LTC Lens: Taking a Cue (Card) from Hospitality

Taking a Cue (Card) from Hospitality



Taking a Cue (Card) from Hospitality

Steve Shain shares the latest healthcare trends, news and policy updates. LTC Consulting Lens is a great way to keep on the pulse of the Healthcare business world, without searching further than YouTube.


It’s funny that you’re thinking I colored that…but also this à People got bored of reading so we found a better way to get your attention – VIDEO!

It’s funny that you’re thinking I colored that…but also this à Now video’s becoming boring too! So here’s a twist, a video you gotta read. This also saves us loads of $$ on subtitle creation (that was a lie)

Have you noticed this new trend in healthcare news? Healthcare facilities are starting to go high class. Providers are upping their game big time.

It’s funny that you’re thinking I colored that…but also this à From theaters and recreation to saunas and spas, or Free Wifi and Amazon Alexa. 1 boasting this: Princess Diana’s personal chef Darren McGrady. Another, a well known hotel exec: Former President of The Ritz Carlton Horst Schulze. What do you think is driving this new healthcare trend? I’ve got my own thoughts…but people are definitely bored of those! (that was not a lie)

Comment below.

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 Change Up, Mash Up

 Change Up, Mash Up



Change Up, Mash Up

Enough about skilled nursing facilities! LTC Contracting’s newest video will focus on the great work substance abuse and addiction treatment centers are doing, although there are some corrupt providers out there taking advantage.


Steve Shain: Hey everyone! We’re back, thank you for joining me again. This time we’re changing things up. We’re not talking about skilled nursing facilities. Enough with the skilled nursing facilities, we don’t want to hear about it anymore! Today we’re talking about substance abuse and addiction treatment centers. These guys are doing such wonderful work, they really are. As I meet with more and more providers, I am so impressed with the dedication that they have and the real interest they have for the rehabilitating of the people that are there and it makes me happy.

(piano music)

Know what I mean? So it makes me happy but at the same time, there are always a couple of bad apples out there. They’re there, there are some unscrupulous ones out there trying to target people that are vulnerable and therefore, if you heard about it, Google AdWords as of January of this year went global in their band on keywords that are related to this industry. So providers that have been looking out to use keywords in order to target potential clients are now unable to do this because of those unscrupulous providers out there. Which is kind of serious.

(piano music)

Know what I mean? So what do we do? We got a lot of good guys, a couple of bad guys, or not bad guys but misdirected, and therefore the industry is having it a little tough. What also is tough is that the insurance companies are still trying to get their hands around this industry because it’s blowing up with the opioid crisis and so much more need in the community for addiction treatment that they were still working with some providers out of network, some in-network and it’s really gotten complicated where their networks are becoming robust. So, we at LTC Contracting are working with the insurers and trying to identify the correct fit for the providers that work for them and at the same time working with providers and making sure they are getting the best coverage for their clients through the insurance company. So, we’re trying to work things out, it’s really very interesting and yes, as I mentioned, it’s a little serious. (piano music) But also a little happy.

Anyways, thank you so much for watching. I hope you enjoyed this. Please give me feedback, give me some feedback, I need some feedback. Tell me how it is, tell me if you’d like anything else changed so we can make this better for you.

Wanted: New Medicare Slogan

Wanted: New Medicare Slogan



Steve Shain: Hey everybody, welcome back. So, I got a lot of shout outs today, I’m just giving you a heads up right at the beginning. A lot of people to thank for this video, just because they had some good ideas and I’m trying to implement them into today’s video. First of all, thank you to Jerry Freedman for recommending that we put the text down at the bottom for those people who are not listening but are actually just reading along with the video. Honestly, I don’t really understand why you wouldn’t blast the volume on really loud so everybody could enjoy what we have to say here but I guess it’s your prerogative. For you guys that are not listening, you got the text here on the bottom. Thank you, Jerry.

Second shout out goes to Yehuda Davis, he mentioned to us a while back about this change and it’s actually going into place. So thanks Yehuda for this tip-off, which I’d like to share with everybody else as well if you did not already hear. New York Medicaid used to obviously be working with MLTC plans – managed long-term care plans – so the managed long-term care plans were covering the long-term care patients in the skilled nursing facilities. What’s happening now is that a rule has gone into place that the MLTC plans only need to extend for three months – 90 days – after that a long-term care patient can disenroll from the MLTC plan and revert back to straight Medicaid. That’s right, they can go back to straight Medicaid, providers will be billing Medicaid directly, communicating with Medicaid directly and the MLTC plans will no longer be covering the resident after three months in the facility. This is actually great news for everyone. It’s good for the providers because providers don’t need to work through a middleman like MLTC. They can work directly with Medicaid. It’s also great for the MTLC plans in a way because they have members of the insurance as a whole and the more complex ones are the ones that are constantly institutionalized, so now that those members are being disenrolled, it kind of makes their job easier for the members that they do need to care for. So it sounds like a real win-win but I’m not sure how Medicaid feels about this, but you know, it’s going back to how it used to be so I don’t really see a problem with that either.

Now there’s one thing that I’m not sure everybody does know about and that is Medicare’s soul-searching that they’ve been doing recently. Medicare was established in 1965. At the time, the concept for what Medicare was there for was to provide care for coverage that was “primarily health-related.” That was their tag line, anything that’s “primarily health-related” is what Medicare covered for Medicare recipients. Now, that was a long time ago. What seems to be happening now is that the folks at Medicare got together and they’re scratching their heads and they’re like “This doesn’t seem right. If our coverage is for ‘primarily health-related’ care, we should be covering more.” And that’s exactly what they’re looking into. And at the same time the Medicare Advantage Plans, which is the insurance plans, that are replacing Medicare, are looking into this as well. Because if the coverage should be “primarily health-related,” it should really be expanded to more services and more kinds of healthcare settings. So to give you some examples of things that are being speculated; nutritious food, transportation to health-related services, independent living, assisted living, adult daycare, other healthcare settings are now considered for Medicare reimbursement. This is an extremely exciting idea for healthcare providers, this is something that they plan on putting in place in 2019, which is not too far away. We’ve actually been in talks with a lot of the national healthcare insurers that are working with us to try to figure out exactly how they can provide services to Medicare members and in what avenues they can now cover. So hold on tight for 2019, we’re expecting that some of these services in some of these avenues will be covered, but hold on tight, it’s not determined yet.

So for the last shout out, I want to give a shout out to Seema Verma at CMS. Your tagline is “primarily health-related” for Medicare. Come on, you can do better than that, I’m going to give you two suggestions and whoever is watching this please put in the comments any other suggestions you think the Medicare tagline should be. I’m sure we can do better with what they have right now. So here’s my two suggestions, they’re not awesome but it’s a start; Medicare – You Paid Into It, Now Cash Out. You like that? How about this one; Medicare – We Keep Your Providers Happy So They Can Keep You Healthy. Right? You like that one, I see you like that one. If you have anything better, put it in the comments and I’m going to take it, stuff it in an envelope, mail it to Seema Verma, and hopefully we can trademark something really quick. Of course, if you have questions, comments, or anything you think can make this video better, please let us know so we can make this better for you. Take care.

LTC Consulting Lens: Good News vs. Bad Weather

Another great clip!

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Subscribe to our You Tube Channel so you don’t miss the next one! Get in touch with us about a free evaluation!


Here we go 2018. If you’re like the most of us here, you probably were covered in snow for the first part of this month and finally just creeping out of it. Or you’re one of those people that completely avoided it – you were in beautiful weather – and you were the ones sending screenshots to your friends of the beautiful forecast you had for the rest of the week, getting us all jealous. Thank you, that was really great. No, it brightened our day, thanks!

Either way, whoever you are, it’s the beginning of the year it’s January. It’s like that fresh snow is out there, nobody stepped on it yet, we like to just keep it positive, keep that holiday cheer going a little bit longer. So for this video I’m going to give everyone some good, positive stories coming out of our industry. So hopefully it’ll brighten up your day a bit.

No. 1 – we have out of Connecticut. There was a pending budget cut for the Medicare Savings Program. Medicare Savings Program was in place by the state in order to help many Medicare beneficiaries – senior citizens – that were getting coverage for their Medicare part B premiums, for some co-pays, deductibles, a lot of out of pocket expenses. And this budget cut that was going into place was going to change the eligibility standard for this program and therefore, many, many seniors were going to lose that coverage. In the beginning of this month, the state announced that although it was going to make about $70 million in savings by going ahead with this budget cut, it was also going to make about 113,000 seniors really, really mad. That was not something that they were just able to pull off, and therefore, they announced that they were keeping everything status quo. The same eligibility standards that were in place are going to stay in place and everybody gets the coverage that they were expecting. So, I don’t know what they’re going to do about that big gap in their budget but maybe a suggestion is don’t try to pass a budget cut that has so much pushback from the whole state. But that’s just a suggestion. I thought that was great news.

Now, I saw in the New York Times this morning an interesting story about hospitals that are losing patience. Many hospitals are losing patience. And they’re running out of patientce because they’re waiting and waiting, the doctors are waiting, for medication to be coming in and the medication in not arriving. When they finally get this medication, the prices are extremely expensive, skyhigh costs, and did you get my joke by the way with the patience thing, I was talking about the other – oh you got it – ok good, I just wanted to make sure, I wanted to make sure you got my joke. The medication is very hard to get and when they finally get it it’s really expensive. They said you know what, let’s pull a page out of the Uber playbook and let’s just cut out the big guys and go straight to the source. So that’s what they did, they got about 300 hospitals together, they went straight to the manufacturers of the medication and they said we want to get these generic medications on our own at a very reasonable cost so we can distribute it to our patients. And that’s exactly what they’re doing. The FDA is actually backing this as well, and it’s going to make available as this thing moves ahead, medication, much more medication, at much more reasonable pricing, which is something that’s really great news for all the other news that we’re hearing about medication prices being sky high and just ridiculous.

Lastly, we have out of Syracuse, New York, actually an LTC client that took over a healthcare facility Bishop Healthcare, Mr. Ed Farbenblum. When they came in, one of the first things they did was announce that they were committing to a $1.5 million salary raise for the nurses and the nurse’s aides in the facility. It made the local news, it was really exciting, and obviously getting started off on the right foot by having the staff happy and appreciative and that spreads to the rest of the facility. So great job Ed and we wish you the best of luck.

And I hope that these stories will keep you smiling, even if your friend sends you one of these-while you’re stuck under the snow, you’ll still be good to go. So until next time, thank you so much for watching and keep warm!


Trump Administration Eases Nursing Home Fines and Gives Long Awaited Relief to industry

The nursing home industry is reaping the benefits of a decision made by the Trump administration to ease up on the use of fines against nursing homes.The policy change will reverse the Obama administration’s policy of fining nursing homes for harming residents or placing them in grave risk of injury, part of President Trump’s resolve to reduce government’s role in federal bureaucracy, regulation and intervention on businesses.

The nursing home industry requested the reversal of these guidelines after 6,500 nursing homes were cited at least once for a serious violation since 2013, for reasons ranging from nursing home neglect to bedsores. As per the new regulations, nursing homes will see lower fines and in some cases possible exemption of amassed fines, even after a resident’s death.

Director of clinical standards and quality at the Centers for Medicare & Medicaid Services (CMS), Dr. Kate Goodrich, told the New York Times ( the past regulations were becoming a burden on health care providers.“Rather than spending quality time with their patients, the providers are spending time complying with regulations that get in the way of caring for their patients and doesn’t increase the quality of care they provide,” she explained.

Most recently, the average nursing home fine was $33,453. However, records show 531 nursing homes accumulated a combined total of $100,000 in fines. To make matters worse for the industry, in 2016 congress increased the fines to factor in years of inflation that were not previously accounted for.

The nursing home facility will now see some respite, as the new guidelines have been gradually implemented throughout the year. Some nursing homes could be protected from fines that have reached $20,965 or higher, the maximum per-instance fine.At the height of it, fines were being imposed daily to incite a quick solution.This became futile, David Gifford, the American Health Care Association’s senior vice president for quality,said, when the reason for the fine was often remedied by the time inspectors got to them.

The consequence of these fines started to weigh heavily on the nursing home and healthcare industry, which prompted The American Health Care Association’s group president, Mark Parkinson, to write in a letter to Trump in December 2016, “It is critical that we have relief.” It seems that relief has been granted.


We provide proficient billing, A/R management, collections services, and expert training to post acute providers and organizations nationwide. From help with individual claims to full contracted billing services on a large scale, LTC’s deep experience and history of performance will help you thrive. Contact us for a free consultation (

LTC Consulting Lens: That’s a Rap!

Watch this fantastic year-end clip from our Vlog!

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Subscribe to our You Tube Channel so you don’t miss the next one! Get in touch with us about a free evaluation!


Steve Shain: For the LTC Lens, we’re doing something a little different here for the end of 2017. We want to show you about the accomplishments of our companies. Over the last year it’s been pretty amazing what we’ve accomplished. I’m here at 100 Boulevard of the Americas, this is our new home. Check out our new logos, our new branding, it’s really amazing, but what’s really amazing is our brand new state-of-the-art building that we have here behind us. We’re going to take you in, and we’ll show you a little bit about what we’ve accomplished this year. You’re going to be amazed – come inside.

Here we are inside. If you take a look around, we have some of our companies. Obviously, our parent company LTC Consulting is the industry leader in A/R and full back office support for skilled nursing facilities, hitting record collections every single year. But I’d like to show you a little bit about some of our other divisions. LTC Contracting – which now is expanding, instead of only servicing skilled nursing facilities, is now doing credentialing and contracting for every single kind of healthcare-related organization. Our financial advisory services, which is brand new for 2017, is an outsourced CFO Service. Another thing that their division does is due diligence; they’ve been at the heart of hundreds of transactions this year for the skilled nursing facility industry. LTC Collections, our collections service that handles outstanding A/R, going back to as far as five years, they’ve collected this year approximately $15 million. These are amazing things about some of our new divisions at our new companies.

Now if you come with me inside – hey, Harold! Why don’t you tell us a little bit about some of the accomplishments of our companies over the last year?

Harold: To wrap up our accomplishments he turns it over to the H.P. In summary, LTC and family have expanded with an array of some brand new companies, encompassing the entire healthcare financial industry. After all, that’s our trademark: “Your bottom line is our top priority.” What we pride ourselves most on is our 400 outstanding employees. Let’s be real – we could have not done it without you. We’re so thankful, please don’t think we don’t feel grateful – we do! To our clients, both old and new, we’ve set our eyes upon an even more amazing 2018, if that’s even possible.

Steve: Wow! And don’t forget – you thought the Healthcare Summit at Metlife Stadium was amazing, check out, where our 2018 event is already underway. From all of us at LTC, have a happy new year.

Where’s My Cash?


Are you often asking yourself this question? You know your operations are well-run, you assume your facility is financially secure and profitable, yet you’re tight on cash. Why?

You’re not alone. Many owners and operators are tossing and turning at night with this very question running through their minds.

Enter LTC Financial Advisory Services, and the outsourced CFO solution.

An outsourced CFO gives you access to just the right amount of senior financial talent, providing high-level oversight and big-picture answers. Small to mid-sized companies can access an experienced financial mind at a cost that matches the needs and budget of their business, and eliminate many worries and headaches.

Through a team of experienced CPA’s, LTC obtains a thorough understanding of your financial picture. Although not physically on hand, the Financial Advisory team is in complete control of your company’s financials.

Imagine having a senior CFO on standby.

  •  Worried about next week’s call with your bank or lender?
  • Struggling with financial projects and accounting decisions?
  •  Are my expenses in line with industry averages?
  •  Going through a merger or acquisition?
  •  Need help developing an accurate budget?

Get some peace of mind! Count on LTCFAS to focus on your complete financial picture and to jump on tough calls with your banks and lenders. Free up your precious time and focus your energy on business development and growth.

The accounting world is evolving, and you need an objective CFO on the leading edge.

An outsourced CFO contributes a broad wealth of knowledge and best practices based on their experiences. This independent viewpoint brings a fresh perspective to the difficulties your staff may be too entrenched in.

Objectivity makes an outsourced CFO solution much more than a financial advisor. They can pinpoint gaps and inefficiencies in your workflow. They make suggestions for streamlined processes and systems. LTC has experience using various technology solutions and programs, giving them the knowledge to recommend and implement new technology that will best benefit your business. The Financial Advisory Services team at LTC oversees your business’ financial and accounting departments, including high-level oversight of these employees.

It just makes sense.

Outsourcing a CFO provides your business with access to just the right amount of senior talent without the full-time price tag. Outsourced CFO services are a function of the Financial Advisory Services division at LTC Consulting Services.

Learn More About Our Financial Advisory Services

LTC Consulting Lens: The 5 letter word shaking up PA

This is a another great clip from our Vlog!

Find out about the MLTSS changes in Pennsylvania from LTC Consulting’s very own Steve Shain.

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Subscribe to our You Tube Channel so you don’t miss the next one! Get in touch with us about a free evaluation!


Steve Shain: Hi, welcome back. Today I’d like to talk more about the Pennsylvania rollout of MLTSS beginning in January 2018, right around the corner for the more rural areas and then January 2019 and January 2020 for the more urban areas. MLTSS as you know stands for Medicaid’s little trick saving shekels, right? That’s what they try to do, they try to save money. No, it really stands for Managed Long-Term Services and Supports. The insurance companies that are participating are Amerihealth, PA Health and Wellness and UPMC. The eligibility process – the same as – it’s basically going to be the same as Medicaid. The application process – basically gonna be the same as Medicaid, same forms submitted. Billing process – the basics can be the same as well. There’s gonna be a little bit of a difference when somebody’s pending Medicaid in regards to their coverage, which will be Medicaid at first and then the insurance company, but overall not much is changing. So what really are you gonna see as a difference? Well, aside for a slower cash flow and a more unpredictable cash flow, probably you’re gonna see a more frequent denials on your claims and a more fragmented process from the insurance companies, especially in the beginning while they’re trying to figure things out. A couple of differences between each of these insurers that is worth noting; No. 1 is that the insurance are not requiring the custodial authorization for coverage similar to what a managed care usually would require. Amerihealth is the only one that’s asking for an authorization but they’re gonna be the ones that are going to be covering that process. They’re not gonna put that burden on the facility to make sure that authorization is in place. In contrast to maybe New Jersey for example, where all of the managed MLTSS insurers do require a custodial authorization be obtained by the facility. Another interesting difference is that the other insurance are giving basically a lock-in of your Medicaid rate for the last 4 quarters, and that goes to the extent of the contract. PA Health and Wellness is giving an option; either you can get your rate similar to those other insurers or you can base it off of CMI, your case mix index. So obviously if you feel your CMI is going to be going up or has been on a trend to go up, you probably want a contract with them on that structure that way your rate has a better chance of being higher, if on the other hand you feel that your CMI is not that awesome, you want to lock in your rate as per the last four quarters of your Medicaid rate in order to make sure that you’re getting decent reimbursement. I also wanted to point out if any of you are going to be at the AJAS conference in February, February 13, I will be there speaking on managed care for everybody at the conference. Would love to see there, if you’re going to be there awesome, if you’re not going to be there and you’d like to ask me questions about managed care or about this specific thing, MLTSS, please reach out. If you’d like to talk to your organization, please reach out, I’ve been happy to talk to you if it helps I’m there. Thank you so much for listening take care.

LTC Consulting Lens: The Healthcare Double Whammy

This is a great new clip from our Vlog!

The President was on fire last week, rolled out 2 potential plans an executive action and
change to cost share reductions. This would mean major changes in health insurance…if it goes through.

Find out about the ramifications and what to expect from LTC Consulting’s very own Steve Shain.

Our mission is to support the Long- Term Care Profession with expert billing and business office services and
enable improved financial performance for our clients.

Stay informed with LTC’s outlook on the Healthcare business world, our AR collections, receivables financing and collection of receivables processes. News, upcoming changes, and policy updates. A great way to keep on the pulse of our industry, without searching further than YouTube.

Steve Shain: Hey everyone, welcome back! So as you’ve heard, the efforts to repeal and replace
Obamacare didn’t really work out too well; they were close but no cigar. Repeal and replace didn’t have
enough votes so therefore Obamacare is back as the law of the land. Everybody said – OK, that’s how
things are going to be for now. Well that’s what we thought, but last week all of a sudden the president
drops these bombshells. An executive action that he’d like to put in place, the changes in the cost-
sharing reduction. Two bombshells in one week…Mr. President, I think you’re the one that should be
called Rocket Man. But anyways, these changes. What are these changes exactly? The executive action
is basically trying to make everyone currently in the healthcare marketplace under Obamacare to see
some much prettier options out there that they would want to join for insurance plans and insurance
coverage instead of Obamacare. These are association health plans, which are health plans that can be
run by small businesses that will allow them not to be held down by many of the state guidelines and
state minimums, they won’t even be held down by state borders. They can cross state borders and
therefore make the healthcare marketplace much more competitive, with many more options out there.
Short term plans that used to only be working for about 90 days would now be able to be extended to
about a year. So again, these plans were not ones that were held down to the same guidelines that
other health insurance plans were and therefore, they’re going to be the ones that are more appealing.
They’re going to be cheaper and they would have better options again, for the healthier population. So
with these kind of options coming up it’ll make a decision for many of the people who are currently in
the marketplace not to really jump in there. And the second thing is this cost-sharing reduction, which
basically is a subsidy that the government was giving to insurance plans in order to help keep down co-
pays, deductibles and premiums that they were offering to their members. Now that that subsidy would
go away, it would make it that much more difficult for the insurance plans to keep these plans active.
So, with open enrollment coming up in a couple of weeks, it’s something that really blows things up and
it’s interesting to see that the timing of this was so interesting how it’s played out but no need to worry
it’s probably not going to make any changes today or tomorrow, it’s probably going to be six months to
nine months before we hear anything. We’re already hearing from the attorneys general in New York
and California – yes attorneys general, that’s how you say it – but these attorney generals are already
working on a lawsuit to go against any of these decisions that they may want to put in place. So there’s
definitely going to be push back, and probably expect that there’s going to be some push back, or a lot
of push back, and therefore nothing is going to happen overnight. And as the former CEO of Aetna, Mr.
Ron Williams was quoted saying in the news that nothing drastic can really happen because there are
many federal reviews that need to go into place in order to see that this law or potential law is
something that could be feasible and something that’s not going to leave anybody high and dry without

any real feasible options so you should expect probably that it’s not going to be as drastic as the
president wants and it’s not going to be as toned down necessarily as the Democrats want, probably
something in the middle. We will be obviously following this to see how it turns out. I’ll keep you posted
and of course you have any comments or feedback let me know so we can make this better for you.

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