Last week, Language Fundamentals attended the annual Zimmet Healthcare Services Group conference, “Lights, Camera, Reimbursement.”  Nearly 1,300 stakeholders from the long-term care community gathered to hear the latest industry information following the release of the FY 2023 Final Rule.

Among the topics covered during the 2-day convention were:

  1. Data Inaccuracy – Marc Zimmet eloquently described the industry’s challenge with fractured data and the inherent difficulty of making logical comparisons of facility performance. He pointed out that SNFs report data to CMS through the UB-04, MDS, and cost reports.   Standardizing the data has become so difficult that it has reached a dangerous level for SNFs.
  2. SNF Occupancy – While there have been reports about SNF census increasing in some areas, Marc Zimmet educated us about “relative occupancy.”  Because many SNF beds have been decertified or taken offline, the occupancy percentage is not as high as reported. Therefore, the recovery of SNF census still has a way to go.  Many SNFs are unable to take the volume of admissions they would like due to staffing constraints.
  3. PDPM – Last year, significant PDPM reimbursement cuts were expected for FY 2023.  The recent Final Rule announced a 2.7% increase effective 10/1/2022.  While this is a pleasant surprise, cuts are expected over future years. When digging into the PDPM numbers, Vince Fedele and Mike Sciacca illustrated the performance of high-performing SNFs, average, and low.  They still feel considerable opportunity remains in the areas of capturing & coding and implementing systems that lead to higher & more accurate reimbursement.
  4. SLP Component – SLP component rates stabilized with a wide disparity between the top and low-performing SNFs. Fedele stated “those who get it, get it.  Those who don’t, don’t..”   Top performers average $52.42 per day while low performers lag behind by $11ppd.
  5. Managed Care- Managed Care continues to be a challenge to SNF providers due to lower payments, administrative challenges, and case management.  There is also a lack of standardized data because managed care organizations keep their information close to the vest. SNFs have very little leverage in negotiating for higher rates unless the plan needs more providers in a given county.
  6. 5-Star System – The 5-star system has many flaws and has become clear to most that it is not always reflective of the best facilities.

Day 2 of the conference brought some excellent insight into the industry’s mounting staffing crisis, dealing with burnout, and nurturing caregivers along the way.

The Zimmet team and their talented group of guest speakers did a fantastic job teaching us about SNF operational topics above and beyond reimbursement alone.