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Healthcare/Medicare/Medicaid/Taxes ·General Newsletters,
Articles, & Financial Calculators In the mid-1980s, hospital reimbursement for Medicare in-patient services made a drastic change. The cost based system changed to a single payment system based on a diagnostic related group (DRG). As a result of this reimbursement change, hospitals had to respond rapidly to ensure financial stability. Although not all hospitals were successful as evidenced in a number of closures, many were due to their ability to creatively manage costs and diversify their services, thus producing increased revenue and profit. Today’s Staffing/Labor: Labor is the largest cost center in the SNF. It is imperative that one evaluate staffing patterns to ensure over-staffing is not present. Monitor "hourly creep" closely to control overtime expense. Involve staff in developing and implementing incentive plans for the purpose of motivating staff to be present and to perform quality work. Consider increasing benefits to assist in both staff recruitment and retention. Material/Supply Cost: Due to the SNFs inability to pass through medical supply costs, one must be aggressive in negotiating with suppliers. Multi-facility organizations should utilize their purchasing volume to negotiate lower prices. Continuous staff training on the proper use of supplies must be implemented to reduce waste. There are a number of Internet sites available for medical supply purchasing. We believe SNFs should become acclimated in using the method of purchasing as "middle-man" costs can be eliminated. Therapy Cost: One must negotiate aggressively with their therapy supplier if this service is out-sourced. Target 70% of the therapy component of the RUG rate for Part A and 80% of the fee schedule for Part B services. We are routinely seeing therapy providers willing to execute this type of agreement. One should complete a cost/benefit analysis to determine if therapy services should be an in-house service versus out-sourcing. Therapy volume, therapists’ availability, salaries, etc. must be considered. Diversify Services: We believe that expansion of service opportunities exist for SNFs. Initially, we suggest SNFs implement an out-patient therapy program. Some facilities are doing this either in the SNF or in a site adjacent to the SNF. Marketing efforts are resulting in out-patient therapy referrals from all payer types. In the rural areas, we are seeing hospitals convert to critical access hospitals which results in their having to decrease services. Due to this, we feel that additional opportunities will be present for SNFs. We will discuss these opportunities in future newsletters. NURSING FACILITY INFORMATION (NFs, ICFs-MR, and PRTFs)
The new bed values for 2008 for Mississippi nursing facilities, ICFs-MR and PRTFs have been calculated using the R.S. Means Construction Cost Index. These values should be used in determining whether purchased assets exceed the new bed values for 2008. The new bed value is $47,552. for nursing facilities and $57,062. for ICFs-MR and PRTFs. The new bed values for 2007 for Mississippi nursing facilities, ICFs-MR and PRTFs have been calculated using the R.S. Means Construction Cost Index. These values should be used in determining whether purchased assets exceed the new bed values for 2007. The new bed value is $40,759. for nursing facilities and $48,911. for ICFs-MR and PRTFs. The new bed values
for 2006 for The new bed values
for 2005 for The new bed values for 2004 for The new bed values for 2003 for Mississippi nursing facilities, ICFs/MR and PRTFs calculated using the R.S. Means Construction Cost Index was $32,210 for nursing facilities and $38,652 for ICFs-MR and PRTFs Allowable Board of Directors Fees for The allowable Board of Directors fees that will be used by the Mississippi Division of Medicaid in the desk reviews and audits of cost reports of nursing facilities (NFs), intermediate care facilities for the mentally retarded (ICFs-MR), and psychiatric residential treatment facilities (PRTFs) have been computed using the Consumer Price Index for All Urban Consumers- All Items. The per meeting (max. of four) limits are as follows: 2007 cost reports: 0 -99 Beds $ 3,505. 2006 cost reports: 0 -99 Beds $ 3,413.
Maximum allowable
salaries for 2007 are as follows: ICFs-MR $110,772 PRTFs $158,075. Large NFs $129,303 Small NFs $101,621 Maximum allowable
salaries for 2006 are as follows: ICFs-MR $162,908 PRTFs $100,897. Large NFs $124,398 Small NFs $ 94,957 The limits apply to
salaries paid directly by the facility or by a related management company or
home office.
Tax Alert . Mississippi has not adopted the
Federal Sec. 168 guidelines related to the 30% additional depreciation
writeoff for 2001- 2003 tax years. The
For business the optional mileage allowance replaces actual expenses such as maintenance, repairs, tires, gas, oil, insurance, registration fees, and depreciation. For leased vehicles it replaces the lease expense. If a business deducts actual expenses in the first year an auto is placed in service, it can not elect the optional mileage deduction at any point during the life of the auto. On the other hand, if the optional mileage allowance method is used in the first year the vehicle is placed in service, you can change to the actual expense method in later years. This can only be done if straight line depreciation is used. For leased vehicles the
mileage allowance method can only be used for the entire lease period
including renewals. The articles above are provided for general
information purposes only. Before implementing any of the suggestions, please
consult a professional to discuss your personal situation and how you may be
affected. |
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