to be revenue-neutral. CMS didn’t plan to spend any more under this model than it did before. But that’s exactly what is happening, and we don’t expect it to keep happening for long.

 

Topics: Skilled Nursing Facility, Medicare, PDPM, length of stay, reimbursements

Health Dimensions Group Adopts primeVIEW Performance Dashboard to Advance Skilled Nursing and Senior Living Operations

By Prime Care Tech Marketing on Tue, Feb 11, 2020 @ 11:47 AM

Access to more timely data drives decisions to improve productivity and quality care across 30 managed care communities

In a press release today, Prime Care Technologies, Inc. announced that Health Dimensions Group (HDG) has adopted the primeVIEW performance dashboard to track key performance indicators across its 30 managed care communities to improve operational productivity and quality care for seniors. Additionally, the organization will use the dashboard to track the overall organization’s corporate and department performance.

The primeVIEW solution pulls data directly from electronic health records and other core information systems to offer a single analytics dashboard for post-acute leaders. One simple login delivers a multi-dimensional view of facility and organizational performance, empowering senior care providers to accelerate decisions and drive productivity using critical benchmarks, rankings and trends.

“HDG is a mission-driven organization dedicated to improving the lives of seniors,” stated Erin Hennessey CEO, Health Dimensions Group. “Through our aligned sense of mission, we are pleased to partner with Prime Care Technologies on primeVIEW to drive results across all aspects of our organization, including care communities, as well as management and consulting services. Access to more timely operational data will help shape our decisions to expand quality services and programs.”

PrimeVIEW is a cloud-based application providing post-acute operators with data-driven insights by combining census, labor, clinical, revenue cycle, patient satisfaction and Five-Star quality ratings into one decision platform.

“With the ability to drill down to the resident level or view at a corporate level, evaluating outcomes like rehospitalization rates by hospital, facility or diagnosis is easy,” noted Jim Hoey, President and CEO, Prime Care Technologies. “The primeVIEW app also syncs resident-level data with associated MDS and UDA reports, resulting in better decision making and risk mitigation strategies for our customers.”

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About Prime Care Technologies
Since 2003, Prime Care Technologies has equipped long-term care providers with flexible hosting, managed services and cloud software that evolve with industry demand. Based in Atlanta with 175 employees and 200+ healthcare/IT partnerships, its technology-driven solutions are installed in 6,500+ facilities. With deep multi-vendor interoperability expertise, including the integration of 70+ healthcare applications and 3,500+ EDI payers, Prime Care Technologies offers the leading data warehouse and claims clearinghouse in post-acute care. Learn more at http://www.primecaretech.com – We provide the tech. You provide the care.

About Health Dimensions Group
Minneapolis-based Health Dimensions Group (HDG) is a leading consulting and management firm, providing services to post-acute, long-term care, and senior living providers as well as hospitals and health systems across the nation. HDG has been serving health care organizations for more than 20 years with a firm commitment to its values of hospitality, stewardship, integrity, respect, and humor.

Identify the Threat: 3 Types of Cyber-Attacks Faced by Long-Term Care Facilities

By Prime Care Tech Marketing on Thu, Jan 16, 2020 @ 11:46 AM

Long-term care cyber-attacks are on the rise. From single-location facilities to nationwide organizations, the long-term care industry is facing cyber threats like never before.

How can you keep your long-term care organization safe from attacks? The first step is to know what you’re dealing with.

Threat Type #1: Email Phishing Attacks

By far the most common cyber-attack, email phishing is when a hacker attempts to gain protected information (usually passwords) through deceptive means. Often, victims will receive an email from a trustworthy individual or organization insisting that they click a link or fill out a form. As soon as they do, the hacker captures their information and can use it however they wish.

Phishing attacks are dangerous because they rely on human error, not software loopholes or vulnerabilities. The emails often seem credible. For instance, your staff might receive a bulk email from you stating that their passwords have been reset and that they must enter their login information to confirm. They click the link in the email, which takes them to a landing page that looks exactly like software your organization uses. Since it looks legit, they enter their information, and the attackers now have access to your systems.

Staff training and vigilance can reduce the likelihood of a successful phishing attack, but it only takes one slip-up to compromise your security.

Threat Type #2: Ransomware / Malware Attacks

Malware attacks are viruses, worms, Trojan horses, spyware, or any other type of malicious software application that a user downloads to your system. The programs themselves can do anything imaginable to your network. Some malware simply hides or deletes information. Other programs shut out users or make certain applications totally inoperable.

A malware attack becomes a ransomware attack when the hackers offer to reverse the damage they have caused for a monetary payment. Larger organizations have paid ransoms in the millions of dollars just to get their systems back online.

Malware and ransomware attacks are initiated through clicked links or file downloads. Once downloaded, the program attaches itself to different files and gets to work. Email filters and other scanning programs help, but hackers are finding more and more ways to get these files onto your organization’s computers.

Threat Type #3: Social Engineering Attacks

Phishing isn’t the only cyber-attack that relies on human error. Other types of cyber-attacks take a different, yet still personal, approach to stealing information.

Baiting is a type of cyber-attack that promises a desirable good in exchange for a user’s information. For example, a website might offer free music downloads for providing your email login and password.

Pretexting is all about the story. The attacker creates a plausible pretext for requiring the information they ask from you. For instance, they might ask for your full name, social security number, and mother’s maiden name to confirm your identity. In reality, they’re using that information to commit identity theft.


In the end, your best defense against cyber-attacks is education. Talk to your staff about cyber-attacks and make sure they understand what’s really at stake.

Beyond your employees, consider partnering with an IT provider to secure your long-term care organization’s data against cyber-attacks. For instance, Prime Care Technologies offers a highly secure Tier III+ data center as well as a separate disaster recovery center to its clients.

It’s not a question of if you’ll be the victim of a cyber-attack — it’s when. And when it happens, don’t you want to be ready?

Topics: cyber security, cyber threats, phishing, ransomware, malware

"Tech Pilots: End Strong" - Cheryl Field Cited in McKnight's

By Prime Care Tech Marketing on Tue, Dec 10, 2019 @ 12:02 PM

Technology pilots are a proven way for vendors and skilled nursing providers to try out new products before bringing them to market or full-time in-house. Cheryl Field, chief product officer for Prime Care Technologies, likens the process to buying a pair of new jeans: While they may look good in the catalog, it’s much different after trying them on.

Check out vendor-suggested tips that can help you make the right decision before taking the leap.

Read the full article here.

 

Prime Care Technologies Makes the Company List in McKnight's

By Prime Care Tech Marketing on Fri, Dec 06, 2019 @ 01:52 PM

Along with several other long-term care and tech companies, Prime Care Technologies was included in the December issue of McKnight's for its recent mobile app and predictive tools release for primeVIEW, the company's business-intelligence dashboard. The cloud-based product integrates EHR data, labor, accounts receivable, satisfaction scores, hiring and Five-Star quality ratings, and forecasts PDPM revenue opportunities.

Read the full article in McKnight's Long-Term Care News. 

 

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