Strategic Care Solutions, LLC (SCS) provides customized financial services for both Skilled Nursing facilities and Assisted Living communities. SCS has shown unparalleled creativity in developing systems and strategies to both achieve and enhance fiscally sound organizational models for its clients.
Important components of financial services include Business Office Management and Accounts Receivable. SCS has experienced Business Office and Accounts Receivable personnel to assist with the creation of a strong Accounts Receivable Team through education and hands on training with the client. SCS staff have knowledge of diverse billing programs, Medicaid applications and the fiscal intermediaries. The overall impact of weak business office processes and collections of state and federal receivables can and will have a negative impact of a facility’s ability to move forward, pay vendors timely, incur missed billing deadlines, and can ultimately lead to crippling debt. SCS has successfully responded to the collections of Medicaid, Medicare, and Managed Care receivables both through onsite interventions as well as remote support.
- Business Office Management with both onsite and with remote capabilities
- Acting CFO, Finance Director, or Controller
- Receivable Management, including specialty claims/billing recovery services for problem AR
- Training & support of key financial personnel
- Liaison between the facility, DHS supervisor and caseworkers
- Develop and maintain tracking for the Medicaid Application process for SNFs and Assisted Living communities.
- Client Reporting
- Financial Reporting (Internal and External) with a focus on DSO, Cash Collections and Bad Debt.
- Review and renew third-party contracts
- Work with facility/company senior management to review and establish goals to maximize cash flow and reduce bad debt
- Budget Development
Interim Administrator and Director of Nursing Placement
The complexities of managing the day to day demands of skilled nursing and Senior Living services are challenging. It is common for owners and Senior operators to experience vacancy in one or more key leadership positions for a variety of reasons. The recruitment and hiring process can extend up to six months leaving the community without strong leadership. The impact will be felt in decreased performance in all aspects of operations.
SCS is working with numerous organizations to provide immediate leadership solutions via highly skilled professionals. We provide licensed Nursing Home Administrators and Executive Directors for ALFs. SCS’ Director of Clinical Services provides support in the nursing leadership space. Our interim leaders bring many years of experience and are directly supported by our leading management and consulting partner team.
- Transitional services provided for leadership positions
- Initial Assessment
- Interviews with owners
- Interviews with key employees, residents, medical director
- SCS site review/needs assessment
- 60 – 90 day Strategic Plan
- Execution of plan with regular written reports
- Assistance with recruitment of permanent leaders
- Assistance with transition
- On-going support as needed
SCS’s results-driven management consulting services takes advantage of a guidance/oversight model that works. SCS uses its expertise in the senior care arena to provide unique opportunities and/or solutions to any challenge facing an operation. Experts in the health care/senior care field, who understand the rapid changes the industry is undergoing and how this transformation is creating new challenges, will provide a customized solution.
- System Development to respond to the changing healthcare environment
- Business Development with a core focus on customer relationship management service and building market share
- Performance Analysis to evaluate current programs and processes and identify opportunities for improvement
- Executive level management and mentoring advisory service: Short term/long term management
- Engagement of stakeholders to identify opportunities for improvement, development of goals and foster an environment of inclusion and collaboration
- Provide opportunities for ongoing staff development and education
Strategic Care Solutions (SCS) Clinical Services provides leadership for the advancement of geriatric nursing practice. It includes assessment, planning, implementation and evaluation of clinical practice standards to meet the needs of both the post-acute and long-term residents. An analysis of nursing care practices and an evaluation of patient outcomes is done to ensure practice standards and clinical programming meet identified patient outcomes and compliance with Regulatory agencies. Regulatory compliance and Turnaround services are also available.
- Executive level clinical consulting with a focus on implement effective compliance and quality programs to improve the lives of their residents and patients
- Educational and mentoring services including training on systems development and data use for root cause analysis and other quality and compliance related functions.
- Expertise in development of innovative services, implementing innovations and evidence-based approaches to providing value-based healthcare.
- Consultation for regulatory /survey issues/ regulatory program development, review and audits/QAPI program development and review.
- Compliance monitoring and turnaround service.
SCS Consultants are experts in Post-Acute Care Reimbursement systems, including Federal and State Reimbursement programs and Regulatory requirements. Our Reimbursement division has extensive knowledge on Medicare Reimbursement Systems, Medicaid Case Mix Systems in multiple States, CMS Medicare Appeals Management, Reimbursement Forecasting and Trending and as well auditing for Regulatory compliance.
- Review of facility Medicaid Case Mix processes and procedures for compliance and maximization of revenue in MA, RI and NY.
- Review of the facility / organization facility Average Case Mix scores and classification
- Compliance Audits for accuracy and supporting documentation and medical necessity to support the claim integrity.
- Case Mix education to Corporations/ Facilities and Organizations.
- Post Audit review of MMQ reductions and preparation of appeals.
- MMQ Mock Audits.
- MMQ Interim assignments – completion of MMQ Turnarounds/MMQ Conversions and review of systems and documentation.
- Review of MDS Coding for accuracy to support PDPM claims.
- Staff education on PDPM
- Audits of Medicare skilled criteria to support Medicare claims.
- Audits of submitted PDPM for optimization.
- Strategies for success in Medicare Reimbursement and capturing of skilled care provided.
- Therapy Documentation review and analysis
- Skilled Nursing Documentation review and analysis and identification of Trends, Risk Management and Risk Mitigation.
- Review of Medicare Claims, UB04 audits, Review of facility billing practices.
- Review of facility PDPM Scores, trending, and payment forecast.
- Medicare Mock Claims Audits.
- MDS/PPS Interim assignments – completion of PDPM assessments/ MDS OBRA assessments.
- Provides Prepayment Reviews to identify Risk and justification of claims.
- Provides Post Claims Review to determine patterns and areas of risk, and identify claims requiring appeals through the various levels of appeals – Additional Development Request(ADR).
- Claims Review for completeness / accuracy prior to claims submission.
- Implementation of Reimbursement Compliance Programs and provide staff with compliance education and system monitoring tools and support.
- Action Plans and regular Compliance Reviews for identified Risk Areas.
- MDS Consulting Services – Interim assignments
- MDS Audits for general compliance and accuracy
- Review and Analysis of the Quality Measure reports and Five Star Reports.
- Pre-Survey Preparation – audit for accuracy.
Planning and Development
The definition of strategic planning is quite simple – the process of envisioning a future and translating this vision into defined goals, objectives, strategies, and tactics. There are many factors to take into consideration when outlining a strategic plan to grow or realign a senior care operation. SCS’s extensive background working with varied senior care providers over the last 25 years gives it a unique ability to understand the critical challenges that influence decision-making. SCS has the capacity to work with a multitude of constituencies, management, governance or ownership. Strategic Care Solutions will provide the guidance and direction to enable the client to identify solutions and determine the most successful planning action and innovation.
- Strategic Planning, including assistance in determining Strategic Vision
- Feasibility Studies and Future Demand Analysis. Determination of Need (DON)/Certificate of Need (CON) Advisory Services
- Demographic Research to capitalize on market share
- Ideas for expanding and diversifying service capabilities to enhance and sustain market share.
- Project Management – Plan and execute capital projects relating to the renovation, expansion, and new construction of facilities including all start up functions, including regulatory matters, development, financing, marketing, and project design
- Training of Boards and staff in the areas of competitive advantage and SWOT (Strengths, Weaknesses, Opportunities, Threat) analysis
- Targeted analysis of how the growth of managed care will impact an organization’s referral sources and bottom line
Information technology is the backbone of any successful senior care operation. SCS can assist in streamlining existing IT infrastructures to improve productivity, manage change, minimize risk and lower the total cost of ownership. The company offers three categories of service: business process services, application services and infrastructure services. An IT Director will provide a consultation to evaluate the existing information system and determine the best way to advance and enhance current IT services.
- Evaluation of Current System Configuration
- Microsoft Back Office Support
- All aspects of Email Infrastructure
- Design and implementation of Wi-Fi Architecture
- Disaster Recovery Architecture
- Network Security Assessment
- Data Security Systems and Encryption Solutions for Protected Health Information
- Health Care Regulations