Try these 3 programs to increase Medicare census and reimbursement

October 1st is looming. That dreaded date, what with its Medicare cuts, is causing facilities to scramble and evaluate budget savings and other measures to maintain bottom line performance. While cutting costs is one way to respond to the loss in revenue, program and service development may be the approach you should instead consider.

Hey, how about this—develop pulmonology programs! You know, services such as:

Fresh trachs. With rehab potential, treating fresh trachs could fall into the RUL RUG category and, although the reimbursement is being cut substantially, this is still one of the highest RUG rates. An assessment of RUG rates by client reveals that they had only one RUL patient who stayed 30 days in the first half of 2011. Increasing the RUL average daily census to two per day over a 12-month period would actually increase revenue to a facility.

General pulmonology programs. Programs designed to treat pneumonia, COPD and related diagnoses are very attractive to hospital referral sources. Why? Because hospitals are focused on the diagnoses being identified by Medicare/CMS that represent a high risk for re-admission. While the reimbursement may not be spectacular, the length of stay will be (and remember, this was one of the strategies I suggested in a previous blog to overcome the loss in revenue).

Ventilator rehabilitation programs. I know that I’ve just scared the ‘you-know-what’ out of you. However, several of my clients are developing these programs, targeting patients who can be weaned and have a need for rehabilitation. These patients fall potentially in the RUX RUG rate and could significantly increase your Medicare average daily revenue.

These types of programs can be daunting. However, as the healthcare industry continues to evolve, it’s a good bet that skilled nursing facilities will have to consider new approaches to meeting the clinical needs of the elderly population. Luke Fannon is the Founder and Principal at Premier Coaching and Training, Unionville, Pennsylvania. PCT provides long-term and healthcare sales and marketing training, admissions and marketing team coaching and other strategic consulting services. For more information, visit

Topics: Medicare/Medicaid