Nursing: Unions and Reimbursement

Nursing Home Reimbursement Rates

As we discussed in Chapter 1, the federal government gives each state flexibility in establishing its own Medicaid reimbursement methods and rates for nursing home services. While the five states examined all use prospective, facility-specific reimbursement methods, the way each state has designed its reimbursement system varies significantly. The combination of historical, facilityspecific cos...

Nursing Home Cost Studies and Reimbursement Issues

This review of nursing home cost function research shows that certain provider and service characteristics are systematically associated with differences in the average cost of care. This information can be used to group providers for reasonable cost related rate-setting or to adjust their rates or rate ceilings. However, relationships between average cost and such service characteristics as pa...

Nursing Unions 1 Running Head: THE IMPACT OF NURSING UNIONS The Impact of Nursing Unions on Job Satisfaction and Patient Outcome

Medicare skilled nursing facility reimbursement and upcoding.

Post-acute care provided by skilled nursing facilities (SNFs) is reimbursed by Medicare under a prospective payment system using resource utilization groups (RUGs) that adjust payment intensity on the basis of predefined ranges of weekly therapy minutes provided and the functionality of the patient. Individual RUGs account for differences in the intensity of care provided, but there exists sign...

Analysis of nursing home capital reimbursement systems

An increasing number of States are using a fair-rental approach for reimbursement of nursing home capital costs. In this study, two variants of the fair-rental capital-reimbursement approach are compared with the traditional cost-based approach in terms of after-tax cash flow to the investor, cost to the State, and rate of return to investor. Simulation models were developed to examine the effe...