Post-Acute Care Services

We serve skilled nursing facilities, swing bed hospital units, law firms representing providers, assisted living centers, home health agencies, and hospices to help them gain operational efficiency, enhance revenue, and mitigate risks. Combining our accounting and consulting expertise with team backgrounds in long-term care (including reimbursement, clinical, and pharmacy) uniquely positions us in the market to serve all of your financial and operational consulting needs.

Services Overview

Clinical/Reimbursement

  • OIG approved Independent Review Organization (IRO)
  • Informal Dispute Resolutions
  • Abatement of Immediate Jeopardies/Developing AOC
  • Development/Implementation of Plan of Corrections
  • RAI/MDS process
  • PDPM training
  • Medical record compliance audits
  • SWOT Transitional Analysis (in preparation for new payment programs)
  • SWOT Clinical review/education/implementation
  • UB-04 consolidated billing, part A & B
  • CDI/ICD 10 training
  • QRP/VBP training
  • RAC audit preparedness
  • Mock Survey
  • Medication Administration Observation
  • Requirements of Participation (RoP) education
  • Customized clinical education, training, strategic planning
  • Swing bed hospital conditions of participation (CoP), customized education
  • Clinical Risk mitigation/CDI
  • Developing Effective Action Plans
  • Professional Legal Nurse Consulting (LTC)
  • QAPI education/training/implementation
  • Professional customized clinical educational service offerings
  • Clinical support and guidance with clinical consulting
  • Clinical operational efficiency improvement
  • CEU’s may be offered with educational presentations upon request

Pharmacy Services

  • Pharmacy pricing validation and cost reduction opportunity review
  • Pharmacy medication cart and storage room review and inspection
  • Medication waste reduction initiatives
  • Antibiotic stewardship program assessment
  • Policy and procedure review for optimizing and reducing opioid use
  • Minimizing fall risks through medication management programs

Accounting Services

  • Audit
  • Benchmarking
  • Cost report preparations
  • PPS and managed care education
  • Team approach to due diligence for acquisitions and mergers to include clinical and operational reviews
  • Intergovernmental transfer agreements
  • Tax returns and tax planning

Network Operations

  • Identify care partners using cost and quality metrics
  • Produce network claims and quality reports
  • Ongoing management to reduce cost and produce outcomes
  • Management inclusion and exclusion of preferred providers
  • Develop education program internally and externally for best placement of patient for level of care needed
  • Pharmacy program analysis

Readmission Reduction

  • Identify care partners using cost and quality metrics
  • Produce network claims and quality reports
  • Ongoing management to reduce cost and produce outcomes
  • Management inclusion and exclusion of preferred providers
  • Develop education program internally and externally for best placement of patient for level of care needed
  • Pharmacy program analysis
PAC Billing Codes

Denied Claims due to Billing Codes

A new issue is affecting some inpatient hospital and Skilled Nursing Facility (SNF) claims when an interrupted stay is billed at the end of the month. The system incorrectly assigns edits U5601-U5608 (overlapping a hospital claim). If you billed the interrupted stay correctly, and your claim is rejected, modify your billing so the claim spans […]

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CMS ends staffing waiver

CMS has ended the waiver of Staffing Data

Effective Immediately: the CMS has made updates to the Nursing Home Compare Website and Five Star Quality Rating System. Under the COVID-19 Emergency Declaration Blanket waiver, CMS waived the requirements for submitting staffing data to the Payroll-Based Journal database (PBJ). CMS is ending this waiver and facilities are required to resume submission of staffing data […]

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SNF Proposed Payment and Policy Changes for FY 2021

SNF Proposed Payment and Policy Changes for FY 2021

On April 10, CMS issued a proposed rule [CMS-1737-P] for FY 2021 that updates the Medicare payment rates and the quality programs for Skilled Nursing Facilities (SNFs). This proposed rule is part of CMS’s continuing efforts to strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care […]

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Connect with our team.

To learn more about our services and areas of expertise, send us a message.