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SKILLED NURSING ISSUES

SKILLED NURSING ISSUES. Lori Costa Regulatory & Clinical Consultant. FEDERAL FINANCES. Medicare 2 % budget cut Therapy caps Pay for performance Accountable Care Organization agreements MedPAC recommendations. ENFORCEMENT. Federal Anticipated 10-12% cut in budget

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SKILLED NURSING ISSUES

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  1. SKILLED NURSING ISSUES Lori Costa Regulatory & Clinical Consultant

  2. FEDERAL FINANCES • Medicare 2 % budget cut • Therapy caps • Pay for performance • Accountable Care Organization agreements • MedPAC recommendations

  3. ENFORCEMENT • Federal • Anticipated 10-12% cut in budget Reduce lower value activities, target high risk areas, strengthen incentives and enforcement, target technical assistance to poorly performing providers and place a top priority on state onsite surveys. Implementation of new quality measures. Questionable QIS implementation

  4. ENFORCEMENT • MDS changes • Affordable Care Act Provisions

  5. QUALITY • Advancing excellence • Five star rating system • QIO • 10th scope of work • Patient Safety Collaborative • Identify and characterized all California based initiatives in Partnership for Patient areas • Improve medications safety across transitions.

  6. STATE FINANCES • 2011-2012 Budget • 2012-2013 Governors budget • Funds to restore 10% cut • Funds to implement Quality & Accountability Program • No COLA increase for 2011-12 or 2012-13 • Extends rate methodology permanently • Extends QAF permanently

  7. STATE FINANCES • Dual eligibles demonstration • Value-based purchasing trailer bill

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