In nearly all provider segments of healthcare, revenue maximization and integrity are directly tied to compliance and quality ratings. In home health, submission of quality data via the OASIS (known as HHCAHPS) is required. Agencies that fail to submit the required data receive reimbursement reductions of 2%. For SNFs, reporting QRP data is required. Failure to meet the 80% threshold reporting requirement on quality measures equals a 2% payment reduction (beginning October 2019). The cutoff date to meet the compliance level for the period of October 1–December 31, 2018 was May 15, 2019; too late for facilities that underperformed.
Although nursing services is often the biggest cost center to be managed in a long-term care facility, one cannot overlook many of the other areas that need to be closely scrutinized. One area that can be an albatross for many administrators is preventing runaway costs in the dietary area. In particular, food costs are a major concern. Furthermore, administrators have to maintain adequate staffing in areas such as housekeeping, maintenance, laundry, and physical and occupational therapy and yet avoid overstaffing that could incrementally increase costs. This chapter will discuss some of these important areas and how their costs could be managed.