Skilled nursing leaders across Connecticut are preparing for an important shift: the transition to PDPM for Medicaid reimbursement. While the payment model itself is changing, the real challenge for many facilities isn’t simply understanding PDPM, it’s ensuring that current clinical processes, documentation practices, and interdisciplinary workflows will perform well under the new system. That’s exactly … Continue reading
PDPM reimbursement, quality reporting, and survey outcomes are more connected than ever; and many of the same MDS items sit at the center of all three. To help skilled nursing facilities proactively identify areas of vulnerability, we developed a complimentary assessment tool that aligns high-risk CMS F-tags with Patient-Driven Payment Model (PDPM) audit risk areas. … Continue reading
Being selected for MDS data validation can feel stressful, but it’s manageable when your facility has a clear plan. This guide walks SNF leaders and staff through the steps from notification to record submission. Pre-Validation Readiness: Questions to Ask Now Even before your SNF is selected, asking the right questions can save time and prevent … Continue reading
CMS has announced the start of the Skilled Nursing Facility (SNF) MDS Data Validation Process, with validation beginning January 1, 2026 and provider notifications issued mid-January 2026. SNFs will be randomly selected for validation, and notifications will be delivered through iQIES. While selection is not performance-based currently, preparation is critical, particularly because failure to meet … Continue reading
Skilled nursing facilities are being asked to respond to something entirely new, and understandably, many are struggling to wrap their arms around it. The Long-Stay Antipsychotic Medication Quality Measure is CMS’s first-ever hybrid quality measure, blending MDS data with claims from outside providers. That alone makes it different. But what’s proving most challenging for SNFs … Continue reading
What MDS Coordinators need to know (and do) right now. If you’ve heard the buzz about CMS’ first-ever hybrid quality measure, the Long-Stay Antipsychotic Medication QM, you’re probably wondering: “How will this impact our quality scores? And why does it feel like half the data will come from places I don’t even control?” You’re not … Continue reading
In today’s post-acute and senior care environments, financial stability has become harder to maintain. Rising aging A/R, tighter cash flow, staff turnover, and increasing payer scrutiny are pushing providers to reevaluate how effectively their billing and revenue cycle operations are working. Whether you are a Skilled Nursing Facility, Home Health Agency, or Assisted/Independent Living community, … Continue reading
At the American Health Care Association’s (AHCA) Delivering Solutions 25 Conference, Celtic Consulting’s Founder and CEO, Maureen McCarthy, presented to a standing-room-only audience eager to learn about the latest managed care and Medicare Advantage updates impacting skilled nursing providers. During her session, McCarthy outlined significant regulatory changes already in effect for 2024 and 2025, and … Continue reading
The New York State Department of Health (DOH), in collaboration with Myers and Stauffer (M&S), has released details on the next phase of transitioning to a PDPM-based case mix methodology. Celtic Consulting is here to help you stay ahead of the curve. Key Highlights: 🔹 Two PDPM Components Analyzed to Date:M&S has reviewed MDS data … Continue reading
Celtic’s CEO, Maureen McCarthy, is connecting with clients and partners from across the country at the AAPACN Conference in Louisville this week. The annual event brings together leaders in post-acute care nursing to collaborate, share insights, and advance best practices in long-term care. During the conference, Maureen had the opportunity to meet with representatives from … Continue reading