Reimbursement changes, regulatory updates, and clinical intelligence across skilled nursing, home health, hospice, and assisted living — delivered before your morning huddle.
Compare your patient across all four post-acute settings. Enter key clinical indicators to see which setting produces the best reimbursement alignment for each patient's needs.
Comparison based on CMS FY2026 payment rates and published clinical appropriateness criteria. Actual reimbursement varies by patient case mix, geographic wage index, and payer contracts. This is a clinical and financial planning tool only — not a substitution for individualized clinical judgment or coverage determination.
The only briefing that covers SNF, home health, hospice, and ALF in one place. What changed, what it means, and what to do about it.
CMS's FY2026 SNF PPS final rule distributes the +3.0% market basket update unevenly across case mix groups. NTA-heavy facilities and those with strong cognitive impairment capture above-average rate increases.
LUPA rates continue to be the most-audited billing pattern in home health under PDGM. Agencies with LUPA rates above 15% face elevated review activity. The threshold varies significantly by HIPPS code.
General Inpatient hospice billing remains the primary OIG target in the hospice space. Documentation of unmanageable symptom burden must be explicit. "Pain not controlled" alone is insufficient.
Medicaid HCBS waiver expansions continue to reshape the ALF competitive landscape. Facilities that document person-centered planning and resident rights protections are better positioned for Medicaid referrals.
Hospital readmission penalties affect referring hospitals across all PAC settings. SNFs, HHAs, and hospices that can demonstrate lower readmission rates have a measurable competitive advantage in referral relationships.
Phase 2 of CMS minimum staffing requirements is in effect. The 3.48 total HPRD and 0.55 RN HPRD minimums now carry citation authority. Facilities below threshold face survey deficiency findings.
One briefing covering all four post-acute settings. Administrators, clinical directors, and PAC executives read it before the morning huddle.