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David Sorkin

Steven Littlehale in McKnights: Risk mitigation strategies for supporting employees too!

March 3, 2023

Poor support of staff contributes to a negative reputation in the community, complaints to an ombudsman or the local department of health, or even whistleblower complaints, among others. As a result, your facility might experience undesired resident outcomes, a lawsuit, an allegation of criminal actions, or investigations by external oversight agencies.

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Filed Under: News

Steven Littlehale Quoted in McKnights: Providers support state’s flexible, incentive-laden staffing mandate but CMS may soon make it moot

February 21, 2023

“The nuanced details really matter,” said Steven Littlehale, a gerontological clinical nurse specialist and chief innovation officer at Zimmet Healthcare Services Group.

Virginia’s use of payroll-based journal data plus its inclusion of nursing directors and others who perform administrative as counting toward the daily hours duties differs from other states. It also links the staffing requirement to facilities’ Medicaid value-based purchasing program.

“Simply put, [nursing homes] have financial incentives to meet the staffing requirement,” said Littlehale, an expert columnist at mcknights.com.

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Filed Under: News

Steven Littlehale in McKnights: Beyond ‘document, document document’ — Risk mitigation strategies that work

February 3, 2023

We encounter risk every day. Risk is present in the most innocuous actions, like crossing the street, walking into the supermarket, and even eating dinner. And as nursing home operators and providers well know, caring for the elderly is far from innocuous — it’s risky business.

What operators and providers may not realize is how many sources of risk they grapple with on a daily basis.

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Filed Under: News

Steven Littlehale and Marie Infante in Skilled Nursing News: Staffing, Psychotropic Scrutiny Contribute to Tough Litigation Climate for Skilled Nursing

January 26, 2023

As the skilled nursing industry is beset by crippling staffing shortages, inflation costs, and increased government oversight in an already highly regulated field, operators must be proactive in shielding themselves from litigation risk.

Risk is coming from a multitude of different places, according to experts at a Zimmet Healthcare Services Group webinar on Thursday, and operators should be most attentive to potential litigation stemming from issues related to residents, their families and staffing.

In addition, recent CMS policy updates related to psychotropic drug use give operators an “immediate heads up” on this as an area of heightened risk.

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Filed Under: News

Steven Littlehale in McKnights: Setting up for MDS 3.0 success

January 6, 2023

Are you a “New Year’s resolution” kind of person? I am not, but I am a strong believer in establishing goals and setting intentions. Whether you prefer to make a resolution or set a goal, January 2023 is the perfect time to set yourself up for Minimum Data Set (MDS) 3.0 success.

The MDS changes that will be implemented come October 2023 are significant and should not be simply delegated to your amazing Resident Assessment Instrument (RAI) coordinator. Version 1.18.11 of the MDS will impact reimbursement systems, quality measurements, surveys and Five-Star, to name a few. As such, your policies, procedures, and mechanics around data capture also will need to be updated. This will be a major organizational shift in how you assess, document and report about care. It will impact your bottom line, your public data profile and — most importantly — the care you deliver to your residents.

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Filed Under: News

Marc Zimmet in Skilled Nursing News: Industry Experts Share 2023 Outlook to Reimagine How We Deliver Skilled Nursing Care

January 4, 2023

My last outlook called 2022 the “Year of Good Data,” making me officially 0-for-1 in this space. That said, I’m optimistic this year will be different, despite having underestimated how “bad data” so thoroughly infects every facet of SNF operations.

For context, industry stakeholders can’t even calculate basic performance measures that define pandemic-recovery. That’s a problem. Either way, the future of skilled nursing will be written in state capitals throughout 2023.

Medicaid relief is flowing in a handful of states and stagnating in others, but funding is only half the equation. In fact, it’s more important for long-term stability that dollars be distributed based on positional need; to allocate funds evenly across the provider community only perpetuates skilled nursing’s economic imbalance. We are already seeing brutally uneven rate increases across state lines that do little to correct fundamental inequities in government payment systems.

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Filed Under: News

Alicia Cantinieri featured in McKnights: CMS releases more new MDS draft details; more changes to come?

January 4, 2023

An Oct. 1 start date “seems pretty close, with all the information and training pending release,” said Alicia Cantinieri, vice president of MDS policy and education for Zimmet Healthcare Services Group, in an email to McKnight’s Tuesday.

Calling the most recent MDS draft issuance “a December gift,” Cantinieri, reminded that CMS said it would release final versions of the new MDS item sets in “early 2023.” The agency also said last month that it hoped to release the corresponding new RAI manual during the second-quarter of 2023.

“This feels like receiving the gift of a new bike as a child, except that it isn’t assembled, and the instructions will be shipped separately in six months,” Cantinieri said.

She said she also would not be surprised to see more changes coming.

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Filed Under: News

Steven Littlehale in McKnights: A Love Letter To Baby Boomers

December 14, 2022

Dear baby boomers,

Thank you, thank you, thank you! You made my ugly-as-sin, chunky, deep-cut, orthopedic “sneakers” acceptable to wear with my fancy tailored business suit. I don’t have to pull a Mr. Rogers and change into my beautiful Italian dress shoes while choking down a grimace due to the foot pain.

Because of you, boomers, I can unapologetically rock these bad-boy size 12 shoes (but aren’t they really a 13 with all the cushion?) as I stand up from the speaker’s table. I thank you; my hammer toes thank you; and the global orthopedic footwear market currently valued at $8.3 billion thanks you too!

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Filed Under: News

Vincent Fedele and Michael Sciacca in McKnights: Medicare Advantage plans forcing providers to take ‘optional’ payment reductions

November 15, 2022

“The IPA is an optional assessment. In the eyes of Medicare, that is very clear,” Zimmet Chief Operating Officer Michael Sciacca said during a webinar last week. “What we’re hearing from some of our clients is that some of the insurance companies are requiring it when there’s a [positive] change in condition, which I would certainly push back on.”

“The requirement to continuously change reimbursement levels, that administrative burden was the whole point of making this assessment optional in the first place.”

Sciacca and Zimmet partner Vincent Fedele, who is also chief operating officer of CORE Analytics, said there continues to be confusion around this — even though some software systems are made to alert and potentially stop providers from submitting IPAs that lower their reimbursement.

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Filed Under: News

Steven Littlehale in McKnights: Making Sense of the Data Deluge

November 11, 2022

My happy place is standing in front of nursing home providers and honoring them through education. Shining a loving light on these special people and honoring their commitment to better care feeds my soul. So when Moshe Kelman asked me to present at his provider organization’s annual educational/holiday conference, I gleefully accepted.

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Filed Under: News

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