SNF Survey Stress

SNF Survey Stress



SNF Survey Stress


Hey everyone, how are you. Welcome back.

So last week I was scrolling through my news feed.

Looking through whatever happens in the news that day, and I pass by the terrible, unfortunate incident that happened at Virginia Beach on Friday, where there was a shooting.

12 people were killed, others were injured, and the whole community is mourning.

It’s a really terrible story, but what I’m embarrassed to say is that I found my self beginning to scroll past the story, and then I caught myself..

How can I pass by a story that’s so devastating like this, and so many people are terribly hurt, and so many families are mourning, and I’m just gonna scroll past it?

And it hit me that I’m not even sure what I’m sadder about, the fact that this terrible incident happened, or the fact that us all over are inundated with so much of these terrible stories happening one after another after another.

That we’re kind of sadly numb to it, and it doesn’t even catch our attention anymore that I was just gonna scroll right past it.

So firstly, our thoughts and prayers are with the Virginia Beach community, the victims and family members.

But what I want to talk about is a recognition in the health care community.

That this is something that is traumatic, and something that you’re seeing more and more victims or patients that are suffering from this trauma, induced by such events like this.

And because of that CMS is putting into place in November of this upcoming year, new regulations that everyone should be aware of that are going to address to make sure that patients who may have had traumatic events in their life, may be suffering from PTSD or something similar, will be monitored and there’ll be steps put in place to make sure that they don’t trigger another traumatic event to happen to them at any point.

So to add to this trauma, now administrators are gonna start getting traumatized by the fact that they need to stress out before survey to make sure they have the right care plans in place, the right policy in place, to identify people that may be prone to something like this, or be subject to getting into another event that they couldn’t have caught.

So, for all the administrators out there, make that you understand about what these requirements are in order not to get this F tag at survey.

And for us as a company, it’s interesting to us because it’s kind of a way we’re seeing a link between skilled nursing post-acute care providers, behavioral health, and even substance abuse treatment which are all areas which LTC contracting services.

And the reason why that’s happening is because very often, people that do suffer from these traumatic events and have PTSD, do suffer from behavioral or mental health issues as well as turning to substance abuse, and therefore need the substance abuse treatment.

So, we’re seeing a lot of policies and requirements that are similar for each of these provider types, but for you administrators out there, make sure that it’s early enough before November.

Make sure you’re prepared, and make sure you know what needs to be in place so you don’t suffer from any traumatic events by your survey.

But if you do, hopefully your staff will put a care plan in place to make sure it never happens again.

Thank you so much for watching and I hope you have a great week, take care.

Foresight is 2020

Foresight is 2020



Foresight is 2020

Ok, who is ready to play a game? Are you ready? Here we go! It’s going to move quick so hold on tight.

We’re going to show you pictures. I’m going to show you picture after picture after picture and you have to choose if they fall under Category A or Category B.

Pretty simple, right?

Category A and Category B are as follows.

Category A are things that are primarily health related. That means they have a lot to do with your health.

Category B are things that improve health or functions, so they have to do with health but they’re not primarily health related.

So, again, A has a lot to do with health and B, eh, not so much.

Ok? We’re going to do this quick like a lightning round. I’m going to show you the picture and you’re going to choose A or B. Here we go!

The first picture is adult daycares. A or B? It’s A, good!

Companionship: someone that needs help so they’re not lonely or getting depressed. B, good!

A grab bar: when someone’s in the shower and they don’t want to fall down or they need help getting up. A, good!

Next, shampooing your carpets if someone has asthma and they can’t breathe and this will help them breathe better. A or B? B, very good!

How about transportation like Uber Health? Transportation to a medical visit. A.

How about the next one? Transportation not for medical needs? B. I see you’re catching on.

You’re doing well. One more!

Pest control? A or B? If you answered B you got it right.

Now, let’s show you all of your choices. Here are the “A’s” and here are the “B’s.”

Why in the world am I telling you this? First of all, so you can see that you’re good at this game. We should play this more often!

But also because there’s a very big difference between Category A and Category B.

Category A is what CMS told insurance companies they can roll out for 2019 as benefits to their premium paying members.

Category B are new benefits that CMS said can be rolled out by insurers for their membership in 2020.

So, this is going to be another thing we’re going to see changing in 2020, is that they loosened the shackles, they loosened the terms of what should be included by insurers.

So, as the competition gets greater, and as the market gets more interesting, you’re going to see insurers offering more Category B stuff.

These are just some of the examples, they can really choose anything that improves health or function. Let’s see what happens and thanks for playing! See you next time.

CMS and Seema

CMS and Seema



Hey everyone and welcome back!

I want to talk to you about something that is going on now that is so impressive: we have a government-pending shutdown.

Is it going to shut down? Is it not?

Is it going to stay open? We don’t know.

But that’s why it’s so impressive when you have a bipartisan backing on something going to The White House.

Everybody agrees to this. Yes, everybody is agreeing to the concepts that were put forth by CMS in December of this past year by Seema Verma.

The suggestion was to expand Medicare Advantage plans and push forward for value-based insurance design as much as possible.

Value-based insurance design, as we’ve discussed in the past, is something that’ll keep the cost down for the membership and the insurer by making sure that the value is at the highest level possible for the care that is provided.

So, I just want to point out to you all, that we will see a big expansion from the insurance companies on Medicare Advantage and of course, more membership on Medicare Advantage plans.

You probably already knew this because you saw our preview 2019 video where we discussed this would be coming down the pipe.

So, yes, this is something that was suggested by Seema Verma and, by the way, Seema, what does a guy have to do to get connected with somebody on LinkedIn?

I put the request out there, I keep trying to get connected. Seema, do you see me?

Another thing that I want to point out, back to business, is Any Willing Provider.

This is something that is in certain areas of the marketplace where, if you’re a willing provider and you want to participate with a certain health plan you are able to.

They are also suggesting that this gets scaled back because it is putting the insurers a little bit in a corner.

By making them have to bring providers in network, that takes away their leverage. Therefore, in order to keep their cost down, they end up charging the membership more money, which nobody likes.

So, they did put in a suggestion regarding the Any Willing Provider to try to scale that back down. But, remember, for the Medicare Advantage plans, yes, you probably will see a big expansion of that.

So, while the government is deciding if they should shut down or not, you just make sure that your business doesn’t shut down. That’s what you’ve got to do and they’ll handle that part.

If you have any questions, comments, or suggestions, please let us know so that we can make this better for you.