Presentation is loading. Please wait.

Presentation is loading. Please wait.

REIMBURSEMENT ISSUES RELATED TO SWING BED CONVERSIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524.

Published byBetty Millicent Rice Modified over 9 years ago

Similar presentations

Presentation on theme: "REIMBURSEMENT ISSUES RELATED TO SWING BED CONVERSIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524."— Presentation transcript:

1 REIMBURSEMENT ISSUES RELATED TO SWING BED CONVERSIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

2 SWING BED CONVERSIONS ONLY WORK FOR CRITICAL ACCESS HOSPITALS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

3 CAH REIMBURSEMENT SWING BED VS SKILLED NURSING HOME SWING BED – MEDICARE PAYS FULL COST BASED REIMBURSEMENT SKILLED NURSING HOME – MEDICARE PAYS RUG BASIS OF REIMBURSEMENT MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

4 HOWEVER MEDICARE SKILLED NH CARE REIMBURSEMENT IS NOT THE ISSUE WITH SWING BED CONVERSIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

5 THE ISSUE WITH SWING BED CONVERSIONS IS CONVERTING UNREIMBURSED COST TO REIMBURSABLE COST MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

6 WHAT IS A SWING BED? A SWING BED IS A BED THAT CAN BE USED FOR: –OBSERVATION BED –ACUTE CARE –SKILLED NURSING HOME CARE –INTERMEDIATE NURSING HOME CARE MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

7 SWING BEDS DO NOT HAVE TO BE USED FOR ALL FOUR PURPOSES ALL THE TIME MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

8 CAN SWING BEDS BE USED FOR SHORT TERM CARE? ABSOLUTELY YOU HAVE ALL USED SWING BEDS FOR SHORT TERM CARE MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

9 CAN SWING BEDS BE USED FOR LONG-TERM NH CARE? ABSOLUTELY MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

10 CAN THE HOSPITAL SET ASIDE BEDS? OBSERVATION BED YES ACUTE CARE YES SHORT TERM SWING BED SKILLED NH CARE YES SHORT TERM SWING BED INTERMEDIATE CAREYES MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

11 WHY WOULD I WANT TO CONVERT LONG-TERM BEDS TO SWING? MORE MEDICARE ACUTE CARE REIMBURSEMENT MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

12 THE KEY TO SWING BED CONVERSIONS IS MEDICARE’S HANDLING OF NON-MEDICARE SWING BED DAYS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

13 THE FOLLOWING IS A SIMPLE EXAMPLE MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

14

15

16 WHO QUALIFIES DAYTONYES PORT ANGELESNON-CAH SOAP LAKENON-CAH NEWPORTYES EPHRATAALREADY AT MAX PROSSERYES FORKSYES ODESSAYES POMEROYYES TONASKETYES REPUBLICYES QUINCYYES DAVENPORTYES GRAND COULEEYES RENTONNON-CAH MORTONYES MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

17 HOW MANY BEDS SHOULD BE CONVERTED? A CRITICAL ACCESS HOSPITAL IS LIMITED TO 25 ACUTE CARE AND SWING BEDS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

18 TO DETERMINE HOW MANY NH BEDS SHOULD BE CONVERTED SEVERAL QUESTIONS MUST BE ANSWERED? MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

19 HOW MANY ACUTE CARE BEDS DO YOU NEED TO MEET THE CURRENT DEMAND? KEEP IN MIND THAT BEDS USED STRICTLY FOR OUTPATIENT SERVICES DO NOT COUNT AS PART OF THE 25 BED LIMIT MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

20 HOW MANY SWING BEDS DO YOU ALREADY HAVE? MOST CRITICAL ACCESS HOSPITALS ALREADY HAVE EITHER 5 OR 6 SWING BEDS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

21 THE MAXIMUM SWING BED CONVERSION IS 25 BEDS LESS NEEDED ACUTE CARE BEDS LESS EXISTING SWING BEDS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

22 DO YOU WANT TO CONVERT THE MAXIMUM? LARGE NURSING HOMESYES SMALL NURSING HOMES ? MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

23 FOR FACILITIES WITH SMALL NURSING HOMES A PARTIAL CONVERSION IS RECOMMENDED CONVERT ALL NURSING HOME BEDS AND PRO SHARE ELIGIBILITY MAY BE ELIMINATED MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

24 SMALL NURSING HOMES PARTIAL CONVERSION WEIGH GAIN FROM CONVERSION OF SOME NURSING HOME BEDS WITH AFFECT ON FUTURE PRO SHARE FUNDING MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

25 PRO SHARE RELATED QUESTIONS FOR SMALL NH IS PRO SHARE GOING TO CINTINUE? NO - CONVERT ALL BEDS YES – ADDITIONAL INFORMATION NEEDED MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

26 PRO SHARE WILL CONTINUE ADDITIONAL QUESTIONS FOR SMALL NH HOW MUCH WILL PRO SHARE BE? HOW WILL MY SHARE OF PRO SHARE BE DETERMINED EQUAL DISTRIBUTION TO ALL DISTRIBUTION BASED ON MEDICAID NH DAYS DISTRIBUTION BASED ON MEDICAID LOSS OTHER METHOD MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

27 PRO SHARE WILL CONTINUE DISTRIBUTION EQUAL SMALL NH SHOULD HAVE AT LEAST ONE BED MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

28 PRO SHARE WILL CONTINUE DISTRIBUTION BASED ON MEDICAID DAYS KEEP NH BEDS NEEDED TO ACCOMPDATE MEDICAID NH PATIENTS CONVERT THE REST TO SWING MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

29 PRO SHARE WILL CONTINUE DISTRIBUTION BASED ON MEDICAID LOSS KEEP NH BEDS NEEDED TO ACCOMPDATE MEDICAID NH PATIENTS CONVERT THE REST TO SWING MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

30 PRO SHARE WILL CONTINUE PUT PRIVATE PAY AND MEDICARE PATIENTS IN SWING BEDS KEEP MEDICAID PATIENTS IN NURSING HOME MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

31 WHEN PRO SHARE CHANGES REEVALUATE OPTIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

32 CAPITAL PROJECTS WHAT HAPPENS WHEN YOU CONVERT NH BEDS TO SWING BEDS? BEFORE CONVERSION MEDICARE AND MEDICAID PAY FOR THEIR SHARE OF HOSPITAL CAPITAL COST BEFORE CONVERSION VERY LITTLE HELP RECEIVED FROM NH SIDE MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

33 CAPITAL PROJECTS WHAT HAPPENS WHEN YOU CONVERT NH BEDS TO SWING BEDS? AFTER CONVERSION MEDICARE AND MEDICAID PAY FOR THEIR SHARE OF HOSPITAL CAPITAL COST WHICH INCLUDE SWING BED COSTS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

34 CAPITAL PROJECTS BEFORE CONVERSION MEDICARE AND MEDICAID PAY FOR 35% OF CAPTIAL PROJECT AFTER CONVERSION MEDICARE AND MEDICAID PAY FOR 55% OF CAPTIAL PROJECT MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

35 RECOMMENDATIONS DAYTONNO DATA PROVIDED PORT ANGELESNON-CAH SOAP LAKENON-CAH NEWPORTPARTIAL CONVERSION – NO AFFECT ON PRO SHARE EPHRATAALREADY AT MAX PROSSERLIMITED CONVERSION – MAXIMIZE PROSHARE FORKSNO DATA PROVIDED (CONVERSION IN PROCESS) ODESSANO DATA PROVIDED POMEROYPARTIAL CONVERSION – NO AFFECT ON PRO SHARE TONASKETPARTIAL CONVERSION – NO AFFECT ON PRO SHARE REPUBLICLIMITED CONVERSION – MAXIMIZE PROSHARE QUINCYLIMITED CONVERSION – MAXIMIZE PROSHARE DAVENPORTNO DATA PROVIDED GRAND COULEELIMITED CONVERSION – MAXIMIZE PROSHARE RENTONNON-CAH MORTONLIMITED CONVERSION – MAXIMIZE PROSHARE MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524

36 MICHAEL R. BELL & COMPANY CERTIFIED PUBLIC ACCOUNTANTS & CONSULTANTS 12 E. ROWAN STE. 2 SPOKANE, WA 99207 (509)489-4524 EMAIL:bellcpa@AOL.COM ANY QUESTIONS?

Download ppt "REIMBURSEMENT ISSUES RELATED TO SWING BED CONVERSIONS MICHAEL R. BELL & COMPANY 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524."

Similar presentations

1.03 Healthcare Finances.

1.03 Healthcare Finances.
Designing a Long Term Care Policy. The Very First Thing To Do Personal Health History –Age –Health of self, parents, & siblings –Marital status List of.

Designing a Long Term Care Policy. The Very First Thing To Do Personal Health History –Age –Health of self, parents, & siblings –Marital status List of.
NATIONAL HEALTH SERVICE CORPS 1. AGENDA 2 Overview of the National Health Service Corps Loan repayment program Scholarship program NHSC-approved sites.

NATIONAL HEALTH SERVICE CORPS 1. AGENDA 2 Overview of the National Health Service Corps Loan repayment program Scholarship program NHSC-approved sites.
Medicaid Supplemental Payments

Medicaid Supplemental Payments
Lifestyle 2000 TM LONG TERM CARE POINT OF SALE PRESENTATION.

Lifestyle 2000 TM LONG TERM CARE POINT OF SALE PRESENTATION.
Medicaid and Meaningful Use – The “Other” EHR Incentive Program: What Hospital Leaders Should Know About the Medicaid EHR Incentive Program Wisconsin Hospital.

Medicaid and Meaningful Use – The “Other” EHR Incentive Program: What Hospital Leaders Should Know About the Medicaid EHR Incentive Program Wisconsin Hospital.
DataBrief: Did you know… DataBrief Series ● October 2012 ● No. 34 Residential Care Facilities and Medicaid In 2010, residential care costs for Medicaid.

DataBrief: Did you know… DataBrief Series ● October 2012 ● No. 34 Residential Care Facilities and Medicaid In 2010, residential care costs for Medicaid.
EHR Incentive Program & Meaningful Use in Washington State An Overview.

EHR Incentive Program & Meaningful Use in Washington State An Overview.
What does REMI say? sm Medicaid Expansion; Are You In or Are You Out? Presented by Chris Brown Senior Economic Associate.

What does REMI say? sm Medicaid Expansion; Are You In or Are You Out? Presented by Chris Brown Senior Economic Associate.
Decades of Experience in the Full Continuum of Care Founded in 1966, Interim was the original home care franchise company Exceptional national leadership.

Decades of Experience in the Full Continuum of Care Founded in 1966, Interim was the original home care franchise company Exceptional national leadership.
Skilled Nursing Facility Rules and How “The Rules” Impact Patients

Skilled Nursing Facility Rules and How “The Rules” Impact Patients
Why is it so important that I enter the correct code? 5/12/20151.

Why is it so important that I enter the correct code? 5/12/20151.
CRITICAL ACCESS HOSPITAL OPPORTUNITIES MICHAEL R. BELL & COMPANY, PLLC 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON 99207 (509) 489-4524.

CRITICAL ACCESS HOSPITAL OPPORTUNITIES MICHAEL R. BELL & COMPANY, PLLC 12 EAST ROWAN, SUITE 2 SPOKANE, WASHINGTON (509)
Notification of Hospital Discharge Appeal Rights (CMS-4105-F)

Notification of Hospital Discharge Appeal Rights (CMS-4105-F)
1.03 Healthcare Finances. 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.

1.03 Healthcare Finances Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.
Slide 1 Chapter 2 - - The Health Care System. Slide 2 Health Care Delivery, Past and Present.

Slide 1 Chapter The Health Care System. Slide 2 Health Care Delivery, Past and Present.
Copyright ©2004 Pearson Education, Inc. All rights reserved. Chapter 11 Health and Disability Insurance.

Copyright ©2004 Pearson Education, Inc. All rights reserved. Chapter 11 Health and Disability Insurance.
A Comprehensive Protection Plan Protect Your Family | Protect Your Money M8620 (2-15) © 2015 Forethought.

A Comprehensive Protection Plan Protect Your Family | Protect Your Money M8620 (2-15) © 2015 Forethought.
Healthcare Finances HS II Unit 1.03.

Healthcare Finances HS II Unit 1.03.
Montana Medicaid Electronic Health Records Incentive Program for Eligible Hospitals This presentation will focus on information related to your registration.

Montana Medicaid Electronic Health Records Incentive Program for Eligible Hospitals This presentation will focus on information related to your registration.

Similar presentations

Ads by Google