Skilled Nursing Facilities (SNFs) face constant regulatory and economic challenges, all while trying to focus on quality patient care, maintaining staff and positive cash flow.
As a SNF professional, what should you focus on when the landscape is rapidly changing? In this post, we’ll examine the three most common areas causing headaches for SNFs and what you can do to alleviate challenges.
Challenge #1 Reimbursement
The SNF industry is in an unparalleled period of uncertainty with changing regulations, reimbursement models, all while facing an aging population. SNFs are experiencing less demand for services because of increased home health referrals and payment models that emphasize length of stay management.
Additionally, Medicare margins have decreased by approximately two percent from 2015 to 2016, while expenses continue to rise. SNFs are forced to operate on thin margins, and every dollar counts, whether it’s a dollar saved or a dollar earned.
It may be time to reevaluate how you handle your revenue cycle. Are you still manually working in Medicare’s system? Are you able to check eligibility quickly and in real-time? Do you have access to streamlined data to help you improve cash flow? Consider a revenue cycle management partner that can add value in these key areas:
- Patient eligibility verification
- Secure claims submission
- Claims management, including working suspense claims, denials and rejections
- Improvements through claims reporting and analytics
Another reimbursement obstacle is the shift to value-based payments and managed care, which has created a per-patient daily revenue slide as the patient mix increases. It’s also robbed SNFs of negotiating power, since managed care companies dictate their daily payments to skilled nursing providers. Partnering with managed care companies may help SNFs increase referrals and raise occupancy, thus improving revenue.
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Challenge #2 Improving the Patient Experience
Now that patient experience is tied to reimbursement and Five Star Ratings, creating the best patient experience possible is a central focus for SNFs. Organizations must be innovative and embrace technology that either enhances the patient experience or frees up time for more direct care.
SNFs that excel in patient experience often have technology systems that automate daily tasks. These systems free up time for either direct patient care or administrative duties that help improve patient care. While investing in technology solutions, like an electronic health record (EHR) or revenue cycle management (RCM) system, can be costly at first, most SNFs realize a significant return on investment.
Some SNFs have been apprehensive about joining Accountable Care Organizations (ACOs), as the fear is losing patients to home health care, which may be a cheaper alternative. However, there are SNFs that have succeeded under the ACO model. Participation in an ACO allows providers across the care spectrum to work as a team to improve patient experience and outcomes.
Challenge #3 Workforce Retention
Staffing-related costs continue to account for a majority of a SNF’s operating costs. Clinical and support staff turnover continues to plague organizations, which not only wastes valuable money, it impacts the care quality. Retention of skilled employees is an important factor to reduce turnover, which means employees must be paid fairly and have some level of job satisfaction.
Even though SNF occupancy is down, the industry will likely see a significant occupancy increase by the year 2030 as the Baby Boomer population will be aged 65 and older. This poses even deeper SNF staffing challenges for the future.
Many SNFs have taken an innovative, proactive approach to attracting and retaining staff. Much of the focus should be around proper training that addresses not just clinical processes, but communication, teamwork, and technology for process improvement. Create a culture that embraces technology like online training programs and clinical/administrative systems that streamline routine tasks like charting and billing.
As the industry advances, it’s clear artificial intelligence (AI) will play a key role. By AI, we don’t mean robots performing clinical tasks, but AI platforms that offer predictive and descriptive data analytics on everything from patient health to reimbursement trends. AI will support staff efforts to make care easier and more robust.